“It has certain blood growth factors, and if you get it near hair follicles, it shows reversal of hair loss,” says Michael Beckenstein, MD, a Birmingham plastic surgeon. “It gets the follicles more healthy, so to speak.”
Studies on the use of PRP for follicle stimulation do not yet exist. “That’s down the road, but it’s definitely working,” Beckenstein says. He’s performed the procedure on sixteen patients since January, and 100 percent have shown improvement.
The treatments rely on the patient’s own blood as the source for the platelets. Blood is drawn and centrifuged on-site to separate out the platelet rich plasma (PRP). Right before application, a platelet activator/agonist activates clotting to produce a gel.
“There are different levels of concentrations,” Beckenstein says. High-end machines create platelet concentrations between eight and twelve times that of native plasma. Cheaper grade machines may produce concentrations as low as two to four.
Because the platelets derive from the patient’s own blood, allergic reactions are not a concern. “That means everybody is a candidate for PRP, if they’re healthy,” Beckenstein says. Those who might not qualify include patients with a history of heavy smoking or drug and alcohol use, and those with medical diagnoses such as thrombocytopenias, acute and chronic infections, chronic liver disease, and metabolic and systemic disorders.
Some practitioners apply the plasma gel to the scalp and then use a device similar to a tattoo needle or a wheel with tiny needles to stimulate a low-grade inflammatory response on the skin. Called micro-needling, the process loosens the skin junctions to allow substances to get through the tight, interlocked cells of the skin.
“However, the best way is to inject the PRP into the hair follicle,” Beckenstein says. He numbs the scalp. “About 4mm in is the hair, and we go in 2 to 3 mm. With injection, you can control the application that much better and it’s not so messy.”
Initially, PRP therapy patients receive three treatments totaling about $1,000 set six to eight weeks apart. “You see results about three to six months out,” Beckenstein says. No follow-up treatments are necessary because of the advancements in home products and devices now available. “You have to keep treating it, because hair loss is a lifelong process, like arthritis,” Beckenstein says. “It’s always going to get worse.”
The term hair loss is actually misleading, Beckenstein says. “It’s not about hair falling out. The follicles are there, they’ve just gone dormant.” But as the follicles fall dormant, the shaft gets thinner and thinner. Newer treatments, like low-level laser therapy, work toward reversing the thinning by stimulating the shaft to thicken, which gives the appearance of more hair.
Beckenstein has offered low-level laser therapy for four years. “The nice thing about the laser is there are no side effects,” he says. “All you do is sit under a laser that looks like a hairdryer in a salon, but not that big. You can work on a laptop, you don’t sweat, and it doesn’t even mess your hair up.”
Treatments run twice a week for half an hour for three months. The next three months, the treatments drop to once a week. The final three months, patients come in only once or twice a month. Boosters are needed annually with home products to augment the effect.
Exactly how the laser rejuvenates the shafts is unknown. “They were treating rats for some other reason and the rats started growing hair,” Beckenstein says. The theory is that under the laser, metabolic activity and blood flow to the tissue increases, and that energy consumption kicks the shaft into a healing process.
“People know that when they have an inflammatory response, things rush in to grow and repair that area, so it makes sense that the inflammatory response caused by the laser starts a hair repair process,” Beckenstein says.
He uses computer analysis to measure hair shaft diameter of his patients and gain quantitative results. Every patient has seen a positive effect on the shafts and in 75 to 80 percent, the hair loss slowed.
Before low-laser and PRP therapies, patients with thinning hair, who did not yet qualify for hair transplants, had zero options. “Especially women and younger patients,” Beckenstein says. “That’s what’s so exciting. Hair replacement is rapidly changing from even a year ago. We can now offer patients a menu of options.”