Difference Between Activated and Non-Activated PRP for Androgenetic Alopecia
Direct Answer
Non-activated PRP is superior to activated PRP and should always be used for treating androgenetic alopecia—activation reduces efficacy by 31% and should be avoided. 1, 2
Key Differences in Clinical Outcomes
Hair Density and Growth Results
Non-activated PRP produces 31% greater increases in hair count and total hair density compared to activated PRP in patients with androgenetic alopecia 1, 2, 3
In direct comparison studies, non-activated PRP achieved hair density increases of 11.2% at 2 months, 26.1% at 6 months, and 32.4% at 12 months 4
Activated PRP showed inferior results with only 8.1% increase at 2 months, 12.5% at 6 months, and 20.8% at 12 months 4
Mechanism Behind the Difference
Non-activated PRP does not require external activation before injection because the natural wound healing response and tissue trauma from the injection itself provides sufficient activation of platelets 1
Pre-activation with calcium chloride or other activators appears to trigger premature degranulation of growth factors before optimal tissue integration occurs 4
The proliferative activity of hair follicle cells and improvement in hair morphology are enhanced when PRP remains non-activated until the moment of tissue contact 1
Preparation Protocol Differences
Non-Activated PRP (Recommended)
Blood is collected and processed through double-spin centrifugation to achieve 1.0-1.5 million platelets per microliter 2
No calcium chloride, thrombin, or other activating agents are added to the preparation 1, 4
PRP is injected immediately after preparation without additional processing steps 2
Activated PRP (Not Recommended)
After initial centrifugation, a second centrifugation step is performed specifically for platelet activation 4
Calcium chloride or other activating agents are added to trigger platelet degranulation before injection 4, 5
This pre-activation step is the critical difference that reduces clinical efficacy 1, 4
Clinical Implementation
Treatment Protocol with Non-Activated PRP
Administer 3 intradermal scalp injection sessions spaced exactly one month apart 1, 2, 3
Use 5-7 mL of non-activated PRP per session with 30-gauge × 4 mm needles 2
Inject at 90-degree angle, 2-4 mm depth, spacing injections 1 cm apart across areas of hair loss 2
Always combine with topical minoxidil 5% at 1 mL twice daily throughout treatment and beyond for superior outcomes 2, 3
Maintenance injections every 6 months are required to sustain results 2, 3
Critical Pitfall to Avoid
The single most important clinical error is activating PRP before injection—this reduces treatment efficacy by 31% and should never be done. 1, 2, 3 The natural activation that occurs upon tissue contact is sufficient and superior to pre-activation with external agents 1
Expected Timeline with Non-Activated PRP
Initial improvements become visible at 2-3 months, with 25% improvement at 2 months predicting sustained response at 6 months 1, 2
At 6 months, expect hair density to increase by 1.74 times, hair diameter by 14.3 times, and telogen phase hair to decrease by 9.3 times 2
Mild to moderate androgenetic alopecia responds most favorably, with more severe grades showing variable results 1, 2