Second PRP Injection After Hair Transplant: Timing Protocol
Your second PRP injection should be administered exactly one month after your hair transplant surgery. 1
Post-Transplant PRP Protocol
The standardized protocol for PRP administration following hair transplantation follows a specific three-injection sequence 2, 1:
- First injection: At the time of hair transplant surgery (month 0) 1
- Second injection: One month after transplant (month 1) 1
- Third injection: Three months after transplant (month 3) 1
This split scalp injection protocol has demonstrated beneficial effects on hair follicle numbers when performed in conjunction with hair transplantation surgery 2.
Technical Administration for Your Second Session
When you receive your second PRP injection at one month post-transplant, the following parameters should be followed 1, 3:
- Volume: 5-7 mL of PRP per session 1, 3
- Needle size: 30-gauge × 4 mm needle 1, 3
- Injection technique: Point-by-point at 90-degree angle, 2-4 mm depth 1, 3
- Spacing: Injections placed 1 cm apart across mapped areas 1, 3
- Platelet concentration: 1.0-1.5 million platelets per microliter 1, 3
- Activation status: Use nonactivated PRP (shows 31% greater improvement in hair density) 4, 3
Apply pharmaceutical-grade topical anesthetic cream before the injection due to significant pain associated with the procedure 3.
Maintenance Phase After Initial Three Sessions
After completing your initial three-injection protocol (months 0,1, and 3), you will need maintenance injections every 6 months indefinitely to sustain results long-term 1, 4. This maintenance schedule is critical, as some patients experience progressive hair loss 12-16 months after their last treatment if maintenance is not continued 2.
Concurrent Therapy for Optimal Outcomes
The triple combination approach yields superior results compared to PRP alone 4, 3:
- Topical minoxidil 5%: Apply 1 mL twice daily throughout treatment and continue indefinitely 1, 4
- Finasteride: Consider starting ideally one month before transplant and continue as background therapy 1
- PRP injections: Follow the month 0,1,3 protocol as outlined above 1
The combination of PRP with topical minoxidil demonstrates significantly greater efficacy than either monotherapy, with studies showing 57% median increase in terminal hair density versus 48% with minoxidil alone 3.
Expected Timeline and Outcomes
Understanding the timeline helps set realistic expectations 4:
- 2-3 months: Initial improvements in hair density become visible 4
- 2 months: A 25% improvement in hair density at this point predicts sustained response at 6 months 2, 4
- 6 months: Hair density increases by 1.74 times and hair diameter by 14.3 times 1, 4
In the specific context of hair transplantation with intraoperative PRP, studies show that all subjects achieved >75% hair regrowth at 6 months, with reduced fall of transplanted hair during the catagen phase and faster activation of dormant follicles 5.
Critical Pitfalls to Avoid
Several factors can compromise your treatment outcomes 3:
- Skipping maintenance injections: Results will not be sustained without the 6-month maintenance schedule 1, 4
- Using activated PRP: Nonactivated PRP demonstrates 31% greater increases in hair count and density 1, 4
- Inadequate injection volume or platelet concentration: Low platelet concentration or insufficient volume leads to treatment failure 3
- Not combining with topical minoxidil: Monotherapy is significantly less effective than combination therapy 4, 3