Over the past decade, advancement in treatment for pain conditions has accelerated past what we once thought imaginable. Thanks to this advancement, we now have a solid understanding of the treatments that work and those that are less than effective.
We understand that some treatments have deleterious side effects that can lead to worse conditions or are not nearly as effective as we had hoped. However, there is a more recent treatment for pain that we have come to understand to be one of the more safe and effective treatments available.
For patients suffering from osteoarthritis or an acute ACL tear, high-dose platelet-rich plasma (PRP) is one of the most effective treatments discovered and developed over the past decade. The more we learn about PRP as a treatment for these various ailments, the more we understand that its application may apply to more than we had initially anticipated.
In addition to PRP being used to treat pain conditions, it also has cosmetic purposes, including the regeneration of skin like facial skin. While this treatment does have a record of efficacy, some may remain skeptical and feel that a treatment that works for several different purposes is too good to be true.
While a healthy level of skepticism is necessary to temper our excitement when seeking out any treatment, it is also necessary that we conduct responsible and thorough research behind PRP – more specifically, PRP as a treatment for hair loss (alopecia).
Understanding Platelet-Rich Plasma
But what exactly is platelet-rich plasma?
In an evaluation of PRP conducted by the China-Japan Union Hospital of Jilin University, researchers explain that “[p]latelet-rich plasma (PRP) is a platelet concentrate extracted from autologous blood by centrifugation, which is a kind of bioactive substance.” (Wang 2022)
Patients might wonder how this works and whether it is safe – especially when hearing Dr Wang refer to it as a “bioactive substance.” It is likely that many would be unwilling to apply a bioactive substance to treat their alopecia.
However, as is always the case, further evaluation and a deeper understanding of PRP will help patients understand its legitimacy as a treatment for alopecia. First, let’s capture a greater understanding of alopecia, its more common variants, and why effective treatments are needed.
The Need For Hair Regeneration Treatments
Continuous research is being undertaken to investigate the prevalence, causes, and treatments of alopecia, all with the goal of learning more about the various types and specific implications it can have.
While the data varies depending on the underlying cause, it is widely understood that a considerable proportion of the US population will experience hair loss during their lifetimes, particularly androgenetic alopecia (AGA), also known as pattern hair loss.
The 2018 International Journal of Women’s Dermatology states that “By the age of 60 years, 45% of men and 35% of women develop AGA.” (Stevens and Khetarpal 2018)
While alopecia can start throughout adolescence, it usually becomes more prevalent with age. An article by Ho et al (2022 indicates that the incidence of male pattern hair loss affects up to 80% of men by the age of 70. In women, the condition is also quite common, with an increase in incidence after menopause.
Beyond the cosmetic concerns, hair loss is known to cause a significant burden on an individual’s quality of life. The societal emphasis on a youthful appearance, often being perceived as more attractive, adds to the distress and life-altering implications of hair loss, potentially affecting a person’s self-esteem and mental well-being.
Deciding to treat hair loss is a personal choice, and addressing symptoms early can lead to more favorable outcomes, preventing further loss and encouraging regrowth. Treatment options include medicated creams, pills, surgical transplants, and lasers, as well as the newer method of PRP therapy.
Because of its potential to produce excellent outcomes without the use of harsh drugs or surgeries, PRP is gaining in popularity for its ability to encourage hair renewal and improve hair density. Nestor et al note in their 2021 literature review on AGA treatment options that “patient satisfaction is typically very high, and 60-70% of patients continue to undergo maintenance treatments“ with PRP. (Nestor et al 2021)
To better understand PRP’s ongoing advancements as an evolving treatment for hair loss, let’s look at some of the most recent research on how it works.
The Evolution Of PRP As A Treatment For Hair Regeneration
With the preservation of hair follicle stem cells in mind and the goal being the regrowth of these hair follicles, cosmetic dermatologist Dr Jason Emer explains the potential of PRP to regrow these follicles by concluding that “[p]latelet-rich plasma (PRP) is an autologous serum containing high concentrations of platelets and growth factors.
PRP continues to evolve as an important treatment modality with many applications in dermatology, particularly in the areas of hair restoration, skin rejuvenation, acne scars, dermal augmentation, and striae distensae [stretch marks].
Furthermore, combining PRP with laser therapies, microneedling, dermal fillers, and autologous fat grafting produces synergistic effects, leading to improved aesthetic results. Future studies should standardize PRP treatment protocols for specific indications. PRP holds considerable promise in dermatology with therapeutic applications continuing to expand.” (2019)
One of the studies cited explicitly by Dr. Emer is another 2019 study evaluating the efficacy of platelet-rich plasma as a treatment for alopecia.
In this study, Dr. Aditya Gupta and her associates with the Journal of Cutaneous Medicine and Surgery found that “platelet-rich plasma (PRP) is being used to encourage hair growth through the release of growth factors and cytokines. […] In androgenetic alopecia (AGA) patients, 3 monthly PRP injections (1 session administered every month for 3 months) exhibited greater efficacy over placebo as measured by a change in total hair density (hair/cm2) over the treatment period (mean difference: 25.61, 95% CI: 4.45 to 46.77; P = .02).
“The studies included in the meta-analysis used a half-head design, which may have influenced the results because of the effects PRP can induce. […] In conclusion, to achieve an improvement in hair restoration in patients with mild AGA, 3 initial monthly PRP injections should be given.”
Whether patients utilize platelet-rich plasma as a singular treatment for alopecia or to supplement existing treatment, they can be reassured by the research that decisively concludes it is a safe and effective method for hair regrowth.
What Kinds of Hair Loss Conditions Can PRP Treat?
Because platelet-rich plasma and its application is a more recent treatment for several ailments and conditions like alopecia (hair loss), the research continues to develop, but it is growing rapidly.
This section aims to provide a full overview of the factors linked to alopecia, as well as how recent research into PRP therapy is presenting a potential and successful route for men and women struggling with AGA and stress-related hair loss (telogen effluvium).
Associated Factors Of Alopecia
In a study conducted in the European Journal of Pharmacology, Yuan and his associates explain that “[a]ttributed to hereditary factors, emotional stress, and psychiatric disorders, alopecia is highly prevalent in current society, resulting in devastating physical and psychological sequelae [psychological ramifications].
Considering the role of stem cells in pathogenesis, alopecia can be divided into two types: nonscarring alopecia and scarring alopecia.
“In nonscarring alopecia, the progenitor cells are destroyed, while the hair follicle stem cells (HFSCs) are preserved, which is why this kind of alopecia can be reversible. Androgenetic alopecia (AGA) accounts for the majority of the nonscarring alopecia cases, affecting up to 80% of Caucasian men by the age of 80 and nearly 40% of Caucasian women by the age of 70.” (2020)
According to Yuan’s study, we must qualify that their findings related to PRP as a treatment for alopecia only apply to nonscarring alopecia in which the hair follicle stem cells (HFSCs) are preserved. Fortunately, as the study suggests, most alopecia cases are nonscarring and therefore are candidates for this treatment.
Hair Loss Due To Stress
With the increasing stress of today’s society, telogen effluvium (TE), or stress-related hair loss, has become another prevalent cause of alopecia. A literature review published by Fahham et al 2020 describes it as “…a scalp disorder characterized by excessive shedding of hair. Several factors such as drugs, trauma, and emotional and physiological stress can lead to the development of telogen effluvium.”
Fatani et al (2015) note in their study that “TE does not appear to have a predilection for particular racial or ethnic groups.” However, both Fahham and Fatani indicate that TE is more commonly seen in females and is highly prevalent in individuals dealing with chronic systemic illnesses such as thyroid dysfunction, auto-immune conditions, diabetes, or low levels of iron and ferritin.
TE can develop suddenly, presenting as an acute (short-term) condition. It may also go on to persist for more than six months, transitioning into a chronic issue. Interestingly, TE can also occur in a fluctuating pattern, appearing and disappearing over a person’s lifetime. Additional factors that can influence the progression of TE include psychological and physical stress levels and different types of medications.
Because TE is non-scarring, PRP treatments are likely to be a beneficial treatment option. In one pilot study from early 2023 evaluating the safety and effectiveness of PRP treatments on 30 women with chronic TE, El-Dawla et al (2023) showed significant improvement at the clinical level and high patient satisfaction.
Though limited by sample size, this randomized, controlled, double-blind, pilot clinical trial concluded that “Platelet-rich plasma could be considered as a promising therapy for patients with chronic telogen effluvium with an excellent safety profile.”
Menopausal And Female Pattern Hair Loss
AGA in women, also known as non-scarring female pattern hair loss (FPHL), is defined by Nestor et al 2021 as “diffuse hair thinning between the frontal scalp and vertex, typically sparing the frontal hairline, which creates a more visible scalp.”
Even though it’s more common around menopause, women can also experience FPHL during their childbearing years. Fabbrocini et al (2018) note that 12% of women develop FPHL by age 29, 25% by 49, 41% by 69, and >50% by 79. Ramos et al (2023) warn against antiandrogenic meds during pregnancy, stating that it is essential for premenopausal women to use highly effective contraceptives while being treated with FPHL drugs.
FPHL can greatly impact the quality of a woman’s life, self-esteem, and mental health. Hoffer et al (2021) suggest this is owing to the common belief that a woman’s hair plays a significant role in her identity and that women place greater importance on their appearance than men. Finding successful treatments for FPHL is understandably a priority; nevertheless, conventional treatments may not fulfill patients’ expectations.
Ramos, PM (2023) states that “Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment.”
Kaushik and Kumaran explain in their 2020 paper that PRP is a promising solution for patients with AGA (or FPHL). The authors found that many studies show significant improvements in hair count, density, and the percentage of anagen hairs with varied sessions of PRP injections.
The authors also came to the same conclusion that more extensive, diverse research is needed for a clearer understanding of PRP’s effectiveness in AGA treatment, but is still presenting an exciting prospect in the evolving field of hair loss treatments for women.
Male Pattern Hair Loss And Balding
Male pattern hair loss (MPHL) and baldness are two further types of non-scarring AGA alopecia. They differ from FPHL in that they affect multiple areas of the head, with hair loss extending from the frontotemporal and vertex scalps.
In the Medizinische Genetik journal, Henne et al(2023) suggest MPHL is a “…highly heritable and prevalent condition…” and that “This androgen-dependent hair loss may commence during puberty, and up to 80 % of European men experience some degree of MPHL during their lifetime.” They also mention that “Current treatment options for MPHL have limited efficacy.”
Conventional treatments for MPHL include minoxidil ointment and finasteride tablets. Both of these treatments may initially cause increased hair shedding, with their effects stabilizing anywhere between six and 18 months, and both necessitate lifelong use and have potential side effects. This current approach underscores the importance of finding a more encouraging and sustainable solution that supports a more realistic long-term regime for men with MPHL.
A systematic review by Gentile and Garcovich (2020) reviewed 12 clinical trials on PRP treatments for AGA in both men and women. The review concluded that PRP “…present[s] a safe and effective alternative procedure to treat hair loss compared with Minoxidil®, Finasteride®, and Dutasteride® […]”
This emphasizes PRP’s potential as an innovative solution for people seeking to avoid the demanding regimen and potential side effects of current medications.
Early Intervention For Hair Loss
Despite how common hair loss is, it may be surprising to learn that it is one of the most challenging conditions for dermatologists to address. Its complexity includes the many available treatment options, their effectiveness, associated side effects, practicality of patient compliance, and treatment costs. The chronic nature of AGA can compound all of these factors. (Nestor et al 2021)
Early intervention is key for optimal outcomes in individuals experiencing initial signs of hair loss. For individuals experiencing early-onset symptoms, commencing PRP treatments may significantly slow down the condition’s progression, offering a treatment alternative that reduces the reliance on medications, surgery, or lasers.
Nestor et al (2021) noted that PRP is particularly suitable for early-stage AGA, where intact hair follicles are present, maximizing the potential for significant hair restoration. Opting for PRP in the early stages allows individuals to promptly address hair loss concerns and can lead to better results and long-term satisfaction.
Furthermore, PRP therapy not only requires less daily commitment for patients but is also potentially more cost-effective than the surgical transplants recommended for severe cases that have been left untreated.
The PRP Treatment Process
Stevens and Khetarpal (2018) highlight the challenge of precisely defining how PRP helps with hair regeneration due to the lack of globally standardized preparation methods. This means it is essential to manage patients’ expectations for hair regeneration treatments with PRP, given the evolving state of research and application in practice.
While PRP treatments offer a more flexible approach with proposed three-monthly injections for sustained effects, Nestor et al (2021) underscore that it’s not curative for hair loss and requires long-term continuation for lasting effects.
Understanding that no medical intervention is risk-free, the authors also highlight that mild, transient side effects can be associated with PRP, such as scalp pain, headache, and burning sensations, but they note that these are often relieved by vibration or cool air.
Despite the promising adjuvant treatment for AGA, the lack of standardization in PRP methods, as emphasized recently by Anon and Anand Paichitrojjana (2022), calls for caution.
Therefore, individuals considering PRP should understand its substantial promise while also acknowledging the current limitations due to the lack of standardization in methods across different studies and practitioners.
When Is PRP For Hair Regeneration Not Recommended?
PRP treatment for hair regeneration is generally safe and minimally invasive but is not recommended for individuals with certain health concerns.
Stevens and Khetarpal (2018) note that PRP’s autologous origin will reduce infection and rejection risks. However, Nestor et al (2021) more recently cautioned against PRP use in individuals with bleeding disorders, autoimmune diseases, active infections, or those on anticoagulants.
Anon and Anand Paichitrojjana (2022) also highlight that, while few, some absolute contraindications include individuals with thrombocytopenia, platelet dysfunction, sepsis, and local infection. The authors also outlined that relative contraindications may include recent NSAIDs use, glucocorticoid injections, systemic glucocorticoids, recent illness, cancer, anemia, thrombocytopenia, and tobacco use.
It’s most important for individuals considering PRP to discuss their medical history and current medications with their healthcare providers to determine the suitability of PRP treatment and ensure their safety. Always prioritize open communication with your healthcare team to make informed decisions aligned with your health goals.
How Orthagenex Uses High-Dose PRP For Hair Regeneration
With the advancement of medical technology, Orthagenex can now assist the regrowth of hair follicle stem cells through high-dose platelet-rich plasma.
From autologous blood (a patient’s own blood), Orthagenex high-dose PRP can condense platelets in a highly concentrated form. When blood is taken from a patient and put in a centrifuge, it is spun quickly to separate red blood cells from white blood cells and concentrate the number of platelets together.
Once extracted and applied to alopecia-affected areas, these concentrated platelets act as supplemental regrowth that can be used to target balding areas. With Orthagenex high-dose PRP, patients with alopecia will have options and hope through high-dose platelet-rich plasma.
See How High-Dose PRP Can Make A Difference In Your Hair Growth
Orthagenex high-dose PRP protocols offer the treatment, education, and follow-up that patients need to return to and maintain a renewed confidence level in their appearance.
Without the worry of invasive procedures or unpredictable medications that cause multiple unwanted side effects, patients can have hope and confidence in their ability to find how treatments like high-dose PRP, the most advanced platelet-rich plasma in use today, will work for them.
