This article examines the potential of PRP in promoting hair growth and its viability as a non-surgical alternative for specific patients.
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PRP stands for "Platelet-Rich Plasma." It is the processed liquid fraction of peripheral blood that contains platelets above their normal level.
PRP therapy is a procedure that involves extracting blood from a patient and centrifuging it to get a large number of platelets. These platelets contain growth factors (GFs) that play a crucial role in tissue repair and regeneration.
This minimally invasive procedure offers numerous benefits for patients seeking to improve their hair regrowth and boost their confidence. Since it uses an individual's blood components, there is minimal risk of allergic reactions or adverse side effects.
The PRP therapy involves separating platelets from a person's plasma to get the following constituents. [2]
The growth factors (GFs), cytokines, and lysosomes present in platelets promote tissue regeneration and healing.
The adhesion proteins in platelets initiate new connective tissue synthesis and revascularization.
An increased amount of growth factors present in the PRP produces the following effects: [3]
● Increase blood flow to the hair follicles
● Stimulate dormant follicles to enter an active growth phase
● Reduce the duration of the hair growth cycle
● Thicken the pre-existing hair shafts
● Prevent further hair shedding and thinning.
Regarding PRP therapy for hair restoration, several different protocols can be followed. Each protocol has its unique approach and variations, but all aim to harness the power of platelet-rich plasma for enhanced results.
1. Standard PRP Protocol:
● A 20 cc syringe is filled with 2 cc of 3.8% sodium citrate, which is an anticoagulant.
● A small amount (18 cc) of the patient's blood is taken in that syringe.
● The blood sample is centrifuged at 1800 rpm and the platelet-rich plasma is separated from other components.
● The PRP is collected in a syringe.
● This PRP is injected into the scalp, targeting areas of hair thinning or hair loss.
● The treatment procedure is repeated every 4-6 weeks for 3-6 sessions, depending on the patient's needs and response.
2. Enhanced PRP Protocol:
This method involves adding some topical agents with PRP therapy. A
2023 study has shown that PRP therapy combined with topical biotin recently, and saw palmetto showed better outcomes for Androgenetic alopecia than PRP therapy alone. [4]
The procedure for enhanced PRPT is as follows:
● Initial steps are similar to the standard protocol.
● Specific hair growth factors or bioactive substances, such as vitamin D, biotin, or minoxidil, are added to the collected PRP.
● The enhanced PRP is injected or micro-needled into the scalp, targeting areas of hair thinning or hair loss.
3. Combination Therapy Protocol:
This combination approach aims to enhance the overall effectiveness of the hair restoration treatment and shorten the time for hair improvement. [5]
4. PRP with ACell Protocol:
PRP therapy is combined with ACell, a regenerative medicine product derived from porcine bladder tissue. It is a new advancement in the hair treatment industry. "ACell" means extracellular matrix or acellular matrix with regenerative properties.
The platelet-rich plasma is mixed with ACell to create a PRP-ACell mixture. This PRP-ACell mixture is injected or micro-needled into the scalp, targeting areas of hair thinning or hair loss. However, there has been no solid evidence to show the effectiveness of this treatment protocol.
Precaution: ACell-PRP therapy is contraindicated in individuals with porcine allergies.
5. PRP Maintenance Protocol:
● After completing the initial PRP treatment sessions, transit to the PRP maintenance protocol.
● Schedule maintenance sessions every 4-6 months to sustain the results achieved from the initial treatments.
● The frequency of maintenance sessions may vary depending on the individual's response and hair loss progression.
With ongoing research and technological advancements, different protocols continue to emerge within the field of PRP therapy for hair restoration.
The best protocol depends on various factors, including individual patient needs, medical history, extent of hair loss, and desired outcomes. However, the standard PRP protocol is the most widely used form of PRP therapy.
Here are the indications of platelet-rich plasma therapy for hair treatment:
● Mild hair loss
● Complete hair loss
● Alopecia areata
● Male pattern hair loss
● Before and after the hair transplant surgery
Additionally, PRP therapy can be beneficial for patients who are undergoing hair transplant surgery. Applying PRP directly onto the donor and recipient areas helps improve graft survival rates and speed up healing.
PRP therapy is contraindicated in individuals with:
● Autoimmune diseases
● Skin inflammation
● Uncontrolled diabetes
● Cancer
● Anticoagulant therapy
Moreover, PRP therapy is contraindicated in pregnant and breastfeeding women.
In the ever-evolving field of hair restoration, PRP therapy has emerged as a promising solution for patients. PRP has become an invaluable tool in combating hair loss because it can stimulate hair growth and improve the overall quality of existing hair. By understanding the various protocols available for PRP therapy in hair restoration, doctors can tailor treatments to suit each patient's needs. Whether using different concentrations or frequencies of treatment sessions, these protocols allow for customization and optimization of results.
1. Justicz, N., Derakhshan, A., Chen, J. X., & Lee, L. N. (2020). Platelet-Rich Plasma for Hair Restoration. Facial plastic surgery clinics of North America, 28(2), 181–187. https://doi.org/10.1016/j.fsc.2020.01.009
2. Everts, P., Onishi, K., Jayaram, P., Lana, J. F., & Mautner, K. (2020). Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. International journal of molecular sciences, 21(20), 7794.
https://doi.org/10.3390/ijms21207794
3. Ferrando, J., García-García, S. C., González-de-Cossío, A. C., Bou, L., & Navarra, E. (2017). A Proposal of an Effective Platelet-rich Plasma Protocol for the Treatment of Androgenetic Alopecia. International journal of trichology, 9(4), 165–170.
https://pubmed.ncbi.nlm.nih.gov/29118521/
4. TR, P., TS, R., K, S. K., & Prasanna, H. (2023). A comparative study of topical procapil with platelet-rich plasma therapy versus topical redensyl, saw palmetto, and biotin with platelet-rich plasma therapy in the treatment of Androgenetic Alopecia. Cureus.
https://doi.org/10.7759/cureus.38696
5. Ramadan, W. M., Hassan, A. M., Ismail, M. A., & El Attar, Y. A. (2021). Evaluation of adding platelet‐rich plasma to combined medical therapy in androgenetic alopecia. Journal of Cosmetic Dermatology, 20(5), 1427–1434.
https://doi.org/10.1111/jocd.13935
6. Mercuri, S. R., Paolino, G., Di Nicola, M. R., & Vollono, L. (2021). Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature. Medicina (Kaunas, Lithuania), 57(4), 311.
https://doi.org/10.3390/medicina57040311 
