When applying PRP for hair loss, is there evidence regarding whether it is better to use injection, or micro-needling?

When applying PRP for hair loss, is there evidence regarding whether it is better to use injection, or micro-needling? I noticed that some doctors advertise both, and some only one or the other.

Doctor Answers 3

PRP. Microneedling vs injection? ENGLEWOOD CLIFFS NJ

This is an excellent question. Although there have been multiple studies on the effects of PRP, there are no Comparison evaluations as to the best method to deliver PRP to the scalp. I prefer to use subdermal injections as the major circulation of the bulb is in this space.  Furthermore,  this allows diffusion into surrounding areas.It is also less painful.  Find a p r p expert. Ask to see photos. Hope this helps. Good luck. 

Englewood Dermatologic Surgeon
4.6 out of 5 stars 38 reviews

For greatest hair growth effect, inject PRP at the level of the follicles under the skin.

While there is now good evidence in the literature for PRP influencing hair regrowth, the "evidence" regarding application technique is lacking.  Here are my anecdotal impressions after performing more than 1,000 PRP treatments for hair regrowth:  Unless you have a healing wound from a hair transplant, it is highly unlikely that a topical (surface of skin) application of PRP will have any effect whatsoever.  In my experience, best results are obtained with careful and precise intradermal (under the skin) injection of high concentration of platelets. Research in the literature shows that at least 1.5 million platelets per microliter is needed for recruitment of stem cells, new blood vessel formation.  If your "PRP doctor" is spreading PRP for hair growth on the skin topically, not injecting the PRP where the follicles reside, not testing their end-product PRP for platelet concentration, or worse, not applying local anesthesia so the PRP can be placed appropriately at the level of the follicle under the skin, these are RED FLAGS that indicate poor levels of understanding of the hair follicle anatomy, and a lack of understanding of proper protocols of PRP preparation, activation and application for hair regrowth.The idea of PRP for hair regrowth is to deposit the powerful concentration of growth factors near the weakened hair follicles. Microneedling at the surface of the skin in the area either before or after provides microtrauma which helps trigger release of the growth factors from the platelets (i.e., platelets 'see' a wound and will perform their duties of initiating tissue regeneration and repair by releasing their contents).  Some doctors may consider the injection of the platelets to be "enough" trauma, but it seems to me like the mechanical microneedling provides the most homogeneous microtrauma to the skin to create the desired effect.  There are many other "nuances" to the successful use of PRP for hair regrowth, so look for a physician who has experience and expertise in this area and who can accurately diagnose your situation, determine if you are a good candidate and accurately quantify/measure your results over time. Sincerely,Alan J. Bauman, M.D. 

Alan Bauman, MD
Boca Raton Hair Restoration Surgeon
1.0 out of 5 stars 2 reviews

PRP Scalp

Thank you for your question.  Injection of PRP in to the Scalp can be done in both ways.  In my practice we have had amazing results with injecting the PRP in to the area of hair loss in a grid pattern.  We no longer Micro-Pen the area as we use all the PRP during our injections. Be sure to find a Surgeon that is well trained in PRP and has an understanding of hair loss patterns.  Best of luck!

Shahin Fazilat, MD, FACS
Mountain View Plastic Surgeon
4.7 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.