PRP Treatment Frequency After Hair Transplant
For patients undergoing hair transplant surgery, administer PRP as three intradermal scalp injections at the time of transplant (month 0), month 1, and month 3 post-transplant, followed by maintenance injections every 6 months indefinitely to sustain results. 1, 2
Initial Treatment Protocol Post-Transplant
The split scalp injection protocol specifically designed for hair transplant patients involves:
- First injection: At the time of hair transplantation (month 0) 1
- Second injection: One month after transplant 1
- Third injection: Three months after transplant 1
This differs from the standard androgenetic alopecia protocol (which uses consecutive monthly sessions) because the surgical trauma of transplantation creates an optimal window for PRP to enhance follicle survival and integration. 3
Maintenance Phase
After completing the initial 3-session protocol, maintenance injections every 6 months are required to sustain results long-term. 2, 4 This is critical because discontinuation results in loss of gains—patients who stopped treatment experienced progressive hair loss starting at 12-16 months after their last injection. 5
Technical Administration Details
Each treatment session should deliver:
- Volume: 5-7 mL PRP per session 1, 4
- Needle: 30-gauge × 4 mm 4
- Technique: Point-by-point injection at 90-degree angle, 2-4 mm depth, spacing injections 1 cm apart across mapped areas 4
- Preparation: Use manual double-spin method targeting 1.0-1.5 million platelets per microliter 2
- Activation: Do NOT activate PRP—nonactivated PRP demonstrates 31% greater increases in hair count and density 2, 4
Concurrent Therapy for Optimal Outcomes
The evidence strongly supports combination therapy rather than PRP alone:
- Topical minoxidil 5%: Apply 1 mL twice daily throughout treatment and continue indefinitely 2, 4
- Finasteride: Consider adding as background therapy, ideally starting 1 month before transplant 1, 6
- The triple combination (PRP + minoxidil + finasteride) represents the most effective evidence-based approach 4, 6
Expected Timeline and Outcomes
When PRP is used with hair transplantation:
- Immediate benefit: Preserving grafts in PRP before implantation increases graft uptake and hair thickness compared to saline preservation 3
- 2-3 months: Initial improvements in hair density become visible 2, 4
- 6 months: Hair density increases by 1.74 times and hair diameter by 14.3 times 2, 4
- >75% hair regrowth: All participants in PRP-treated transplant groups achieved this by 6 months 3
Critical Pitfalls to Avoid
Do not use activated PRP—activation reduces efficacy by 31% compared to nonactivated preparations. 2, 4
Do not skip maintenance injections—four patients who discontinued treatment after initial success experienced relapse at 12-16 months, requiring re-treatment. 5
Do not use PRP as monotherapy—combination with topical minoxidil 5% is significantly more effective than PRP alone. 2, 4
Emerging Alternative: PRF
Platelet-rich fibrin (PRF) is emerging as a potentially superior alternative with theoretical advantages including lower cost and easier preparation, while maintaining similar efficacy and safety profile. 2, 4 The same timing protocol applies if using PRF instead of PRP. 1