Female hair loss, am I a good candidate for PRP or cortisone shots? (photos)

Question

My hair is thinning out and had started to loose lots of hair on top. It's slowly growing back but not s it use to be. I know when it starts to happen...top of my head gets sensitive and tender. Dermatologist has prescribed me a topical steroid ointment to help with the tenderness. Are there other options to get lots of hair grown back thicker. Am I a good candidate for PRP or cortisone shots?

Donovan Rosas, MD · Answer

PRP treatments are fast growing in popularity. While there is a good deal of anecdotal data on its positive effects, there is very little randomized controlled (i.e. high quality) data available. With respect to hair restoration, proponent have demonstrated impacts ranging from slowing/cessation of loss to thickening/strengthening of hair. Some will claim to have demonstrated regrowth.
Ultimately, there is very little drawback or risk to the procedure with the potential for significant reward. While the mechanism of action is not entirely clear, the effect will likely be rooted in the native concentration of growth factors in any given patient's plasma. Some will have better quality or more concentrated plasma than others. The results range from decreased hair loss to thickening of existing or emerging hairs to increased growth. Ultimately, the variability in response is likely linked to the inherent (i.e. genetic) quality of the plasma which will differ from one patient to the next.
PRP has (anecdotally) proven to be effective in the arena of hair restoration both as an adjunct to grafting as well as standalone treatment for those who may not (yet) be a candidate for grafting. Patients have demonstrated slowed loss, thickening of existing hair and regrowth. The typical duration of effect is 6-9 months with most patients being treated 2x yearly (at least initially).
In my experience, it is a nice option for young people who have yet to reach a stable hair pattern (i.e. not ready for FUE grafting/Neograft) and are looking for an adjunct to traditional medical therapy. That being said, it is important to limit your expectations as not everyone experiences regrowth at the same pace (or at all). However, anecdotally speaking, everyone seems to gain some benefit with regular treatments (annually to bi-annually after 3 treatment induction).
As always, discuss your concerns with a board certified plastic surgeon (ABPS), with experience in hair restoration.
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Jason Emer, MD · Answer

This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. See an expert. Best, Dr. Emer

Kevin Ende, MD · Answer

While PRP may turn out to be a good option for you, it sounds like you have not fully investigated the cause of your hair loss.  You should first ask the dermatologist about lab work and potentially a biopsy based on the doctor's history and physical.

Jeff Rapaport, MD · Answer

There is no question that PRP is effective in most cases of hair loss. Multiple studies, including meta-analysis, show the value of PRP. It has been shown to work best in pattern alopecia . The response rate is approximately 70% when utilized by itself as monotherapy. Combination therapy with other agents improve the effectiveness of the treatment. Find a PRP expert.
Jeff Rapaport MD FAAD
Realself Verified All-star

Tim Neavin, MD · Answer

Thank you for your question and for your photos. Based on your photos, you are an ideal candidate for PRP injections. This will stimulate new hair growth and helps heal damaged hair follicles. Up to 3 treatments is recommended. Best of luck!

Nicole Hayre, MD · Answer

Ideal candidates tend to be at the beginning stages of thinning hair and have follicles that are still at least partially active. This, however, doesn’t mean that people with advanced hair loss or inactive follicles are not candidates. Hair loss can be a complicated issue and there may be other underlying medical issues that need to be addressed by a board certified dermatologist.

Jeff Donovan, MD, PhD · Answer

You need a careful evaluation to exclude a scarring alopecia and likely a biopsy.  If your biopsy comes back showing you have a scarring alopecia, PRP is not the first step. I urge you to speak with your provider about a biopsy if the trichoscopic evaluation of your scalp shows any concerns. Your photos are blurry so regretfully I cannot provide any further comment. The sensitivity and tenderness you mention is a concern.

Matt Tahsini, MD · Answer

Hello and thank you for your question. You really need to see a hair loss professional for an in person consultation. Best wishes to you.Dr. T

David Perez-Meza, MD, FISHRS · Answer

Excellent and very frequent question. Female Pattern of Hair loss includes ONLY 50%-60% of all the cases. You didn't mention the hair loss cause.So I would like to know more about your case and I won't recommend any treatment at the moment until you have the appropriate hair loss diagnostic. You need a 2nd opinion, I will suggest you to book a consult with a local and experienced hair loss specialist. Good luck.

David E. Berman, MD (retired) · Answer

there are good studies, though they are in smaller number of patients (since this is not a high price item like a medical drug, there is not going to be funding for large scale studies) that very clearly demonstrate an improvement in both the thickness of the hair, as well as an increase in the number of hair follicles. you should plan 3 sessions of injections, each one month apart. there is little to no risk. Steroid injections, unless there is some inflammatory or immune basis, will not be helpful. Steroids have a plethora of side effects.david berman md

Female hair loss, am I a good candidate for PRP or cortisone shots? (photos)

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