Thank you for your question.
You submitted a question without a photo but you’re asking essentially a question trying
to figure out what’s the best method of delivery of PRP. You’re asking is there
evidence to support whether it’s better to do PRP with microneedling or PRP with injection.
Well, certainly I can share with you my perspective on both of these methods as well as the application
of PRP for hair loss in my 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’m also the founder
of TrichoStem™ Hair Regeneration Centers. This is a technology we developed in our practice
which does use PRP in addition to Acellular matrix and other ingredients that we developed
over the course of several years and it is a non-surgical solution for hair loss. So
I can tell you how I made these determinations in the development of this treatment which
I feel, in my experience, is actually much more effective than PRP whether it’s microneedled
or injected and I’ll explain why.
So to begin with, let’s understand a little bit of what is the rationale behind these
methods. Back in 2007, an article was published by a famous, well-respected dermatologist
researcher about an injury model on mice that resulted in new hair formation. And so, the
concept was that if a particular biochemical pathway is manipulated, you can actually create
hair. And the understanding is that when skin is injured, it can generate the new skin which
originates from hair follicles or it is often observed with microneedling that you can grow
very fine hair. In fact, we have patients come to us who told us that they would routinely
microneedle their scalp and they would feel that there’s a very fine fuzz of hair growth.
The problem is that the fine fuzz is as far as it goes. This is the type of hair known
as vellus hair. And vellus hair is often referred to as lanugo hair or hair that is fine. When
we say that our bodies are covered by fine hair, that’s exactly it. You can’t really
see it. But when you use a microscope, you can actually see it. In order for those hairs
to continuously keep growing as a response to injury, you have to keep microneedling.
So certainly, when we were developing Hair Regeneration, and a little bit of background
of Hair Regeneration, essentially, we were doing hair transplant several a week including
amongst the other cosmetic surgeries I performed. We noticed that periodically when we were
using PRP with Acellular matrix to help the wound healing of the donor area and the hair
grafts that were transplanted, the thinning hair became thicker. So what I decided to
do was to develop a strategy to see if independent of hair transplant, an injection using PRP,
using Acellular matrix and briefly Acellular matrix is referred to as extracellular matrix
derived from pig bladder that essentially stimulates healing by duplication of cells
in the injured tissues. So when you place it on muscle, you’re able to grow muscle.
When we are placing it for skin, we were able to accelerate the healing process of skin.
So I use it a lot in my facelift incisions and reconstructive procedures and grafts including
skin grafts and tissue grafts and I was really impressed with this material.
Ultimately, during the development, I was also thinking about the wound healing technology
that this material was originally used for and came up with different methods of using
microneedling. And we found that microneedling has a role but for the treatment of an individual
patient, we don’t use it consistently for everybody. I actually developed an algorithm
which is the basis of our company TrichoStem™ Hair Regeneration so that dosing, method of
delivery, factors that have to do with the person’s age, age of onset of hair loss,
progression, gender, various other factors that go into how I dose and deliver. I use
microneedling in very specific indications. Microneedling is also adjustable. It can be
mild which is like half a millimeter or it can be deep, at 2.5 millimeters.
So you have to think about why does the doctor see a benefit in microneedling versus injection.
In our practice, when we do Hair Regeneration treatment, we use an injection as a given
in pretty much every patient we treat. And it’s an injection using PRP, Acellular matrix,
Vitamin D placed in a very specific way. And we will occasionally do microneedling as part
of this procedure but in my opinion, delivering the active ingredients that are necessary
for the hair follicle to function and just to go over that element, what we’re doing
with Hair Regeneration is we’re stopping progression. We’re inducing the shed of
thinning hair and we’re inducing the regrowth of hair that’s not growing.
Now PRP does induce regrowth but it doesn’t induce sustainable regrowth in my experience.
What I have found is that PRP which we use in our practice for everything including under
eye dark circles, for acne scars, for fine lines and wrinkles is a remarkable material
but it cannot stop the progression of hair loss and often, people need to go for consistent
treatments, once a month, once in every 3 months. Certainly, there are a lot of different
protocols that colleagues have developed that they’re comfortable with. But in our practice,
when we do this injection treatment, people do not need that type of schedule. We’ll
do a treatment at a single point and then in certain select patients, we’ll do another
treatment at around 15 months. We have data for over 5 years, people have not had regression
from a treatment that was done at a single time or with a second treatment 15 months
later which we refer to as a booster.
That being said, I think that if you had to choose between PRP by injection versus PRP
with microneedling, I think of microneedling as a method that is designed more to help
epidermal and dermal wound remodeling. So, it works very well for fine lines and wrinkles
around the eyes. It works very well for acne scars. And we use PRP with microneedling routinely.
But when it comes to hair loss, my concern with aggressive microneedling is that you
can potentially cause inflammation of the glands that are associated with the hair follicles
as well as you may traumatize the hair follicle themselves depending on the depth. But at
the minimum, you may be traumatizing the hair shaft and the elements of the hair that are
more superficial. So you have to be mindful of that.
The rationale I think is that if you microneedle and you apply the PRP, you get a nice uniform
absorption and I certainly believe in that when it comes to skin rejuvenation for the
rejuvenation of wrinkles and sun damage. And I would say that if you had to make a choice,
I would say that the injection has an advantage. In terms of your own healing process, it’s
actually easier to heal from the injection versus the microneedling because you don’t
have any rawness in the surface. Now, typically, 24-48 hours, microneedling injuries can actually
heal up very well. But again, putting aside your question about one versus the other,
I would say that you have an opportunity to know and learn about the technology and the
work that is behind Hair Regeneration which is PRP with Acellular matrix and a protocol
that has been very successful.
So I hope that was helpful, I wish you the best of luck and thank you for your question.