Platelet Rich Plasma
Benefits & Limitations
One of the more exciting uses of Platelet Rich Plasma (PRP) injections are their extended use for alopecia treatments in patients. Though they are generally used in combination with other treatments for the hair it has been shown to work as well as a stand alone treatment option. The evidence based science behind these results correlate to the various growth factors and concentration of stem cells within PRP.
Within each dormant hair shaft there are stem cells responsible for the growth cycle of hair, it does not contain pigment or melanin but is responsible for the production of hair follicle cell within the hair matrix. Platelet Rich Plasma (PRP) when introduced to the scalp will trigger a number of biological activities through the release of glykoproteins thus activating specifically KGF/FGF7 Â Keratinocyte growth factor. KGF/FGF7 is a paracrine mediator of epithelial cell growth including hair. CD34+Cells and other cytokines (Alpha SDF-1?) attract additional stem cells to the damaged follicle and regeneration site. There are other growth factors released within the PRP and they also help in differentiation, proliferation, and inducing other intracellular events. It is believed that these various biological activities and events will activate a dormant hair follicle and allow for new hair growth.
So why doesn’t PRP work for all patients suffering from thinning hair or patterned baldness? There are medical conditions and reasons for thinning and balding hair and there are certain hair follicles where the stem cells are permanently damaged. Differing delivery methods concerning PRP and the concentration of PRP can influence outcomes as well. Typically platelet rich plasma (PRP) for alopecia treatments are injected using micro needling devices, these devices are used to force the solution to the proper depth for tissue interaction. Since PRP can only be absorbed through the skin through the pores of the skin and hair shafts it is an inexact method of delivery.
The second issue with PRP deals with the variability of platelet concentrations within PRP. Single spin methods in preparing PRP are inferior to the dual spin units in preserving CD34+Cells and in the concentration of platelets needed for differentiation, regeneration, angiogenesis, and new cell proliferation to begin. The FDA Approved dual spin method for harvesting blood platelets yields over 6 times more than other methods of harvesting platelets. Other factors affecting successful outcomes are the handling of the PRP and in proper diagnosis of the type of hair loss the patient is suffering from.
The practical side of using PRP in alopecia treatments is that there are a number of hair follicles that are dormant despite their condition. Platelet Rich Plasma has been shown to initiate hair growth for these dormant cells due to the biological nature of the treatment and interaction of stem cells within the hair follicle. Therefore, whether used in combination with hair transplantation, use of medications (i.e. Minoxidil), cold level lasers (LLT), or other type of alopecia treatments being used there is a benefit of using PRP in combination with other therapies or by itself.
What is Platelet Rich Plasma
Platelet Rich Plasma (PRP) is blood plasma that contains a concentrated source of autologous platelets, growth factors and or cytokines present in PRP include:
- Connective tissue growth factor (wound healing)
- Insulin-like growth factor 1 and 2 (ILGF)
- Vascular endothelial growth factor (organ regeneration)
- Epidermal growth factor (wound healing/aesthetics) (EGF)
- Interleuken 8 (ILGF)
- Fibroblast growth factor (wound healing/aesthetics)
- Keratinocyte growth factor (wound healing/aesthetics)
- Transforming growth factor beta (TGF)
When activated, platelets release adhesive glycoproteins and various growth factors. These proteins and growth factors interact with present cells residing in tissue such as skin fibroblasts, endothelial cells, and osteoblasts. Once these proteins and growth factors bind to cellular receptors, they activate intercellular events which help mediate:
- New cell proliferation
- Migration of stem cells to area
- Production of extracellular matrix proteins
Regeneration occurs within the tissues and fibrils ensues. Growth and repair continue for up to (1) month after these injections, the result is new, healthy tissues that is permanent. Chronic pain many times is eliminated and surgeries are either deferred or in many cases eliminated.
Why is Platelet Rich Plasma so popular?
PRP promotes local tissue growth and repair of damaged tissue and is natural and nontoxic so there is no serious patient safety issues. PRP is also convenient where these treatments can be given within your practice and is simple to use where there is no need for external materials for the injection. Platelet Rich Plasma injections allow you to treat problem areas such as the forehead, lower/upper lid, and neck areas that fillers and Botox injections do not allow for correction. Finally, as compared to these other injectible solutions PRP is not synthetic (Dermal Fillers) or a bacteria (Botulinum Toxin) that have a limited life span. PRP promotes and creates new permanent soft tissues based upon what your body dictates as damaged skin needing repair.