Successfully treating hair loss is a huge concern for millions of individuals. Androgenic alopecia, the most common form of hair loss, effects 40% of women and 80% of men at some point in their lifetime.¹ According to Statista, the global hair loss market is worth 2.8 billion dollars. Most individuals affected by hair loss begin searching for a solution at the first sign, but prospects were dim until recently. Results from recent well-designed PRP studies are bringing hope to millions suffering with hair loss.
Searching for a Hair Loss Cure
Hair loss is a triggering event, especially for women. In western cultures a youthful and attractive appearance can serve to open some doors or keep them shut. Though there are millions of examples of outliers to this generalization, the discriminatory bias in western culture is based on first glance appearance, according to one study.² Outer appearances trigger assumptions about competency and trustworthiness while internally, the changes in appearance often come with thoughts of mortality and/or doubts around self-worth, which has been shown to increase incidences of anxiety and depression.³ The cultural and physiological factors of hair loss cannot be ignored because psychological stress is intrinsically intertwined with physical stress.
The struggle to cure hair loss continues to baffle doctors who espouse an allopathic view of medicine because there doesn’t appear to be a single root cause. The etiology of androgenic alopecia indicates that it is easier to treat with systemic healing of the digestive and nervous systems. But results and protocols for such internal approaches vary as much as each individual’s biochemistry or microbiome, so many patients are opting for lifestyle changes along with PRP injections.
Common Hair Loss Treatments
The lasting results of PRP hair treatments are favored over topical treatments such as 2% or 5% minoxidil. Topical results only last as long as you’re actively treating yourself twice a day for the rest of your life, which is about $300/year or $12,000 over the lifespan of an average case (assuming $25/month and a 40-year disease course). Additionally, minoxidil solutions are not meant for individuals with total baldness or receding hairlines and can come with unwanted side effects like application site irritation, irregular heartbeat, swelling, dizziness, or unusual weight gain.
For those unwilling to utilize twice daily topical treatments, the FDA has approved the use of Finasteride, a 5-alpha-reductase inhibitor. The drug was originally designed to treat men with benign prostatic hyperplasia by reducing dihydrotestosterone levels. The type 2 isoenzyme, 5-alpha-reductase, transforms testosterone into dihydrotestosterone, the androgen at the center of androgenic alopecia. This drug is not recommended for women and may come with lasting side effects such as sexual impotence.⁴
Study Finds Promising Results: PRP Injections for Hair Growth
Platelet rich plasma is a biological treatment for hair growth and is offered regionally from $500-1500/treatment. PRP has emerged as the more economical and biologically gentle procedure. We looked at a 2016 level I study from researchers at Universitat Internacional de Catalunya, Barcelona, Spain. The experiment was designed to test the efficacy of PRP injections for hair growth compared to placebo. Twenty-five patients (12 men, 13 women) were randomized into 2 groups. Each group received a series of 3 injections, at 4 week intervals, with PRP treatment on one side and placebo saline injections on the other. A separate dermatologist assessed each patient 6 months after the initial treatment. Measured outcomes included: average anagen hairs, telogen hairs, hair density, and terminal hair density. Hair density and the anagen to telogen ratio improved significantly in the treatment group 3 months after baseline and terminal hair density improved significantly at the 6-month follow up.
The PRP was prepared by transferring 18 ml of blood to a tube with 2 ml of 3.8% sodium citrate, an anticoagulant. The sample was centrifuged for 8 minutes at 460g to yield 3 ml of leukocyte poor or pure PRP. The final product was activated with .15 ml of 10% calcium chloride then immediately injected into the treatment area. The PRP preparation contained three times the platelet count as whole blood. As a control, the opposite side of the scalp received a 3 ml saline injection.⁵
PRP Growth Factors and Hair Loss
Platelets begin to degranulate and secrete growth factors within 10 minutes of activation by either local collagen or calcium chloride, which is commonly used in research. Transforming Growth Factor and Platelet Derived Growth Factor regulate collagenase secretion and collagen synthesis, benefiting the follicle environment. Epidermal growth factor stimulates angiogenesis to increase local blood flow, nourishing the follicle. Ninety-five percent of the pre-synthesized growth factors are secreted within the first hour and continue to secrete newly synthesized growth factors throughout the next 7 days. The increase in hair follicle size and total anagen hairs can be attributed to the local increase in platelet levels.⁶
The promising results of PRP injections come without lasting side effects. Few patients experience injection site irritation which resolves within 3-4 days and there is no risk of an immune response because the final product is native to the patient’s immune system. The market for PRP injections continues to grow as clinician’s hone in on ideal preparation methods.
- Garg S, Manchanda S. Platelet-rich plasma—an “Elixir” for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investigation. 2017;4:64. doi:10.21037/sci.2017.06.07.[ncbi]
- Cosmetics as a Feature of the Extended Human Phenotype: Modulation of the Perception of Biologically Important Facial Signals. PLOS ONE. 2011;6(10):e25656.[plosone]
- The Psychological Impact of Alopecia. The BMJ. 2005 Oct 22; 331(7522): 951–953.[ncbi]
- Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011;8:1747–53. [ncbi]
- Alves R, Grimalt R. Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia. Dermatol Surg. 2016;42(4):491-7.[ncbi]
- Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author’s Perspective. Journal of Cutaneous and Aesthetic Surgery. 2014;7(4):189-197. doi:10.4103/0974-2077.150734.[ncbi]
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