Is it normal to not be numbed at all before receiving PRP injections in the scalp?

Thank you for your question. You are asking if it is normal not to be numbed before PRP injections, and describe that your physician who performed this treatment felt that the numbing would interfere with its effectiveness, You describe the experience as very painful.

I can certainly give you my experience with this type of treatment as we do hair loss treatment similarly in our practice every day. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I am also the founder of TrichoStem™ Hair Regeneration Centers that uses a system we developed which uses platelet-rich plasma (PRP) in addition to a material called Acellular matrix and other elements to help men and women from around the world with pattern hair loss. I’ve been in practice for over 20 years, and we use platelet-rich plasma (PRP) for hair loss in our practice every day so I am familiar with the treatment.

In our local area in New York City (we have an office in Manhattan) I’ve been made aware of colleagues who believe in doing this treatment without any anesthetic from the feedback we are getting from our patients. Many of our patients used to go monthly for platelet-rich plasma (PRP) injections and endured a fair amount of discomfort getting them. By around the 4th month, they questioned the justification of the pain against limited results, and where the endpoint would be.



I can tell you from my personal practice, style, and from my own philosophy that pain should be avoided as much as possible. Frankly, as a cosmetic surgeon, as a specialist who does everything from head to toe in the cosmetic field and with specialized areas beyond that, it has been my mission from day one to make my patients comfortable and to make cosmetic procedures less daunting, and more accessible. From the beginning of my career I proved that lower and upper eyelid cosmetic surgery and face lifting surgery can be performed without general anesthesia, but rather under local anesthesia with LITE™ IV sedation. I evolved many procedures in a way so our patients, whether they are sedated or wide awake, are completely comfortable.



Hair Regeneration is a system we developed based on a technology for wound healing using platelet-rich plasma (PRP) and Acellular matrix. We are able to help patients with 99% successful outcomes, meaning stopping the progression of hair loss, reactivation of hair that is not growing, and inducing shedding of thinning hair so thicker hair can grow - all with a single treatment session. In some cases of advanced hair loss a second treatment at around 15-18 months later is done. However, our data shows patients have continued to benefit from a single session even after more than 5 years.



With that said, I can see how it is pretty daunting to go back for platelet-rich plasma (PRP) treatment without any anesthetic. I am familiar with this practice, but I don’t know exactly what the justification is.  We get pretty amazing results, even with numbing the scalp. We first use a topical anesthetic applied around the scalp in the perimeter of the planned area of treatment, then let the anesthetic work for a while. We then do what’s called a ring block like in a hair transplant so the top of the scalp is completely numbed, and then I do the actual injection treatment. In a treatment process where we numb the scalp, we’ve had tremendous success with this treatment.



I understand that every doctor has their justification, but I think it is reasonable to ask why the  is pain necessary. From my experience, pain is not necessary for this process. Once the top of the scalp is numbed, I am not saying it is painless from the beginning - a few local anesthetic injections are going to be uncomfortable, but we use the tiniest needles after application of topical anesthetic. That said, Hair Regeneration has been extremely successful for us, so I think you need to figure out what is right for you. Like I said, a lot of people come to us once they got tired of feeling uncomfortable with the platelet-rich plasma (PRP) injections without anesthetic. Learn more and make some decision so you can feel better about treating your hair loss. I hope that was helpful, I wish you the best of luck and thank you for your question.

Dear Allie5000:We are now mixing a little lidocaine with the PRP in the syringe. This makes the procedure nearly painless, a huge improvement over the prior protocol. This has not interfered with the response to treatment in any way.  All the best,  Dr. Clark

Hi.  We routinely offer topical numbing cream and/or local anesthetic injections to patients and have not seen any interference with the hair growth.  There are other techniques that provide comfort that do not include a cream or injection, so before your next treatment, ask your plastic surgeon what else they can offer.  Being more comfortable, a more thorough treatment will be possible.