Is Platelet-rich Plasma (PRP) therapy effective for treating hair loss?

PRP Therapy for Hair Loss: Effectiveness and Recommendations

Platelet-rich plasma (PRP) therapy is effective for treating androgenetic alopecia (AGA) and can be considered as a treatment option, with the best results achieved when combined with minoxidil rather than as monotherapy. 1

Mechanism of Action

PRP works through growth factors in platelets' granules that bind to the bulge area of hair follicles, promoting:

• Increased hair density (up to 31% improvement)
• Increased hair diameter (up to 14.3 times)
• Decreased proportion of telogen (resting phase) hairs
• Enhanced proliferative activity of hair follicle cells
• Improved hair morphology 1, 2

Effectiveness by Treatment Approach

Most to Least Effective:

1. PRP + Minoxidil combination (highest efficacy)
2. PRP alone
3. Minoxidil alone
4. Placebo 1

Studies show that complex therapy combining PRP with minoxidil is more effective than minoxidil monotherapy, with statistically significant increases in hair density 1. The average patient satisfaction score is 7.29 on a scale from 0 to 10, indicating high satisfaction with treatment results 3.

Treatment Protocol

The most effective protocol based on current evidence:

• PRP injections: Three sessions at monthly intervals
• Administration: Intradermal injections to the scalp
• Activation: Non-activated PRP appears to have greater efficacy than activated PRP 1
• Combination: Best results when combined with daily topical minoxidil 5% 1

Clinical Effects

Patients can expect:

• Improvement in hair density (64% of patients report this)
• New hair growth (57%)
• Less hair loss (48%)
• Improved hair quality (46%)
• Increased hair thickness (38%)
• Enhanced hair sheen/luster (27%) 3

Important Considerations and Caveats

1. Treatment durability: Some patients may experience relapse after 12-16 months, requiring re-treatment 4

2. Standardization issues: Current evidence shows variability in:

   • Preparation methods
   • Treatment protocols
   • Injection techniques
   • Activation methods 1

3. Patient selection: PRP appears to be more effective in:

   • Earlier stages of hair loss
   • Mild to moderate AGA
   • When combined with other treatments 1, 5

4. Follow-up timing: Improvements are typically noticeable at:

   • 2-3 months: Initial improvements
   • 6 months: Maximum benefit 1

5. Safety profile: PRP has minimal side effects, with no major adverse effects reported across studies 1, 3, 6

Platelet-Rich Fibrin (PRF) as an Alternative

PRF, a second-generation platelet concentrate, shows promising results:

• Safe, cost-effective adjuvant treatment for AGA
• May have theoretical advantages over PRP
• Particularly effective in mild cases
• Can be combined with microneedling for enhanced results 1

While PRP therapy shows promising results for hair loss treatment, it's important to note that the evidence base still has limitations including variability in preparation methods and treatment protocols. For optimal outcomes, combining PRP with established treatments like minoxidil appears to provide the greatest benefit for patients with androgenetic alopecia.