FAQ’s – Frequently Asked Questions about PRP Hair Growth
The increase in research, availability and success of PRP Platelet Rich Plasma in a variety of fields of medicine has generated many Frequently Asked Questions (FAQs) about the treatment. Hair Restoration Physician, Dr. Alan Bauman has compiled some answers regarding these questions below.
What causes hair loss in women?
Hair thinning in women which affects nearly 40 million American women is mainly due to heredity and can start any time after puberty. However, we also know that female pattern hair loss can be strongly influenced by age, nutrition, stress, surgery, medications, illness, social/lifestyle factors, hair care and more. As hair follicles weaken and stop producing hair, hair loss occurs.
What causes hair loss in men?
In men we know that hair loss follows a very specific, progressive pattern that is passed on through heredity and is triggered by hormone–specifically dihydrotestosterone or DHT. An estimated 60 million American men are suffering with male pattern hair loss. As hair follicles miniaturize and weaken, coverage of the scalp diminishes leaving thinning or balding areas.
How is a hair loss diagnosis obtained?
The first step for anyone with a hair or scalp problem is to visit a full-time, credentialed hair restoration physician with experience and expertise in accurate diagnosis, successful treatment and long-term follow-up required in the medical management of hair loss patients. A medical hair loss “work up” starts with a detailed medical history, including family history, history of medical illness, poor nutrition, current medications, hair care regimen, recent surgeries and a detailed history of the hair loss situation. A scalp biopsy, blood work or other testing (like a HairDX genetic test) may be performed if indicated by the history and physical symptoms. Physical exam would include evaluation of the scalp for signs and symptoms of hair loss and any concurrent problems, such as inflammation. HairCheck cross sectional trichometry is used to measure Hair Mass in the relatively permanent areas of the scalp compared to the non-permanent or at-risk areas. Video dermoscopy with a HairCam device is used to determine if there is decreased numbers of follicles in the affected areas, a decreased caliber of follicles in the affected areas, or a combination of both.
What are PRP hair regrowth treatments and how do they work?
PRP or Platelet Rich Plasma for hair regrowth is an in-office, non-surgical, autologous treatment derived from the patient’s own blood that can be performed in about an hour. After the area of concern is identified, evaluated and measured, standardized medical photos are taken in the photo suite. Special gentle and sterile techniques and equipment are used to separate and concentrate the platelets and plasma from a small sample of peripheral blood. A small sample of the blood and PRP is tested in a hematology analyzer to measure and document the improved platelet concentration. PRP contains growth factors and cytokines that have been shown to be responsible for stimulating and enhancing hair follicle function. The PRP may be combined with ECM or Extracellular Matrix (like ACell or BioD) for a stronger and longer hair growth result. The scalp is prepared with antiseptic solution and anesthetic (a “ring block,” not simply local anesthetic gel) is used to completely numb the scalp for a 100% painless procedure. Small injections of the PRP deliver the powerful platelet-derived growth factors into the skin at the level of the weak follicles. Electronic, mechanical microneedling is performed. A session of Low Level Laser Therapy is performed before the patient leaves the office.
Who is the ideal candidate for PRP treatments for hair loss?
At Bauman Medical, we focus on two types of hair loss patients when it comes to PRP treatments: patients with areas of “weak quality” hair growth on the scalp, where functioning hair follicles can still be observed, and patients with small areas of alopecia areata. In our experience, these are the patients who appear to have the greatest success with PRP hair regrowth treatments.
How does combining ACell or BioD with help with the overall results of treatment?
It has been reported that when Extracellular Matrix or ECM products like ACell (porcine bladder-derived) or BioD (human amniotic placenta-derived) are added to PRP in appropriate quantities, a stronger and longer duration of hair growth improvement has been observed.
When can you expect results from PRP and how long do they last?
Typically, we can measure improvements in Hair Mass Index using HairCheck months before the results are visible to the naked eye. Increases in Hair Mass Index using the HairCheck device predict how much visual improvement the patient is likely to see in the months to come. It takes six to twelve months to judge the results of PRP “visually” in the mirror or with standardized photos. Measurements are taken every three months, so the plateau phase of improvement can be tracked. When Hair Mass Index starts to decline, the patient’s next PRP is planned. With the exception of alopecia areata, the average hereditary hair loss patient can expect to need PRP with ECM on an annual basis.
What is Hair Mass Index or HMI?
Hair Mass Index, HMI or HairScore is the unit of measure obtained from the HairCheck tool. It is a numerical representation of the cross sectional area of a bundle of hair that grows from a 2cm x 2cm area of scalp. Consider for a moment the thickness of a ponytail of hair. This thickness is a product of the amount of hair fibers within the bundle as well as the thickness of each individual hair fiber. Therefore, Hair Mass Index or HMI is a highly accurate and sensitive measurement of the amount and quality of hair growing from the scalp in any given area. Doctors and others can learn how to accurately perform HMI measurements with HairCheck through the HairCoach training and certification program.
What are the risks and benefits of PRP treatments?
PRP is a comfortable, in-office, non-surgical procedure that takes about an hour start-to-finish, and most of that time is spent in the preparation phase… meaning you, the patient, is just relaxing! Most patients notice a brief period of inflammation during which their scalp remains somewhat pink and numb for a few hours. Swelling is rare (about 15% of the time) and if it occurs is noticeable in the forehead or around the eye area on the next day. Any swelling takes about a day or two to resolve. Hair growth improvements can typically be measured in about three months, but it takes six to twelve months to visually “see” the difference in photos and in the mirror.
The main risk of PRP is that your doctor or technicians are using careless or outdated preparation and application equipment or techniques… resulting in a poor or less than optimal outcome.
Patients with certain blood disorders or on certain medications are not candidates for PRP treatments. PRP is immunologically neutral and poses little risk of allergy, hypersensitivity or foreign-body reactions. At Bauman Medical, we use the yesPRP system of kits and centrifuges to assist in a consistent quality of preparation of PRP.
How long do the benefits of PRP treatments last?
According to published reports, “plain” PRP (without ECM) tends to improve hair caliber and hair growth for about four to six weeks, requiring multiple repeated treatments as often as every other month. When using ECMs like ACell or BioD, the effects of PRP have been reported to be stronger and last longer. In our hands, at Bauman Medical, we have noticed that Hair Mass Index (aka HairScore) measurements performed with HairCheck cross sectional hair bundle trichometry can improve and plateau for up to two years* when PRP is combined with ECM called “BioD-Restore.” On average, however, most patients will require their repeat PRP treatment after an average of one year in order to maintain the hair growth effects.
Is there a recovery period or downtime after PRP treatments?
There is no activity restriction after a PRP treatment. Patients may shower/shampoo/condition their hair normally just several hours after the treatment and resume normal daily and athletic activities. As mentioned previously, some brief mild inflammation noticeable as redness/pinkness and numbness of the scalp may be present for several hours. No harsh chemical coloring or perming treatments should be performed for at least 72 hours. Use of topical hair growth treatments like Minoxidil 82M or similar can resume the next day. Laser therapy treatments can also be resumed the next day.
Are there any contraindications or other factors that would make someone ineligible for PRP?
Patients should be educated by their Hair Restoration Physician as to what results they could expect from PRP in various areas of the scalp. Different areas of the scalp may respond differently to PRP depending on the amount of weak hair follicles present in each zone. Generally, with the exception of small round areas of alopecia areata, locations where severe depletion of follicles has occurred should not be treated. The vast majority of healthy individuals can easily undergo PRP treatments. Certain conditions like blood and platelet disorders, chronic liver disease, presence of an active severe infection, cardiovascular or hemodynamic instability and/or the presence of anti-coagulation therapy (e.g. warfarin) would make PRP contraindicated. Recent steroid treatments and smoking are relative contraindications and should be discussed with your Hair Restoration Physician.
What qualifications should a person look for in a hair restoration specialist before booking a PRP Hair Growth appointment?
1) Unfortunately, it sometimes seems like many non-hair specialists are adding PRP for hair growth to their menu of services without adequate experience or training. Look for a full-time “ABHRS” board certified Hair Restoration Physician and Fellow of the International Society of Hair Restoration Surgery (ISHRS) rather than a plastic/cosmetic surgeon or dermatologist, so that you can be certain you are receiving a thorough hair loss evaluation, standardized photos and scalp dermoscopy, accurate adjunctive treatment advice, as well as the critical pre-treatment measurements using a HairCheck device so you can track your progress in the early subtle stages. Hands-on certification programs, like “HairCoach” teach physicians the most up-to-date methods of hair loss evaluation and application of PRP for the scalp.
2) Seek out a physician with extensive experience specifically with PRP for the scalp, because techniques are different for the scalp compared to other areas of the body.
3) Find a PRP expert who utilizes PRP with ECM Extracellular Matrix, like ACell or BioD-Restore, so you can get the strongest and longest results from the treatment and reduce the hassle and expense of frequent, repeat treatments.
4) Ask your Hair Restoration Physician if they are planning to use a complete “scalp block” for a painless treatment or if they will simply apply anesthetic gel, which can make for a more painful procedure.
5) Ask if low level laser therapy will be applied pre and post-treatment to enhance the procedure.
6) Ask your Hair Restoration Physician or HairCoach to report to you your level of platelet concentration in the PRP.
Resources and Organizations for Hair Restoration Physician Credentialing:
ABHRS – American Board of Hair Restoration Surgery abhrs.org
ISHRS – Fellow of the International Society of Hair Restoration Surgery ishrs.org
IAHRS – International Alliance of Hair Restoration Surgeons iahrs.org
AHLA – American *Each individual's treatment and/or results may vary
If you or someone you know has hair loss or eyebrow or eyelash concerns, click to start either a long-distance phone consultation OR an in-person, in-office consultation with Dr. Bauman. You can also Ask Dr. Bauman a Question or simply call Bauman Medical Group toll-free 844-GET-HAIR or +1-561-394-0024