Thank you for your question. You are 26-years=old and you already had gone through a hair transplant
and you are conflicted because you got a opposing recommendation from 2 different dermatologists
about basically maintenance and prevention of your hair loss. One is recommending minoxidil
and the other one is recommending that you don’t use minoxidil and that you instead
do platelet-rich plasma (PRP).
Well, I can certainly give you some guidance as to how we counsel our patients in comparable
situations. I’m a board certified cosmetic surgeon and fellowship trained oculofacial
plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years.
I’ve been performing hair transplant as well as non-surgical hair restoration for
many years. In fact, I am the founder of TrichoStem™ Hair Regeneration centers where we have developed
a system of non-surgical treatment for hair loss using platelet-rich plasma (PRP) as well
as extracellular matrix, vitamin D and other methods that we employed in a specialized
way that we customize for every patient for both male and female pattern hair loss. So
the question about platelet-rich plasma (PRP) as well as minoxidil and finasteride and basically
the universe of hair loss treatment is something we deal with every day and all day long.
So, I am going to just give you a little bit of perspective as I see it when we see patients
like yourself. If you have lost enough hair that you moved ahead with hair transplant,
clearly there has to be some way for you to keep the existing hair you got. And when you
look at the medical options, you are looking basically at two: one is finasteride , taking
a pill daily 1 mm once a day. This is a drug that blocks the conversion of testosterone
to dihydrotestosterone by an enzyme called 5-alpha reductase. It has been a significant
method or significant modality for the treatment or maintenance of hair for male pattern hair
loss since the late 90s since about 1997. Unfortunately, in recent history there has
been a lot of fear about long term sexual side effects which is resulted in a large
scale abandonment of this option which leaves you with topical application like minoxidil.
Minoxidil does stimulate hair growth along the growth cycle of thinning hair but what
it does not do is stop hair loss. We have patients who have been on minoxidil for over
20 years and they are practically bald. They come to us and say, “Yes I have been using
minoxidil religiously everyday, twice a day as recommended for 20 years” and they practically
have no hair. So the clinical evidence of substantiates that minoxidil does not stop
progression.
When the question of platelet-rich plasma (PRP) comes up, I use platelet-rich plasma
(PRP) in my practice for many indications. As a cosmetic surgeon, I really help a lot
of patients with platelet-rich plasma (PRP) from the assistance of improving dark under
eye circles, skin quality and texture, to improve acne scars, to improve scars, to improve
fine lines and wrinkles. But in my experience, platelet-rich plasma (PRP) as a standalone
treatment for hair loss has some variability and long term benefit. In general, if someone
is to have platelet-rich plasma (PRP) for hair loss, they are going to be on a regular
scheduled treatment typically once a month and many people usually by 4 treatments find
their way to our office because we offer what we call Hair Regeneration which does involve
platelet-rich plasma (PRP). We are able to sustain five years of growth with one treatment
which does involve platelet-rich plasma (PRP) but is also a method combining extracellular
matrix and vitamin D that was developed treating hundreds of patients over many years and developing
a protocol. Some patients who have moderate to severe loss will do a second treatment
but is not absolutely necessary treatment but we will do it somewhere 15 to 18 months.
Hair Regeneration has been so successful that people have come to us all over the world
so as it relates to your question. If you are considering a treatment like Hair Regeneration,
there is no comparison with minoxidil. I advise most of our patients, if they have been on
minoxidil, that they can stop minoxidil after we do Hair Regeneration treatment. And majority
of our male pattern hair loss patients come to us either having taking finasteride and
having side effects and not taking it anymore or categorically refusing to take finasteride
which means Hair Regeneration stands on its own.
So I think that both dermatologists are using the best of their knowledge and experience
but unfortunately the medical options for hair loss remain extremely limited. When we
developed Hair Regeneration, we actually filled a very important void between medications
and surgery. And since you already had surgery at such a young age, it is critical for you
to hold on to the very hair that you got in the best way as you possibly can. Otherwise,
in a few years, you will need transplant and eventually you will run out of donor area.
So learn more about Hair Regeneration and realize I introduced another concept besides
platelet-rich plasma (PRP) and minoxidil. But speaking from many years of experience
in having developed this process, I can’t get excited enough to talk you about this
treatment which has been so successful to help so many people in our practice.
So I hope that was helpful, I wish you the best of luck and thank you for your question!