Platelet-rich plasma therapy is a type of regenerative medicine used in a variety of medical fields to support natural healing. PRP treatments have also recently been used to reduce hair loss and promote hair growth. Learn more about PRP treatment and its potential use for hair loss below.
What is PRP Hair Restoration?
Plasma is the liquid portion of your blood. Composed primarily of water and proteins, your plasma acts as a carrier for white blood cells, red blood cells, and platelets, allowing these cells to travel throughout the body. Platelets, also known as thrombocytes, are the smallest cells in the blood. They are responsible for forming blood clots and play other roles in wound and growth healing.1
Platelet-rich plasma therapy involves injections of plasma that has a high concentration of a patient’s own platelets. While initially used by hematologists, this injection has since grown in application to support natural wound healing of ligaments, muscles, tendons, and joints, essentially using a patient’s own healing system. This has become increasingly popular in sports medicine, though other medical fields also using PRP therapy include cardiac and pediatric surgery, plastic surgery, urology, and ophthalmology.2
Wounds are known to be high in proinflammatory markers that can impair healing, and they may also have high protease activity, which inhibits the concentration of growth factors. Platelet-rich plasma acts as a source for growth factors while also encouraging cell division, the formation of new blood vessels, and cell migration.2
Platelet-rich plasma treatment has also been applied to cases of hair loss by injecting platelet-rich plasma directly into the scalp. Some studies have shown successful hair growth, though the exact mechanisms remain unclear, but studies suggest that dermal papilla cells produce a variety of growth factors, including IGF-1, FGF-7, hepatocyte growth factor, and vascular endothelial growth factor. These growth factors are responsible for supporting hair follicles and maintaining the anagen (active growth) phase of the hair cycle. By upregulating these specific growth factors in the dermal papilla, platelet-rich plasma could potentially contribute to a longer anagen phase.2
Other proposed mechanisms suggest that platelet-rich plasma may activate various signaling pathways, like protein kinase and extracellular signal-regulated kinase. This may promote cell survival and prevent cell death (apoptosis) in the scalp. In mouse models, this resulted in a faster transition from the telogen (resting) phase of the hair cycle to the anagen phase.2
Does PRP Work for Hair Loss?
While the exact mechanisms of action are not well known, many early studies do show that platelet-rich plasma may be effective in reducing hair loss and supporting healthy hair growth. In one study, researchers evaluated 11 men ages 20 to 40 with androgenic alopecia who were unresponsive to six months of treatment with minoxidil and finasteride. Using an insulin syringe, researchers injected a total of 2 to 3 cc of PRP directly into each patient’s scalp. This was repeated every two weeks for a total of four injections. Along with a hair pull test prior to each injection, outcomes were assessed after three months using photos, clinical examinations, further hair pull tests, and evaluations of patient satisfaction.3
The results of the study found a significant reduction in hair loss from the first to the last injection. On average, hair count increased from 71 hair follicles to 93 hair follicles, suggesting a mean gain of about 22.09 follicular units per square centimeter. Following the last session, the hair pulling test was negative for 81.81 percent of patients. Patient satisfaction overall was high with an average satisfaction rating of 7.0 on a scale of 1 to 10.3 This suggests that PRP injections to the scalp may help to promote hair growth and strength. However, this study is admittedly small in scale and did not follow up with patients after treatment.
Meta-analyses of platelet-rich plasma for hair loss are also promising. In one meta-study, researchers looked at 13 studies evaluating the use of platelet-rich plasma for treating androgenic alopecia. Preliminary results from these studies suggest that PRP is promising in reducing androgenic alopecia.4
In a similar meta-study, researchers identified seven studies that looked at the use of PRP for hair loss associated with androgenic alopecia. Involving 194 patients in total, the meta-study found that platelet-rich plasma injections contributed to a significantly larger increase in hair number per square centimeter and hair thickness cross-sections per 10−4 mm2.
This suggests that local injection of platelet-rich plasma for androgenic alopecia could contribute to an increase in hair number and thickness with minimal negative side effects.5
However, longer term research is necessary to evaluate the efficacy of platelet-rich plasma in relation to androgenic alopecia. This is because androgenetic alopecia is caused by excess DHT. While PRP therapy may increase hair growth initially, DHT will still be present in the body and can continue to cause hair loss. It is important for consumers to know whether or not PRP therapy needs to be used on a continuous basis as the costs can quickly add up.
Procedure and Duration of Platelet-Rich Plasma for Hair Loss
The exact procedures and duration of PRP treatment for hair loss can vary from treatment center to treatment center. In the smaller study above, the PRP treatment was prepared first by collecting 20 cc of fresh blood from each patient. The blood was suspended in vaccutainers containing sodium citrate. These tubes were then spun in a centrifuge at 1,500 revolutions per minute for six minutes, which concentrates the platelets. The first spin, often called the soft spin, allows the blood to separate into three layers:
- The bottom red blood cell layer (about 55 percent of the total volume)
- A middle platelet-rich plasma layer, also known as the “buffy coat” (about 5 percent of the total volume)
- The topmost acellular plasma layer, also known as the platelet-poor plasma layer (about 40 percent of the total volume)3
The middle layer is collected and placed into a separate test tube for further centrifugation. This second series of spins, known as the hard spin, consists of 2,500 revolutions per minute for 15 minutes. The hard spin allows the platelets to settle to the bottom of the test tube, leaving another upper layer of platelet-poor plasma that is discarded. The lower layer of PRP was loaded in a syringe with calcium chloride as an activator.3
In the study, about one hour prior to the injections, researchers applied an anesthetic cream to the bald area on the scalp, which was also cleaned using spirit, cetavlon, and povidone-iodine. Using an insulin syringe, researchers injected the platelet-rich plasma into the affected area of the scalp with the nappage technique. This involves a series of micro-injections in a linear pattern, set 1 cm apart. Up to 2 to 3 cc of PRP was injected total. This process was repeated every two weeks for a total of four injection sessions.3
The Cost of Platelet-Rich Plasma Injections for Hair Loss
Platelet-rich plasma injections are still relatively new and thus still remains an unproven treatment for hair loss. PRP injections are also considered cosmetic and not necessary to your health. This means that very few health insurance plans will cover or provide any reimbursement for PRP injections, so you are likely stuck with paying for platelet-rich plasma therapy out of pocket. However, if you are considering platelet-rich plasma injections, it may still be beneficial to check with your insurance provider.
Costs for PRP injections for hair loss will vary based on your geographic location, the number of injections required, the quality of the equipment, and the addition of any nutritive components in the injection. A report from San Francisco, CA, suggests costs that range from $900 for one injection to about $2,500 for a set of three PRP treatments.6
Is Platelet-Rich Plasma Hair Treatment a Permanent Solution for Hair Loss?
As mentioned, research on platelet-rich plasma injections is fairly limited. Although clinical studies show the short-term effectiveness of PRP injections in supporting hair growth, the long-term effects of these injections still remain to be seen. Some evidence suggests that you may need ongoing maintenance or touch-up injections at least once per year.7 If you want to learn more, consider looking up reviews left at your local PRP treatment centers.
Platelet-Rich Plasma Treatment Side Effects
Most studies show that platelet-rich plasma injections do not come with any negative side effects. As the platelet-rich plasma comes from your own body, the risk of allergic reaction is significantly reduced. You may experience some discomfort or minor bruising during the blood draw. Similarly, you may experience pain, discomfort, or bruising at the injection sites on the scalp.
In one study involving the use of platelet-rich plasma in patients with alopecia areata, some participants experienced minor pain in the scalp, scalp redness, and forehead swelling in the early recovery period (considered the first 24 to 48 hours). In the late recovery period (the first two months), some participants experienced telogen effluvium. This is a temporary form of hair loss characterized by the sudden thinning and shedding of hair that is usually brought on by some form of stress or trauma that forces hair into the telogen phase. However, this was a rare side effect among the study participants.8
While more research is necessary, platelet-rich plasma injections show promise in reducing hair loss and promoting hair growth. Consult with your doctor to determine if PRP injections may be right for you, and consider using natural DHT blockers to address the underlying causes of hair loss.