Frequency of PRP Hair Loss Injections Varies, but Effectiveness Depends on the Doctor's Experience

By: Amiya Prasad, M.D.

Thank you for your question. You submitted your question without a photo. And essentially, you’re asking in your question about the right frequency in which to get PRP treatments for hair loss. And you state that some places are recommending every 4 weeks, some places are recommending every 8 weeks. You’re asking will the effect wear off if you don't do them more closely together. So I certainly understand this confusion since there is now truly a growing popularity in the use of PRP for hair loss.

A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers. This is is a system we developed 7 or 8 years ago using PRP and a material called Acellular matrix to help men and women with genetic pattern hair loss. And it has been very successful and we treat patients from all over the world. So I certainly can share with you my perspectives on PRP as well as what kind of effect it has on the treatment of hair loss. So to begin with, I think that one of the challenges that faces most physicians today who are relatively new and I would argue that it really accounts for the majority of physicians.

Because frankly, when we were doing PRP for either skin rejuvenation, as well as for hair loss, there was a lot of resistance in a lot of our colleagues and a lot of dismissiveness. Well fortunately, medical literature and some of the dermatology publications have recognized what was already obvious to us that PRP does have benefit at many places particularly in skin and hair loss. The question remains with those who are offering PRP as to what the optimal protocol is. And I think the reason why there’s confusion is because hair loss is not, in terms of hair loss treatment to individuals, it’s individualized treatment. And what I mean by that is you’re dealing with male and female pattern hair loss. You’re dealing with a wide range of age of onset, of degrees of progression and rates of progression. So constantly, I see how people are trying to figure out a “one-size-fits-all” approach to treating hair loss. So to begin with, just a little bit of background on how we developed our treatments, we were using Acellular matrix and PRP to help our patients heal after hair transplant.

We wanted the grafts to heal better and the donor area to heal better. Well, a very pleasant side-effect was that thinning hair became thicker in some of these patients. Over the course of several years, I developed systems and protocols based on clinical examinations and watching our patients every 3-6 months to develop protocols to help both men and women with hair loss. Further at this point in time, I’ve developed a classification system for hair loss because I think that one of the frustrations that we all have when we don't see as a good of an outcome as we expect, we wonder why.

Frequency of PRP Hair Loss Injections Varies, but Effectiveness Depends on the Doctor's Experience

Well we developed a system based on gender, age, age of onset, degree of progression, rate of progression and other medical variables. And I think this is what gets confusing when it comes to just using PRP alone. The literature has already substantiated that PRP has many valuable effects on hair loss.

However, what is not being factored in is the individual hair loss profile. Some people may respond better than others. And currently, the prevailing opinion is that PRP works 50% of the time. I think that the numbers are too small and the experience is too little to really make a statement like that. I think that what you have to understand is that PRP alone has a certain stimulatory effect on hair growth. The mechanisms are going to be much more than what we currently know. But in terms of timing, this is a challenge to the sustainability.

Why do I say that? Because when we see patients who have gotten PRP injections done elsewhere, typically they will have gone for once a month treatment for about 4 months. After which they feel very frustrated because they’re dealing with the discomfort of getting injections most of the time without anesthetic in the scalp and they’re not seeing a horizon as to what the outcome will be and for how long. Basically, it’s very challenging to have a sustainable improvement when you have patients come every month for scalp injections and scalp injections can be very uncomfortable. In our treatment strategy, what we do is we developed a treatment plan based on the individual’s hair loss profile. And what I think is the take home message is that hair loss is managed.

It is not cured, it is managed. And based on the hair loss profile, you use multiple tools to help manage hair loss and you customize the plan. So when we see our patients, we generally will do maybe one injection for the duration for several years. We may do two injections and the second injection called the booster injection anywhere between 12 to 24 months after the first. But for a practice like ours, TrichoStem™ Hair Regeneration treatment center, we treat people from all over the world and it’s impractical to have people come back monthly. So I think that we’ve just been further along in our development in our own internal clinical observations and developments.

And so I would say that, to answer your question, without a full evaluation, I would say that you can to a degree expect PRP to cause short-term stimulation of hair growth. But at the same time, you can look at other variables that also impact the progression of hair loss. So I think this is a discussion to have with the doctor. I think you should ask how much experience do they have doing this.

What’s the outlook whether it’s the 4-week or 8-week plan, what can you expect and what else can you do. I think that very often people just get frustrated and what I want to do is to make people understand that there’s more to this than just frequent PRP injections. Hair loss is more about management and not just a single approach that can work some of the time for some people and not work out for others. There’s much more to this. So I think it’s important that you do more research and learn about platelet-rich plasma and Acellular matrix and protocols and most importantly, learn about the experience of the practitioner that you intend to go with so they can guide you based on their experience.

We’re using our experience going for 7-8 years that has really informed the evolution of our treatment system such that we are where we are today from frontline real time experience. So I hope that was helpful, I wish you the best of luck and thank you for your question.

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