Can PRP make your hair worse? I am a 25 female with androgenetic alopecia.

In my  opinion you need to be patient. The Fact that your hair loss has decreased means that the PRP is working. The next step will be that your hair will start growing faster and the diameter of the existing hair will thicken. If you are to get regrowth it may take several more months. If you are followed by a hair loss expert, They should be taking photographs to document your progress. Compare the photos to the initial visit. Find a PRP expert. Ask to see photos.
PRP hair md.com

Thank you for your question. You are asking if PRP treatment can make your hair loss worse. You have already undergone two PRP treatments, and are due for a third, and indicate your hair shedding from 200 hairs a day has lessened to about 64 a day. You also posted a related question previously with some added photos, so I will share with you my answer along with a video made for you for that previous question, in case you may have missed it.
I can share with you my approach to treating androgenetic alopecia in women in my practice. 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 am also the founder of TrichoStem™ Hair Regeneration Centers, a system we developed using PRP, but also using a material called extracellular matrix. We developed a system for both men and women who we treat from around the world for mostly androgenetic alopecia. I can share with you a bit the strategy I use when I evaluate patients like yourself.
It’s very important to first distinguish androgenetic alopecia which is the progressive thinning of hair, from telogen effluvium which is hair shedding often associated with an acute stressful event. Preceded by 2-5 months from a major stressful event such as general anesthesia, or a family type of event, a lot of hair shedding occurs.
Further, there’s also a condition called chronic telogen effluvium. This is a condition more associated with women involving chronic hair shedding. That’s important because we see women experiencing androgenetic alopecia are generally more middle aged women. 50% of women over the age of 50 have pattern hair loss. Now that leaves a significant number of about 30% under the age of 50.
In the work we have been doing since 2011,  we have seen a large number of younger women in their 20s and 30s can also have androgenetic alopecia. As younger women came into our practice, I would feel compelled to do biopsies to confirm the diagnosis of androgenetic alopecia, and to differentiate from other conditions that can be causing hair loss. Our youngest patient we treated was a woman who was 16, and she had the same condition her mother had of a very early onset androgenetic alopecia.
To answer the question about PRP, what we developed in our practice evolved out an effort to help our hair transplant patients to heal better. We wanted the donor area to heal better, and the hair grafts to survive better, so we used a material called extracellular matrix or Acellular matrix, and combined that with platelet-rich plasma (PRP). A beneficial side-effect we saw was thinning hair became thicker. Over the course of several years, we took it upon ourselves to work on systems to more predictively treat people with hair loss, whether it’s men or women. Further, at this point I’ve developed a classification system for both men and women who come to our practice based on their gender, age, age of onset of hair loss, rate of progression, and if indicated other medical issues, as well as the possible need for confirmation diagnosis with scalp biopsy.
For management of female pattern hair loss patients using Hair Regeneration or TrichoStem™ Hair Regeneration, I generally tell our female patients that after one injection treatment, we can expect on average that improvement will be seen in about 9 months. Improvement being defined by regrowth of hair that was not growing which is a classic part of androgenetic alopecia where growth cycles (the anagen phase) get shorter, and the resting phase (telogen) gets longer. Which means at any given time, a certain percentage of hair is actually not growing that’s more than typical for someone who’s not experiencing androgenetic alopecia. Regrowth of hair, strengthening of thinning hair, and essentially prolongation of the growth cycles such that there’s ultimately more hair on the scalp, and we can see that by looking at the hair part, and areas where there may be thinning such as the temple. Often, we see our patients improving sooner than that. We’ll see them at 3-6 months and notice the temple areas have started to fill in, and I always explain that if you see it there, then it’s affecting the entire scalp.
Depending on the profile of the patient, we also consider doing called a booster injection that’s generally done somewhere around 15-24 months after the first injection. The sustainability of our treatment has exceed for many patients 5 years. It depends on the patient profile. There is a continuous evolution of our treatment as we have treated so many people of a wide range of ages and clinical profiles that I developed treatment plans specific to the patient’s profile.
It’s important you discuss with your doctor what the expectations will be. I think that at the current time, people are doing the best they can. I am proud of the influence our work has had in the world of hair loss treatment. We’ve gone from people dismissing it, perceiving PRP and Acellular matrix was not really something that can work, to the point where lots of doctors are offering PRP, and PRP with Acellular matrix with their own approach. I find that much of what I see in other practices is a shotgun approach, and people are seeing what kind of results they get. Currently, a lot of doctors are saying that PRP works 50% of the time, but that is pretty non-specific so we can’t say 50% on exactly who, on what kind of profile, or is it just a broad average where you have a 50% chance. I think the work we have done with Acellular matrix and PRP, and following our patients closely, and the amount of experience that comes from treating so many patients comes with a different perspective.
The question I would ask is how certain are you with the diagnosis of androgenetic alopecia? One of the ways I distinguish androgenetic alopecia from telogen effluvium is based on the degree of hair shedding. Generally, androgenetic alopecia is more of a slow, insidious process with a minimal amount hair shedding, while telogen effluvium is marked by significant hair shedding - that’s just one point. People who have androgenetic alopecia, their growth cycles get shorter, therefore there can be more hair that can shed. They’ll say they notice more hair in their brush, and they notice that compared to 3 years prior, they have significantly less hair. It is always about the diagnosis before you start a treatment strategy.
First confirm the diagnosis. Discuss with your doctor what’s the strategy with PRP, the expectations of treatment, and what kind of schedule is necessary to sustain the growth cycles. If you have androgenetic alopecia, you have to understand this is a condition that’s hardwired in your genetics, and everything we do is about management. What you want is an optimal strategy for management of your hair loss. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

I appreciate your concern.Overall, I think the process is working, but your hair thinning is likely due to male pattern baldness. Bes ure you're supplementing your hair with vitamins and iron. You can also see a specialist to see if an androgen blocker will help. You can also consider minoxidil foam twice daily.Best wishes. Dr. ALDO