What is the comparison between Platelet Rich Fibrin (PRF) and Growth Factor Concentrate (GFC) for hair regeneration?

Comparison of Platelet Rich Fibrin (PRF) vs Growth Factor Concentrate (GFC) for Hair Regeneration

PRF and GFC are essentially the same therapeutic approach—both are autologous platelet concentrates that deliver growth factors for hair regeneration, with GFC being a marketing term for PRF/PRP preparations rather than a distinct treatment modality. 1

Understanding the Terminology

• GFC tubes contain 9-10 mL of peripheral blood without anticoagulants or additional substances, processed via centrifugation to separate blood components—this is identical to PRF preparation methodology 1

• Both PRF and GFC achieve final platelet concentrations of 1 to 1.5 million platelets per microliter, which is the recommended therapeutic range established by the Indian Association of Dermatologists 1, 2

• The active components are identical: concentrated platelets, plasma proteins including fibrin as a scaffold, and growth factors like TGF-β that promote matrix remodeling 1

Clinical Efficacy Evidence

PRF Outcomes for Androgenetic Alopecia

• PRF demonstrates statistically significant improvements in hair density at 2 months, 3 months, and 6 months follow-up, with 25% improvement at 2 months predicting sustained response at 6 months 3

• PRF is particularly valuable for managing mild androgenetic alopecia cases and shows beneficial effects on hair follicle numbers when combined with hair transplantation 3

• PRF functions as both scaffold and reservoir for growth factors with prolonged release, offering theoretical advantages over standard PRP through sustained growth factor delivery 4

• PRF may be more cost-effective than PRP while maintaining comparable or superior efficacy 4

Treatment Protocol Standardization

• The recommended protocol is identical whether termed PRF or GFC: 3-5 treatment sessions spaced 1 month apart during the initial treatment phase 3, 1, 2

• Dosing specifications: 5-7 mL per session, using 0.05 to 0.1 mL/cm², with injections 1 cm apart at 90-degree angle and 2-4 mm depth 3, 2

• Maintenance phase consists of 1 session every 6 months after completing the initial treatment series 3, 2, 4

• Use 30G × 4 mm needles to minimize discomfort, and pharmaceutical-grade topical anesthetic cream is strongly recommended due to significant injection pain 3, 2

Optimizing Treatment Outcomes

Combination Therapy Approach

• Combination of PRF/GFC with topical minoxidil 5% shows the highest efficacy compared to either treatment alone, with superior increases in hair density 1, 2, 4

• Complex therapy should be initiated as early as possible for best results, with background therapy of minoxidil, finasteride, and multivitamin supplements 3

Factors Predicting Treatment Success

• Higher platelet concentrations correlate directly with greater hair density, follicle diameter, and terminal hair density improvements 1

• Treatment failure commonly results from: low platelet concentration, inadequate injection volume, or insufficient treatment frequency 1

• Individual genetic factors significantly influence response to any platelet concentrate therapy 1

Monitoring Treatment Response

• Evaluate efficacy using multiple objective methods: standardized before-and-after photographs, trichoscopy for hair density and diameter assessment, hair pull tests, and patient self-assessment questionnaires 2, 4

• Key response indicators include: increased hair density per cm², increased hair shaft diameter, decreased proportion of telogen hairs, improved patient satisfaction scores, and negative hair pull test after treatment 2, 4

• Evaluate treatment response after one year of combination therapy to determine need for continued maintenance 2

Critical Clinical Pitfalls

• The evidence base for PRF specifically remains limited—most high-quality studies evaluate PRP, and standardized protocols for PRF are still needed to avoid the methodological pitfalls seen in PRP research 3

• Activation of platelet concentrates is NOT required for androgenetic alopecia treatment 2

• Relapse may occur 12-16 months after last treatment in some patients, requiring re-treatment 5

• Inadequate follow-up to assess treatment response leads to suboptimal outcomes—regular monitoring is essential 2