Platelet Rich Plasma (PRP)

One of the newest advances in the non-surgical treatment of hair loss in both men and women is the introduction of platelet rich plasma or PRP. PRP treatments have been used successfully for years on thousands of patients by surgeons in numerous specialties including orthopedics, otolaryngology, oral surgery, plastic surgery, and urology to name just a few.  It is well documented that PRP assists in the healing of joint disorders and injuries of the spine by enhancing the reparative properties of the body’s natural immune system. PRP has been used as an adjunctive treatment for the promotion of healing in fractures, joint replacement surgery, spine fusion, and the management of injuries for cartilage, ligaments, and even tendons. (1).

Platelet rich plasma contains a wealth of growth factors that are contain multiple, vital growth factors (GF’s) as well as bioactive molecules.  The most critical growth factors present in PRP include platelet derived growth factor, transforming growth factor, vascular endothelial growth factor, hepatocyte growth factor, insulin like growth factor, and interleukin 1.  These factors all help to regulate the body’s natural healing process which is constant across most of the body’s tissues. (2) There is scientific evidence that PRP works by several mechanisms of action. PRP seems to prolong or lengthen the growth phase of the hair follicle called anagen phase. Most hair follicles in our scalp are in the anagen or growth phase. (3)

In addition to the numerous growth factors listed, the true clinical effects from PRP treatments also rely upon the platelet concentration in the PRP solution compared with the platelet count in the circulating whole blood. It is well established that the human blood stream contains platelet counts from 150,000 to 400,000 platelets/microliter. The efficacy of PRP was initially thought to rely mostly on the platelet increase factor—the platelet concentration increase in PRP compared with whole blood. The physiologic count of platelets circulating in the blood stream ranges from 150,000 to 400,000 platelets/μL. (3) It seems that the most ideal results  In general, the best hair restoration results seem to be attained with platelet concentrations 3 to 5 times that in whole blood.

It was a plastic surgeon, Dr. Uebel, who first reported the beneficial effects of PRP on male pattern hair loss in the scientific literature in 2006. (5)   He demonstrated increases in hair growth and hair density when PRP was added to hair follicles that were used in hair transplantation.  A recent study published in the Journal of the American Academy of Dermatology compared the results of PRP for 26 patients diagnosed with androgenic alopecia (male or female pattern hair loss) with a control group treated by saline injections. The authors concluded that PRP treatments resulted in a noticeable and significant increase in hair count, hair density, and increase in anagen (growth) hairs as compared to the control group. These findings were documented by trichoscopic examination of the scalp and independent evaluation by a hair lab. (4)

There are more than 10 randomized, controlled clinical trials by dermatologists and plastic surgeons that have been published since that time regarding PRP and androgenic alopecia. All of them demonstrate an increase in hair density and hair growth. In addition, 11 prospective studies have been undertaken that demonstrate similar positive results from PRP on male pattern hair loss in both men and women.

There are multiple companies that sell PRP devices and kits. While there are no studies comparing PRP systems available commercially, a recent evaluation was completed comparing the concentration of platelets amongst the major manufacturers of PRP systems. The study compared the platelet concentrations created by the following companies: Emcyte, Magellan, Regen, and Eclipse. The PRP system designed by Emcyte had the highest platelet recoveries (80 and 78% respectively) and platelet concentration factor (6.6 times baseline) of the systems tested. 

Our practice is the first practice in our region to introduce the Emcyte system for PRP treatments. Emcyte PRP has the highest platelet recovery and a concentration of growth factors more than 6 times baseline. In addition, only a single PRP treatment is required with the Emcyte system versus the other systems which require three treatments over three months to obtain the same concentration of growth factors obtained from a single Emcyte PRP treatment. Our advanced PRP system provides patients with the largest concentration of growth factors in a single treatment significantly reducing patient discomfort and costs.

References

1. Engebretsen L, Steffen K, Alsousou J et al (2010) IOC consensus paper on the use of platelet-rich plasma in sports medicine. Br J Sports Med 44(15):1072–1081.
2. Tschon M, Fini M, Giardino R et al (2011) Lights and shadows concerning platelet products for musculoskeletal regeneration. Front Biosci (Elite Ed) 3:96–107. 
3. Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Skin Appendage Disord. 2018;4(1):18-24.
4. Journal of the American Academy of Dermatology. Volume 80, Issue 3, March 2019, Pages 694-700.
5. Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118(6):1458-66; discussion 1467.