Thank you for your question.
You submitted a question without a photo and you're asking this question, is your PRP
working. And you describe in the text of your question that you had suddenly noticed significant
hair thinning. And that you went ahead with the PRP treatment and then you underwent a
second one. And then at the time you submitted this question, you had undergone a third one.
You feel that your progress photos do not show improvement. In fact, it appears that
you were getting worse. So you're also asking should this be working out this way, will
this PRP stimulate hair growth, should it already have an effect on your hair growth.
Well, I can certainly help you understand how I counsel patients who have hair loss
in my practice and give you a sense of where this modality has a role and in what kind
of strategy is employed. 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. Hair transplant and managing hair loss has
been a very big part of my practice. In fact, I'm the founder of TrichoStem™ Hair Regeneration
Centers, a system that we developed starting about 7 years ago using PRP and Acellular
matrix to help men and women with hair loss, typically genetic pattern hair loss non-surgically
and leveraging this concept of stem cell based restoration of hair growth going into details
further.
To begin with, the current state of knowledge and slow but steady acceptance of PRP as a
modality for hair loss, I feel like there are still a lot of questions that do remain
unresolved and in medicine, that is often the reality. There are many things that clinically
have benefit where at the basic science level, it is still difficult to fully explain the
cause and effect and predictability. So the art of clinical medicine of course is to treat,
observe and extrapolate based on information and experience.
Well, to go back to what we did with our procedure Hair Regeneration, approximately 7 years ago
when we were doing a lot of transplants, we were using a combination of platelet-rich
plasma and Acellular matrix which is a wound healing material to help improve the graft
survival as well as improving the healing of the donor area, both of which we were always
challenges of hair transplant. Well, a beneficial side-effect was that thinning hair appears
to grow thicker. And that thinning hair that grew thicker occurred long after the procedure
was completed and the material was placed.
So, we took it upon ourselves to explore the opportunity to see if we can have a process
where we can treat hair thinning with a non-surgical approach rather than allow the hair to go
away and then keep doing transplants. Well, to make the long story short, we were very
successful with this. We developed Hair Regeneration and the company called TrichoStem™ Hair
Regeneration. We treat patients from all over the world and what that has met is that we
have so much volume of patients with a wide range of ages and conditions such that I've
been able to really define different sub groups of people on how they respond. Globally speaking,
that the overwhelming majority of our patients have benefit from this treatment sustainable
for 5 years and that is for both men and women. Now within these groups however, there are
going to be certain groups of patients who have more aggressive hair loss patterns. Generally
speaking, these tend to be younger people who have had an early onset so maybe teens
and 20s and who have very rapid progression.
Now when we think about that scenario, we also have to look at what are the known associated
causes or interventions that are available to medically treat hair loss. Well, there
is finasteride, an oral drug that is a DHT blocker of dihydrotestosterone. And then there's
minoxidil. When we think about hair loss, it's very important to understand that hair
loss is still a progressive condition and regardless of what modalities are being used,
there is no current cure for genetic pattern hair loss. There are strategies to slow it
down and prolong the lifespan of the hair and therefore provide longer coverage as well
as the surgical strategy which is to place grafts of hair in places that need in that
area to provide coverage. So it gets down to basically providing coverage.
Now, one of the things that I find that a lot of people who are relatively new to this
world of stem cell based hair loss treatment is that when you don't really do hair loss
management as a long-term strategy, a lot of times people are taking a shotgun approach.
And I'm not saying this is the situation for you but a lot of people who are relatively
new to this are getting excited because they go to meetings, they see good results with
PRP and they decide that they're going to add that to their practice. And then when
people are not doing well, they shrug their shoulders.
The challenge with hair loss management is understanding really what the likely prognosis
is for individuals with a clinical picture. Now you describe a scenario where you had
suddenly had significant thinning. Well, that is unusual unless it's more of typically
the awareness of significant thinning. There's a difference. There's the awareness of significant
thinning as often occurs when people think they have more hair than they do and then
suddenly they realize, wow, they barely have any scalp coverage or they get a view of the
top of their head from a mirror or a photo or something and then feel like, "Oh, suddenly
I lost my hair." A lot of times it has been progressing along but because their view when
they look at the mirror, they can only see a frontal hairline and they look pretty good,
they don't realize how much hair they've lost.
So that being said, when you think about this type of steady downward progression, I would
say that it's important to at least consider, if you're male, to consider a DHT blocker.
Again, without more details about your clinical picture and a clinical picture that I rely
on is age of onset, current age, degree of hair loss, history of other interventions
and the effectiveness of other interventions. The reality is of course there is only a finite
small number of interventions.
So to answer the question about whether or not the PRP is really working requires a more
global detail of your clinical situation. I think that the one thing that I can add
to this that might be helpful to you to ask your physician is whether or not it is advisable
to start adding DHT blocker like finasteride to try to reduce the effect of DHT on your
hair. If you have male pattern hair loss and it is 95% of hair loss, it's genetic pattern
loss then you might be in a situation where a DHT blocker can help improve the longevity
of the hair follicles and maybe give the PRP an opportunity to actually have an effective
stimulatory effect. Again, this comes from a lot of experience and many patients are
reviewing our photos very carefully again, almost 7 years of doing this and treating
patients all over the world. So I think it's worthwhile to discuss this with your doctor
and learn a little about their experience with medical and surgical treatment of hair
loss and take it from there.
So I hope that was helpful, I wish you the best of luck and thank you for your question.
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