ACell and PRP treatment for Transgender people with Male Pattern Baldness?

Thank you for your question. You’re asking an interesting question about hormonal manipulation for transgender pursuit, balancing hormone levels of testosterone being virtually zero, and estrogen levels close to a 100, thinking a treatment like Acell plus PRP could result in permanent prevention of hair loss. 
I can share with you my perspective and experience with Acell and PRP in treating both male and female pattern hair loss. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I’m also the founder of TrichoStem™ Hair Regeneration Centers where we created a system using Acell and PRP in our own way to treat people non-surgically for male and female pattern hair loss. 
When it comes to understanding effects of testosterone on hair loss, it brings us to the knowledge we have about DHT or dihydrotestosterone. DHT sensitive hairs can be affected by elevated DHT levels. A drug like finasteride lowers DHT levels. Surgical or chemical castration eliminates testosterone altogether. No testosterone or lowered testosterone results in no or lowered DHT. It is known in that scenario, men will not lose their hair, but the question remains about the longevity when it comes to a transgender situation with genetic pattern loss that is present. 
Understanding androgenetic alopecia is not only caused by DHT. We observed this about 7 years ago when we were developing the Hair Regeneration treatment we have for hair loss. We were using Acellular matrix and PRP to help people undergoing hair transplant, and saw this interesting side-effect. What we can establish is people who are not taking finasteride, which means they were not taking a DHT blocker, as well as women who have 1/6th the testosterone of men, will both respond to treatment with Acell and PRP combination in the way we do it. We can only state this for at least 5 years, so we can’t say that it’s indefinite.  We’re talking about this as a theoretical potential benefit.
DHT affects in a toxic way the progression of hair, growth. In a way DHT inhibits hair growth. Take away the DHT, and the hair should grow. However, when we look at people taking finasteride for extensive periods of time, they can still lose hair. which means it depends a lot on the relative DHT sensitivity, and other genetic factors may be also responsible for hair loss progression. This means you can still religiously take finasteride for 10-15 years which will likely slow down the progression, but it will not stop the progression. 
With the hormonal situation, you might be on the right track. However, when treating women who don’t take finasteride, we don’t believe it’s caused by androgen sensitivity, even though some doctors will do a trial of finasteride for women. Generally speaking, female pattern hair loss, although it may look similar to male pattern hair loss microscopically, we don’t treat it the same way. We’re able to use Hair Regeneration effectively to treat female pattern hair loss by stimulating regrowth of hair that’s not growing, prolonging the growth cycle of existing hair, inducing the shed of thinning hair so that thicker grows in. With our data which began 7 years ago and aggregate overall the largest numbers, we have 5 years of data showing improvement and stability for over 99% of patients. 
When I discuss the treatment plan long-term with our patients, I say there may be a value to a sustaining model of maybe coming in every 5 years to get an injection to see if we can keep boosting the growth of hair. There are a lot of things that happen every 5 years, particularly on the age of onset. Since I’m a cosmetic surgeon, I look at the many parallels between how the hair behaves on the scalp, and how skin and soft tissue behaves on the face. We use PRP on the face to improve skin quality, fine lines and wrinkles, dark circles, and acne scars. we know we want to treat and mitigate progression of tissue loss. In a way, I feel there’s some intrinsic benefit in improving the skin quality of the scalp with Acell and PRP based on clinical observations. 
Depending on how your hair behaves, I think you can explore having this treatment to maximize your hair growth if you have experienced any hair loss. As far as permanence, that’s a question only resolved with longer term use. There’re a lot of theoretical ideals and  conceptual theories about how these things work. This is the challenge of clinical medicine - there’re a lot of theories, but sometimes we don’t know exactly why something works, and yet we do use these technologies because we observe they’re safe and the clinical outcomes are positive. Consider this and certainly don’t stop doing research, and don’t stop asking questions, but don’t make any assumptions. 
I think it’s very important for your own health as well as the ongoing goal of retaining your hair to keep your eyes open and consider this of Hair Regeneration. When you think about having an injection done every 5 years, it’s pretty sustainable. I think it’s likely to be more practical than it is to assume there will be permanence. The reason I say that is I tell my patients I don’t want to wait to see them lose hair before I do another treatment- I want to stay ahead. It is certainly a challenge when you do something that’s an innovation and a development of a new category. As long as we try to adhere to quality of data and making good observations, I think we can only gain insight with time. I hope that was helpful, I wish you the best of luck, and thank you for your question.

I often do a combination of PRP and progesterone to get improvement.  I haven't found that Acell additionally does anything better.  Best, Dr. Emer.

Thank you for your question. In my opinion you should do well with PRP treatment . But again PRP with A Cell is not enough , you need to take proper supplements + green tea extract  and follow extensive  PRP Hair treatment protocol.