What type of PRP Hair treatment is the best? (Photo)

There is no consensus on which technique of PRP hair treatment works best.  The bottom line is that they all work.  PRP alone, PRP with microneedling, with or without ECM or A Cell.  There isnt sufficient evidence to show that adding costly A Cell (ECM) add any benefit.  Although microneedling as a stand alone procedure has been shown that it can stimulate hair grow, adding this to PRP treatment can increase hair growth vs PRP alone but is often less practical and may not be necessary adding discomfort, swelling, and cost to your treatment without a dramatic added benefit.  Many of the different PRP systems on the market work as long as they produce PRP that is 4 to 6 times in platelet concentration. most individuals need an initial series of 3 to 4 monthly treatments and 2 or more maintenance treatments per year.  Minoxidil, Propecia, and LED light home treatments all will add to your results. Good luck

I actually have great success in my practice using injectable progesterone and prp in combination to the scalp, rather than PRP alone. I suggest seeing an expert in hair loss. Any hair loss treatment takes 6 months to evaluate, so you will have to do 6 monthly treatments and then my patients cut the treatments down to every 6-8 weeks there after to maintain if the treatments are working. Best, Dr. Emer

Great question! There are no studies to document which protocol is best. There are no studies to support  Acell or extracellular matrix. It is my opinion that multiple treatments are necessary at inception. Most studies with Injection show good results.  Adding microneedling  or micro needle roller is effective, however it does add to post-operative swelling and side effects. Looking at your photo, there would be benefit adding finasteride orally or topically. Good luck.

The kit used in PRP is very important. I think additives like A Cell and things like that, do not give enough improvement and just add the risk of side effects.

PRP is a restorative regenerative treatment that improves the tissue it is injected into.  In the hair restoration field, it shows great improvement in healing post procedure and can also be used annually (depending on the method used) to reverse the aging process of follicles. 

Unfortunately there is no industry-wide standard protocol for the use of PRP for hair restoration and likely there will never be one because there are so many variables making comparative studies extremely difficult to perform. These variables include the numerous techniques to separate the platelets from the blood to make PRP, but no definitive evidence to show that significantly higher concentrations of platelets produces superior outcomes. Some transplant specialists add healing support factors like A-Cell or the anti-inflammatory drug progesterone, which may help, but again no definitive studies. Then there is the injection technique: individual shots, micro-needling, or an injection gun. Based on the before/after images from major hair centers, it appears that all three techniques work well. There are anecdotal reports that the PRP works on scalp areas outside the injection sites suggesting chemical diffusion. Finally how often? Most centers suggest 3 - 5 treatments one month apart, with maintenance every 6 months. 





PRP by itself is a break through for many causes of alopecia. Assuming that PRP is indicated, I recommend supplementing PRP with other treatments that are generally less successful separately but may be helpful as part of a total regimen: Vivisical supplements, home micro-needle roller, Formula 82M (minoxidil with other agents), low level laser light therapy (Laser Cap Pro), and Tricomin shampoo and conditioner. 

Regarding PRP, early studies were not substantiated enough to introduce PRP as an effective treatment for hair loss with long lasting results.  Also, there have not been large scientific studies to compare different methods and compare the results with respect to PRP use in hair loss.

Thanks for your question. The reason this is confusing is because there is not a standard protocol. I would agree that Acell and ECM have not proven to increase results. Here would be my recommendations-

1. Focus on the QUALITY of the PRP prep kit (and of course the reputation of the provider)- there are over 25 FDA approved PRP prep kits but they do NOT all produce the same concentration of PRP. (I hate to confuse you more, but I must...). An adequate PRP concentration is 4 to 6x the concentration of platelets in the blood. Many kits don't even come close to that. Concentration counts! We use PurePRP II by Emcyte, this is a good one. Harvest is another good system. The best kits will require a 60 ml blood draw (some even 120 ml). If they use a kit where they only draw 10 ml of blood, not so good!! This will NOT produce the same amount of PRP, and the more the better. 



2. We tend to avoid recommending propecia because of the potential for sexual side effects. It is a risk you need to weigh personally. 



3. A quality topical system like Revivogen can help. Also there is a supplement readily available in stores called quilib. It is made by the company Galderma, derived from onion I believe and it helps. No, you will not smell like onions. It's not expensive. 



4. Yes, PRP is usually done 3 sessions about 1 month apart, then you enter maintenance mode of 1 session every 8 to 12 months. Some places only inject, others inject and microneedle as well. Better to do both as the microneedling also stimulates the follicles independent of the PRP. 



5. Look into LaserCap PRO (LC PRO). It's portable and has the most low level laser diodes of any similar system. You can wear it under a baseball cap. Around 30 minutes every other day. It's an investment (list $3000) and you can only get it from an authorized center BUT if you use this you may be able to go longer in between maintenance sessions AND enhance your PRP results. 



6. Consider an oral supplement- such as Viviscal Professional.

7. Home microneedle roller can help a bit..mostly by helping your topical products penetrate better. They are not a replacement for medical microneedling done at the time of the PRP session.



Best,



Lisa Vuich, MD