Thank you for your question.
You submitted your question without a photo and you’re asking if PRP can restore the
hair quality that was there prior to menopause. And you describe in the details of your question
that you’re 54-years-old and that your hair after menopause became thin and flat. Further
you describe having undergone applying the use of Rogaine which resulted in some blood
pressure issues.
Well, I can certainly assist you in understanding how we treat patients like yourself every
day in our practice. A little bit of background, I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice
in Manhattan and Long Island for over 20 years. I am also the founder of TrichoStem™ Hair
Regeneration Centers. This is a system that evolved from performing hair transplant surgery
using regenerative medicine technology and we have made a significant impact in the treatment
of female pattern hair loss. We have been doing this over 8 years and I’ll describe
for you some of the challenges of your situation and how we manage problems like yours every
day as I mentioned earlier.
So to begin with, it is important to understand that although it’s commonly understood that
there is male pattern hair loss beginning at a very early age, one of the areas that
has been underserved is female pattern hair loss. And it is a generally accepted statistic
that 30% of women under the age of 50 and 50% of women over the age of 50 will have
female pattern hair loss. And although it is important to certainly recognize that the
effect of estrogen being diminished after menopause commonly has an impact on hair growth,
it is also important to understand that this condition is often referred to as androgenetic
alopecia which means genetic pattern hair loss. And what happens with androgenetic alopecia
is the numbers of hairs slowly diminish, the hair slowly becomes thinner as you describe
and eventually it progresses until the volume of hair diminishes. And scalp coverage is
a function of both the number of hairs as well as the thickness of the individual hairs.
Now when we were first doing this treatment Hair Regeneration which we developed using
platelet-rich plasma (PRP) and a material called Acellular matrix, we were first using
this for male pattern hair loss in the context of hair transplant surgery. A very pleasant
side-effect was seen which was that thinning hair became thicker. Now although PRP was
part of this formulation at that time, it was very important that we recognize that
Acellular matrix made a big impact.
Now in the early years back in 2011-2012 when we were first presenting preliminary results
which was fairly dramatic for both male and female pattern hair loss, there was a lot
of skepticism in the medical community particularly amongst hair transplant doctors and dermatologist.
Well, we persisted in developing this and over the course of many years, we’ve essentially
developed a system, a system based on certain key elements of a person’s, what we refer
to as hair loss profile and that includes gender, age, age of onset of hair loss, rate
of progression, degree of progression and other medical treatments that have been applied.
We have patients with female pattern hair loss as young as 16 and 18-years-old. And
we’ve treated patients with female pattern hair loss well into their 70s.
Currently, there has been a significant growth and awareness about the benefits of PRP both
in the medical literature and now in clinical practice. The distinction I would make is
that at the level that PRP is being offered currently is essentially, what I describe
as a shotgun approach. Basically, there is established benefit with PRP treatment of
hair loss but the challenge is sustaining the treatment in a way that will be effective.
A lot of my colleagues are offering treatments once a month, once every 2-3 months and I
find that a lot of patients who come to us find that very difficult to sustain and are
often challenged by seeing the relative benefits. In fact, current opinion amongst my colleagues
is that PRP works 50% of the time.
Well, in our practice, what we developed with Hair Regeneration that we ultimately expanded
into TrichoStem™ Hair Regeneration Centers, are formulations and systems based on those
parameters I described earlier. Generally, we treat patients like yourself where we do
a treatment and then somewhere 15-18 months later, we’ll do another treatment. Between
the two treatments, we have been able to sustain improvement for several years even with a
single injection alone.
Consistently, female pattern hair loss patients have seen improvement in quality and quantity
of hair. On average, we see improvements around 9-10 months but we can see improvements occurring
as early 1-3 months. It’s an ongoing process without the need for multiple injections.
Essentially one treatment followed by what we refer to as the booster treatment after
15-18 months. We follow our patients very closely. So we learn that every 3-6 months
of observation, we have been able to establish systems and processes that reflect the various
types of hair loss even within the broad category of female pattern hair loss.
Now as far as the progression of hair loss, it’s important to understand that hair loss
is basically a genetic program. And therefore, what we’re doing is manipulating the environment
of the hair and we’re stimulating growth. Basically, we’re reactivating hair that
isn't growing, thicken thinning hair and prolonging the lifespan of the hair that by nature of
androgenetic alopecia, the lifespan gets shorter or what’s known as the anagen phase of the
growth cycle.
So at this point, certainly I can also support the issue with the Rogaine where a lot of
people do report blood pressure issues. What we’ve generally done is if someone hasn't
been on Rogaine or has just started using it, we don't usually recommend it as part
of a long-term strategy. When we do this treatment, basically instead of losing hair, people gain
hair and are able to sustain that growth for several years again based on 8 years of data
from patients we’ve been treating from all over the world.
So at this point, I think the question to explore is not so much can you get your premenopausal
hair but how does a treatment strategy using this regenerative medicine technology can
help you manage this progression and maximize coverage for a longer period of time. There
may be some value in exploring concepts such as hormone replacement therapy but that is
contingent on the relative risk you may have for estrogen stimulated malignancies whether
it’s breast cancer or uterine cancer but that’s a question to explore with your medical
doctor.
So at this point, I would advise that you meet with qualified doctors who have extensive
experience with platelet-rich plasma (PRP), platelet-rich plasma with extracellular matrix.
Learn about that individual doctor’s experience and see their before and afters. I think it’s
very important to recognize that a lot of doctors don't have a lot of experience in
this area and are just getting into this. And of course, it is important, we all started
somewhere, we started this 8 years ago and it took us a lot of time and a lot of work
and a lot of analysis to get to where we are now.
So I hope that was helpful, I wish you the best of luck and thank you for your question.