How well does PRP work?

Platelet-rich plasma (PRP) is the concentration of platelets that are derived from the plasma portion of one’s own blood.  PRP contains various growth factors, cytokines and other bioactive factors.   Because the plasma is autologous (i.e., extracted from a patient’s own blood), there is minimal possibility of any significant adverse reaction.  To obtain PRP, a small amount of blood is first extracted from a patient. This blood is then spun in a centrifuge that leads to separation into three layers: platelet-poor plasma (PPP), platelet-rich plasma (PRP) and red blood cells. The whole procedure typically required one or two spins of the centrifuge and takes less than 15 minutes. The concentration of platelets in PRP is typically around five times as much as in normal blood.

A number of recent studies on platelet-rich plasma (PRP) have shown favorable outcomes (often used in conjunction with ACell). Two of these studies came out in 2013 and their full versions are available on Dr. Greco’s website (links posted below).  I like the fact that these studies are coming from all over the world rather than from just one country such as the US, limiting potential for any kind of sponsor- or self-interest-driven fraudulent “findings”.  FYI — I will regularly update the below list as new studies come out.

Spain, 2016 — Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia

Italy, 2015 — The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial

Thailand, 2015 — At the 9th Congress for Hair Research, Dr. Ratchathorn Panchaprateep from Thailand presented favorable findings regarding combination therapy treatment of hair loss using PRP and Non-Ablative 1,550 nm Erbium Glass Fractional Laser in 9 patients

India, 2015 — Efficacy of Platelet-Rich Plasma in Treatment of Androgenic Alopecia

South Korea, 2015 — Therapeutic Efficacy of Autologous Platelet-Rich Plasma and Polydeoxyribonucleotide on Female Pattern Hair Loss

Greece, 2014 — Study of Platelet-Rich Plasma Injections in the Treatment of Androgenetic Alopecia Through a 1-year Period

Italy, 2014 — Platelet-Rich Plasma for Androgenetic Alopecia: A Pilot Study

Italy, 2014 — The Effect of Autologous Activated Platelet Rich Plasma (AA-PRP) Injection on Pattern Hair Loss: Clinical and Histomorphometric Evaluation

India, 2014 — Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool

France, 2013 — Platelet-Rich Plasma: a Therapy for Hair Growth

Taiwan, 2013 (done on mice) — Promotional Effect of Platelet-Rich Plasma on Hair Follicle Reconstitution in vivo

Brazil, 2012 — Follicular Unit Megasessions and Platelet Growth Factors

South Korea, 2012 (done on mice) — Autologous Platelet-Rich Plasma: A Potential Therapeutic Tool for Promoting Hair Growth

The key benefit from PRP seems to arise form various growth factors, and the wikipedia on PRP has a good summary of those factors.  The main growth factors in PRP that are relevant to hair growth include:

• Platelet-Derived Growth Factor (PDGF)
• Fibroblast Growth Factor (FGF)
• Insulin-like Growth Factor 1 (IGF-1)
• Vascular Endothelial Growth Factor (VEGF)
• Epidermal Growth Factor (EGF)
• Nerve Growth Factor (NGF)

One of the reasons PRP results can vary so much is due to the fact that there is significant variance in techniques, equipment used and concentrations of platelets in the final product.  It is imperative to see a hair restoration surgeon with significant experience in the use of PRP for hair growth purposes (as opposed to going to a cosmetic surgeon who uses PRP for all sorts of purposes).

The bald truth talk forum section on PRP is worth a visit.

If I was undergoing a hair transplant procedure today, I would certainly request the addition of PRP to the procedure even if the benefits are not always guaranteed (and mind blowing results are a very rare exception).  Just like with FUE, ARTAS and laser treatments, I suspect that an ever increasing number of hair transplant surgeons will be offering PRP in the near future as a result of the above study findings.




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