There are many different types of hair loss. The causes of hair loss can be via a variety of factors such as family history / genetics, hormones, lifestyle, and stress. To treat hair loss, it is necessary to find the underlying issue or medical condition that is causing the hair to thin and fall out. Consulting with a board-certified dermatologist is the best way to diagnose the specific type of hair loss and formulate a treatment plan.
This common type of hair loss is often refered to as male patterned baldness in men and female pattern hair loss in women. This type of hair loss is gradual. In men hair loss occurs in the temporal areas and is caused by androgen-mediated follicular miniaturization. This is due to an inherit sensitivity to the male hormones which are called androgens. In women diffused thinning occurs around the crown area. Women do not experience the horseshoe baldness which occurs in men instead the entire crown experiences diffused thinning.
This is caused when tension is constantly placed on the hair, resulting in damage of the follicle. This type of hair loss can be caused by hair extensions, perms, and wearing hairstyles that apply constant tension to the hair. Unfortunately, some popular styles like messy top knots, braids and high ponytails pull on the hair which will damage the hair follicles, over time.
Before & After photo: Male, Alopecia, after 2 treatments
Stress causing the loss of hair
There are three types of hair loss that is associated with stress, they are Telogen effluvium, Trichotillomania, and Alopecia Areata. With Telogen effluvium, stress causes the hair follicles to become dormant (enters a resting process), and after three months in the resting period the hair falls out. This stress results in reduced hair growth and thinning. Alopecia areata is an autoimmune condition where the immune system attacks its own hair follicles. Trichotillomania is an uncontrolled and impulsive disorder of pulling one’s hair which results in the hair being pulled from the follicle. It can take six weeks to six months from a stressful event for hair loss to occur. Stress related hair loss can be permanent if it’s not treated in its early stages. In some cases, there can also be scar related issues such as cicatricial alopecia – where damaged skin may impact hair growth, or prevent regrowth of new hair.
If you’ve noticed that your hair is thinning or excessively shedding it is important to visit a board-certified dermatologist immediately. Getting treatment for hair loss in its early stages before bald spots appear can help minimize overall hair loss and increase the odds of a treatment’s efficacy. Hair loss can seem overwhelming which is why it is necessary to consult with a dermatologist who will assess your condition and explain all of your treatment options.
PRP Treatment for male and female patients
Before & After photo: Male, age 35, PRP hair loss – 3 months, after 4 treatments
PRP is a non-invasive injectable treatment for hair loss which uses the patient’s own blood. A small blood sample is taken from the patient in a special tube which is then placed in a centrifuge and spun for ten minutes to separate the plasma from red blood cells. The separated plasma contains the PRP (platelet rich plasma) which is injected into the scalp to treat hair loss. The plasma that is separated during this process contains growth factors which are a mixture of proteins and cytokines. The proteins and cytokines both play an important role in stimulating the hair follicles to generate hair growth. The growth factors found in PRP are known to produce the following effects.
- Epidermal Growth Factor (EGF) regulates cell growth stimulating keratinocyte and fibroblast production.
- Transforming Growth Factor (TGF) promotes the growth of new blood vessels.
- Vascular Endothelial Growth Factor (VEGF) stimulates the growth of blood vessels from existing vasculature.
- Fibroblast Growth Factor (FGF) promotes granulation during tissue repair.
- Platelet-Derived Growth Factor (PDGF) Promotes collagen growth and proteoglycan synthesis also attracting macrophages and fibroblast to the treated area.
- Interleukins, Macrophages, Keratinocytes, Endothelial Cells, Lymphocytes, Fibroblasts, Osteoblasts, Basophils, and Mast Cells activates fibroblast differentiation and also induces collagen and proteoglycan synthesis for healthy cell production and repair of damaged tissues.
- Collagen Stimulating Growth Factor stimulates granulocyte and macrophage proliferation for the growth of health tissue and blood cells.
- Keratinocyte Growth factor (KGF) Keratinocyte migration, differentiation and proliferations may optimize conditions for healing and generation of new skin.
PRP is the only non-invasive procedure available at this time for hair loss. Before PRP, surgical hair transplantation was the only available treatment option for those suffering from hair loss. Hair transplantation is an expensive and painful process which removes hair follicles from the back of your scalp and transplants them in areas of the scalp with hair loss. Although today there are several other hair transplantation options, PRP injections are a holistic, non-invasive treatment for hair growth and regrowth.
The ideal PRP candidate are patients experiencing excessive shedding, hair loss without balding both male and female. And while it can combat early signs of male or female pattern baldness, patients with excessive balding are not the ideal PRP candidates. Patients with hair loss who have their hair follicles intact are good candidates for PRP. PRP is safe for the vast majority of patients, except if you have any blood or platelet disorders, active infections, viral outbreaks (such as shingles) or are on steroids or blood thinners (such as Coumadin). Patients who are pregnant should also not consider PRP until after they give birth.
PRP Risks and Side Effects
PRP is a safe treatment with no side effects. There is no limit to the number of treatments a person can have. However, depending on the severity of the condition and treatment combination; it can take up to six months to see results. I recommend four consecutive monthly treatments of PRP injections followed by maintenance treatments every four to six months to maintain the best results. The hair growth cycle grows hair at approximately 1.25 cm a month. The results of PRP are continually evaluated, though the results are best judged after 6 months.
There may be some tenderness on the scalp after injections and some patients report having a slight headache or pressure in the treated area. You should also limit sun exposure to the treated area for forty-eight hours. after the treatment. You can take Tylenol to relieve any discomfort after the treatment. Hair should not be washed for twenty-four hours after treatment. You can resume the use of hair care products and treatments within twenty-four hours after treatment. No harsh chemicals, hair coloring or perming should be done within seventy-two hours of PRP hair treatment. You should avoid heavy exercise for twenty-four hours.
34 year old female, PRP to scalp for hair loss – after 3 treatments
Do not use blood thinning agents such as vitamin E, vitamin A, Ginko, Garlic, Flax, Cod Liver Oil, niacin supplements, and essential fatty acids at least one week after your treatment. Avoid alcohol and smoking for seventy-two hours. Avoid Aspirin, Advil, Motrin, Ibuprofen, Naproxen, Voltaren and other anti-inflammatory medications for five days after your procedure (if possible).
The results of PRP treatments can be maintained by taking oral prescription medications such as Finasteride (Propecia) or Spironolactone. In addition, taking over the counter vitamins such as Viviscal and Nutrafol have been shown effective in hair growth. Finally, topical Minoxidil used daily, and the Laser Cap used three days a week will also promote and maintain hair growth.
- Finasteride (Propecia) is an FDA approved drug for the treatment of androgenetic alopecia (male patterned baldness). DHT (dihydrotestosterone) is a male androgenic hormone responsible for shrinking the hair follicles. This shrinkage of the hair follicles ultimately leads to hair loss and eventually baldness. Finasteride works by lowering the DHT levels in the scalp and promoting new hair growth.
- Spironolactone is an FDA approved drug prescription medication which treats androgenetic alopecia in women by slowing down the production of male sex hormones (androgens). Spironolactone is for females with hair loss due to hormonal imbalance it works by obstructing the androgen (male hormone receptors) which control the dihydrotestosterone (DHT) and testosterone levels, which can lead to different degrees of hair thinning or permanent hair loss.
- Minoxidil is an FDA approved topical treatment for hair loss. Minoxidil comes both as a solution or foam base which needs to be applied to the scalp at bedtime. Minoxidil can be used to compliment PRP hair treatments and can be used long term to sustain the results achieved from PRP.
- Viviscal is a vitamin supplement formulated with essential vitamins such as Biotin, Vitamin C, and B Vitamins in addition to other propriety vitamins which have been clinically proven to thicken and help hair growth.
- The Lasercap is a prescription at home FDA approved device which uses low light therapy to stimulate hair follicles. The device is worn for thirty minutes three times per week. I often recommend this device in combination with PRP treatments. The Lasercap is worn at home and is an excellent complement to any hair loss treatment.
- Nutrafol is a propriety blend of vitamins clinically proven to restore hair growth. Nutrafol comes both as an oral vitamin supplement in addition to a topical vitamin enriched solution to stimulate hair growth. The vitamin and nutrient formulation in Nutrafol such as saw palmetto prevents the conversion of the male androgen hormones into DHT (dihydrotestosterone) which is responsible for baldness.
Whether finding new bald patches, or experiencing thinning hair, find out what options you have and contact board certified dermatologist Dr. Michele Green at her NYC office at 212-535-3088 or contact us online today.