Frequency for PRP hair loss treatments? Does it make much of a difference if you go 4-8 weeks between treatments?

M any aspects of the PRP protocol have not been studied and published. A recent study from Beverly Hills has shown that the ideal treatment spacing is 1 month. This is in the treatment phase and not in the maintenance phase. The maintenance phase depends upon  the patient's response and any concomitant Therapies. No one knows the ideal concentration of PRP. Everybody has an opinion but studies do not confirm any superiority with higher or lower concentrations.PRPHAIRMD.COM 

Prp is effective, but it can take up to 6 months to see results. I have a very specific protocol, every 3-4 weeks for 6 months with prp therapy.  I also add in progesterone to speed the healing process.  After that the injectors are tailored down.  You should also be on viviscal and other growth promoting ingredients.  Best, Dr. Emer.

Thank you for your question. You’re asking about the right frequency in get PRP treatments for hair loss. You state some places are recommending every 4 weeks, some places are recommending every 8 weeks. You’re asking if the effect wears off if you don't do them more closely together. I understand this confusion since there is now a growing popularity of PRP for 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 am also the founder of TrichoStem™ Hair Regeneration Centers based on a system we developed 7- 8 years ago using PRP and a material called Acellular matrix to help men and women with genetic pattern hair loss. It has been very successful, and we treat patients from all over the world. I can share with you my perspectives on PRP, and what kind of effect it has on the treatment of hair loss.
One of the challenges that faces most physicians today who are relatively new to PRP, which I would argue also affects most physicians is experience with PRP. Frankly, when we were doing PRP for either skin rejuvenation or hair loss, there was a lot of resistance from our colleagues and a lot of dismissiveness. Fortunately, medical literature and some of the dermatology publications have recognized, what was already obvious to us, that PRP does have benefit in skin and hair loss. The question remains with those who are offering PRP on what their optimal protocol is.
I think the reason why there’s confusion is because hair loss treatment is often not approached as an individualized treatment. What I mean by that is when you’re dealing with male and female pattern hair loss, you’re dealing with a wide range of age of onset, degrees of progression, and rates of progression. I  constantly see how people are trying to figure out a “one-size-fits-all” approach to treating hair loss.
Just a little background on how we developed our treatments, we were using Acellular matrix and PRP to help our patients heal after hair transplant. We wanted the grafts and the donor area to heal better. A very pleasant side-effect was thinning hair became thicker in some of these patients. Over the course of several years, I developed systems and protocols based on clinical examinations, and watching our patients every 3-6 months to develop protocols to help both men and women with hair loss.
Further at this point in time, I developed a classification system for hair loss because I think one of the frustrations we all have when we don't see as a good of an outcome as we expect, we wonder why. We developed a system based on gender, age, age of onset, degree of progression, rate of progression and other medical variables. I think this is what gets confusing when it comes to just using PRP alone.
The literature has substantiated that PRP has many valuable effects on hair loss. However, what is not being factored in is the individual hair loss profile as some people may respond better than others. Currently, the prevailing opinion is PRP works 50% of the time. I think that the numbers are too small, and the experience is too little to really make a statement like that.
What you have to understand is that PRP alone has a certain stimulatory effect on hair growth. The mechanisms are going to be much more than what we currently know. In terms of timing, this is a challenge to the sustainability because when we see patients who have gotten PRP injections done elsewhere, typically they had gone for once a month treatment for about 4 months. After several sessions, they feel very frustrated because they’re dealing with the discomfort of getting injections, most of the time without anesthetic in the scalp, and they’re not seeing what the outcome will be, and for how long they need treatment. Basically, it’s very challenging to have sustainable improvement when you have patients come every month for scalp injections which can be very uncomfortable.
In our treatment strategy, we developed a treatment plan based on the individual’s hair loss profile. What I think is the take home message is that hair loss is managed, not cured. Based on the hair loss profile, you use multiple tools to help manage hair loss with a customized plan.
When we see our patients, we generally do maybe one injection for the duration for several years. We may do two injections, and the second injection called the booster injection can be anywhere between 12 to 24 months after the first. For a practice like ours with the TrichoStem™ Hair Regeneration treatment center, we treat people from all over the world, so it’s impractical to have people come back monthly. I think we’ve just been further along in our development in our own internal clinical observations and developments.
To answer your question, without a full evaluation, I would say you can to a degree expect PRP to cause short-term stimulation of hair growth. At the same time, you can look at other variables that impact the progression of hair loss. This is a discussion to have with the doctor. I think you should ask how much experience they have doing this, what’s the outlook whether it’s the 4-week or 8-week plan, what can you expect, and what else can you do. I think very often people just get frustrated, and what I want people to understand is there’s more to this than just frequent PRP injections. Hair loss is more about management, and not just a single approach that can work some of the time for some people, and not work out for others. There’s much more to this.
I think it’s important you do more research and learn about platelet-rich plasma, Acellular matrix, protocols, and most importantly the experience of the practitioner you intend to go with so they can guide you based on their experience. We’re using our experience going for 7-8 years that has really informed the evolution of our treatment system to where we are today from frontline, real-time experience. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Frequency of treatment depends on the amount, type, and method of use of PRP.  This is variable in various practices.  Typically approximately 13ml of PRP is needed for each half of scalp.  The type and kit of PRP used is also very critical.  Generally treatments can be every 9-12 months with an optional booster 3 months after the initial therapy has been shown to be helpful. 

Hello Larry832,
Hair regeneration is relatively new. Therefore, you will hear many methods. Hair reduction has been around much longer. Simply follow the same cycle to grow hair as used to kill it.  
The number and frequency of treatments is important. Hair grows in cycles. It is either dormant, active or going into or out of activity every 6 weeks or so on average. When dormant, we can't even kill it with a laser. Therefore, we can't make it grow or stop them from going dormant.
Therefore, I recommend 4 to 6 treatment sessions spread 5 to 7 weeks apart. This should affect all follicles that have a chance at regeneration. Yes, this is a tad aggressive. However, it provides for optimal results.

If you don't see much of a reaction 5 - 6 weeks after the 2nd treatment, you might consider saving some money. Certainly, if 6 weeks after the third treatment you don't see a benefit, I would discontinue and save money. Keep in mind fine hairs is a good thing, they can turn into regular hair when properly nurtured.
Consider adding Propecia and Minoxidil to your regimen. The side effects are applicable only to a very small portion of the population. I encourage you to try them. However, not together at first. Try one first and see. If no problem, then add the second. Start with Minoxidil.

Most importantly, investigate what your hormones are doing. For example, if your DHT is too high, it will work against and possibly inhibit your hair regeneration and longevity of the treatment. 

I very much encourage you to locate and visit a good Integrative or Functional Medicine physician. They are trained to get your hormones and metabolic system optimized. There are a number of methods they can employ to push down inhibiting hormones such as DHT while pushing up beneficial hormones. 

As a side benefit to your quest for great hair, these type of physicians will have you feeling much better as well. 

Consider adding a extracellular matrix (ECM). ECM's will supercharge your results. 
Photo/Light therapy; you can either locate a physician with a light therapy device or purchase a good light cap and use it a few times per week. Don't go with the cheap ones.

Maintenance; The life of these procedures is generally unique to the patient. They generally last between 12 to 18 months if not using photo therapy and hormone management. I don't like to wait this long because it means were starting at or near zero again. Be proactive.
Therefore, consider having a maintenance treatment every 5 to 9 months as appropriate for your condition. Above all, don't wait until you see the restart of hair caliber thinning or loss. Should you do so, you may need to start a whole new cycle of treatments. Don't forget to keep your hormones in check. Doing so will prolong the life of the procedure and is cheaper than the procedure. 

Make sure the practice is using high density PRP. Generally the yield from a 50mL blood draw is about 7mL of PRP, equaling a 6 to 7 x of base. 
I wish you all the best in your quest for regaining your hair.

Warmly,

Arbella Saris, MD

Ideal time between treatments are 4 weeks apart.  PRP won't lose affect as they are bio stimulators. Having the treatments too close may not yield the result that can be achieved in the long term.

Thank you for your question. I don't believe there is a significant difference between 4 and 8 weeks. I generally recommend 4 to 8 weeks between treatments with a total of 3 to 6 treatments depending on the response. Make sure the kit being used for PRP preparation concentrates the platelets to a level in the plasma of 6 to 8 times the concentration in whole blood. Many of the less expensive kits will only achieve a concentration of 1 to 2 times the concentration in whole blood.I hope this was helpful - Dr. Moore.