Treating Diffuse Hair Loss in Women Despite Limits of Hair Transplants, PRP, and Minoxidil

By: Amiya Prasad, M.D.

Thank you for your question! You submitted two photos and you’re asking about minoxidil tablets and the use of platelet-rich plasma for the elusive treatment for women’s hair loss. Well, I can certainly assist you with this question. I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years. I’m also the founder of Trichostem™ Hair Regeneration centers, a non-surgical alternative to hair transplant for men and women with thinning hair. And in fact, we use platelet-rich plasma (PRP) as part of the Trichostem™ Hair Regeneration system. I’ve been doing this work for several years and developing an option and alternative to transplantation and the standard treatments for hair loss so I can certainly give you some perspective on how I manage patients, in particular, women with hair loss.

So, let’s begin with just the minoxidil tablets. Minoxidil was originally a blood pressure medication and it was a letter to the England Journal of Medicine where it was brought to the attention that a side-effect was hair growth. So minoxidil for hair loss for women, currently, is a topical solution of 2% as well as 5 % as an option. Now, minoxidil appears to prolong the growth cycles of thinning hair but it doesn’t stop the progression of hair loss. Now, where does PRP therapy fall in this? Well, PRP alone in my experience and I have a lot of experience, I’ve seen basically is a short term burst of growth with platelet-rich plasma with the injection.

However, platelet-rich plasma alone doesn’t seem to sustain and stop the progression of hair loss. In other words, when I say sustain, I mean sustain growth. We use platelet-rich plasma a lot in our practice. In addition, to hair loss, I use platelet-rich plasma for acne scars, fine lines and wrinkles, dark under eye circles, for keloid scars or hypertrophic scars.

So we have a lot of experience. What we do in our practice is something called Hair Regeneration and this is where we combine platelet-rich plasma with a material called extracellular matrix. This treatment was derived from a system we were developing to help hair transplant healing improve. And from that, the discovery that for male and female patients, we can stop the progression of hair thinning, we can reactivate hairs that are not growing and we can initiate the process where thinning hair sheds out and thick hairs grow in. In our practice, for several years, we have been doing this for more than 5 years of data looking at our patients every 3 months for many years, it appears that more than 90% of women with pattern hair loss will see an improvement. And that has been a tremendous benefit because prior to our system, the only options for women were topical minoxidil and hair transplant surgery.

Treating Diffuse Hair Loss in Women Despite Limits of Hair Transplants, PRP, and Minoxidil

And the challenge with hair transplant surgery for women is that when you have more diffuse thinning, there’s still a lot of hair and when you place the grafts, it takes a lot of hair to create density as well as to compensate for the natural loss of existing hair from the area where the transplant was being performed. It’s often referred to as collateral damage where we know that in a given area, you have to make hundreds of little holes in order to place the grafts. Well, those holes are placed where there is existing hair. With Hair Regeneration, those existing hairs grow thicker.

So I think that platelet-rich plasma alone is not adequate to treat pattern hair loss and it’s not just from our experience. Patients come to us from all over the world and describe platelet-rich plasma treatments that they received in different scenarios. Many come to us after they were going to monthly injections and after a few months, they felt like they didn’t see an end point and where these injections would end. If you had to go to a set of injections every month into the scalp, that’s difficult to sustain. With our treatment, we do one injection, we follow our patients every 3 months and then for a subset of patients, we’ve been seeing a benefit in doing another injection in 12-15 months. Every patient is an individual and there are definitely some trends but we are very meticulous about our follow-up. We see everybody every 3 months. We follow them with digital photography and microscopy to really get the details on how they are responding.

In our practice, most women see some significant improvement that they can actually see the improvement by 9 months and often after 12 months but in a lot of cases, we actually have patients, women, who have short hairs growing across the frontal hairline in the first few months. It just depends on that individual’s pattern. So I think you need to learn more about your options. I would not say that PRP is necessarily the right thing. In fact, with the photos you submitted, it’s hard to determine whether or not you really have significant hair loss but since that photo is just one moment in time, you may have more hair prior but a proper evaluation is necessary before diagnosing pattern hair loss. It’s very common for women to have something called telogen effluvium which often a stress-related hair loss marked by a lot of shedding. So I think you should meet with a doctor and get a proper diagnosis and then learn more about the options I described and hopefully you’ll be able to find a solution that works for you.

So I hope that was helpful, I wish you the best of luck and thank you for your question!.

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