Is Platelet Rich Plasma (PRP) safe? Yes, PRP is recognized as a safe treatment, since we use your own blood platelets. As a result, there is no risk for disease transmission and there are no reported major side effects with PRP in healthy individuals.
What is Platelet Rich Plasma (PRP)? Platelet Rich plasma is a portion of the blood containing a low concentration of red and white blood cells and high concentration of platelets, typically five times the body concentration. The plans portion of the blood ins the clear portion which is also separated out, so that the remaining portion of the clear plasma contains a high concentration of platelets. Platelets are at the beginning of the immune response to healing and have a large amount of growth factors to stimulate metabolism, promote healing and active stem cells. The belief is that the concentration and also activated blood platelets when injected supply a high concentration of the growth factors and stem cell stimulating chemicals to promote hair growth.
What is ACell? ACell is a protein matrix derived from pig bladder that promotes healing and regeneration by first creating a scaffold for stem and regenerative cells to cling to and also by directly stimulating stem cell activity. The stem cells in balding scalp are often present, but the trigger to divide and produce hair cells becomes lost. The ACell acts as a trigger to the stem cells and thus creates increased hair density and volume.
Who is a poor candidate for PRP? Patients with bleeding problems including those with clotting deficiencies and low platelet counts, recent history of cancer and recent blood infections known as sepsis represent absolute contraindications to the procedure, until the condition stabilizes. Relative contraindications are noted in people who smoke, have unstable low blood pressure and use chronic cortisone therapy.
Who is poor candidate for ACell? Individuals with an allergy or hypersensitivity to pork or pig products.
How many times do I need to come in for a treatment? The protocol varies depending on what it is being used for. It may be used in one treatment and depending on results may be repeated at 3 to 6 months. In addition, PRP can be used at the time of hair restoration surgery to promote healing of the recipient graft and donor sites.
How long does PRP work? The typical results appear to last 12 to 15 months, so repeat treatments may be warranted. Remember that the DHT hormone continues to affect the follicle, but PRP is creating a healing and rejuvenating effect. As the growth factors are used up, the effects of DHT and aging will eventually overcome the gains from the PRP. Every case is different, but through followup evaluations we are able to track hair density and hair shaft diameter to determine if repeat PRP injections are required. A recent discussion in our quarterly professional hair forum stated that the effects of the PRP may be increased to 2 to 3 years with he addition of ACell. More research is required to better define and delineate.
How Painful is PRP therapy? The procedure is relatively painless after a ring block of Lidocaine and nerve blocks are completed. Oral sedation can be administered just prior to the procedure for anyone to relieve anxiety and to promote comfort - we do recommend oral sedation and if this completed, a driver will need to be present for the ride home. Local topical anesthesia with Lidocaine is also used to numb the scalp prior to the procedure. The rest of the procedure is relatively painless.
How much downtime is there after a PRP/ACell procedure? None, but we recommend limiting both strenuous exercise or physical work for 48 hours after the procedure. The needle injection sites will clear and likely be invisible within 48 to 72 hours and there is minimal associated swelling or pain afterwards.
How effective is PRP? The overall literature concerning PRP as a effective tool for thinning hear is increasing. Two studies last year showed evidence of improvement of 50 to 70% in some individuals. It is felt that those patients experiencing miniaturization of the hair follicle without a significant amount of hair density loss related to the death of actual hair follicles are the best candidates. Those with complete or near complete balding may not be candidates for PRP, since the chance for significant improvement may be low. Each person is different and discussion concerning the application of PRP can be determined at the time of the hair consultation. The effectiveness may increased and prolonged with the applications ACell along with the PRP.
Should PRP be used at the time of hair transplantation? Since PRP has concentrated growth factors that are activate and released, it is our opinion that the application of PRP after the extraction of the hair follicles from the donor site and prior to implantation can assist with graft survival and overall yield. For those individuals that have some residual thinning hair, especially with miniaturized hair shafts are recommended to have the PRP combined with the hair transplantation to maximize results and healing. The PRP may also decrease the amount of shock loss of miniaturized hairs around the implanted hair grafts.
What is the main disadvantage to PRP? Platelet Rich Plasma (PRP) is a portion of your own blood. It stimulates your immune system to improve the metabolism in and around the hair follicle, promote healing and also facilitate stem cell activation. Some patients have experienced some discomfort after the procedure for a few days and Tylenol is recommended (not and anti-inflammatory). Others have noted some mild facial swelling, especially if concentrated around the frontal hairline.
Should PRP be combined with ACell (by Matristem) or be used alone? There is growing support and recognition in the hair restoration industry that ACell which is a protein matrix that works by promoting healing and stem cell activation may be offer more results when combined with PRP, than with PRP alone. Cell is derived from pig bladder and this has turned some patients away from having it injected along with the PRP. Cell is safe and does not have a high side effect profile. Recent forum discussion and articles point to the need to combine with PRP with ACell to maximize results. More research will be required to definitively describe effectiveness and also better define protocols.