Thank you for your question.
You’re 21-years-old and you state that you’ve been having hair loss for the past 3 years.
And you submitted two photos that clearly demonstrate the extent of your hair loss.
And you’re asking about PRP to help manage your hair loss in light of the advice you
were given to wait about 4 years before undergoing a transplant. So I think the overall question
is about what you can do before doing a hair transplant.
Well, I can certainly share with you my approach to helping patients like yourself 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. In fact, I’m also the founder of TrichoStem™ Hair Regeneration
Centers. This is a system we developed which evolved out of hair transplant to non-surgically
treat hair loss in men and women with genetic pattern loss using PRP and extracellular matrix
which I’ll describe in more detail later.
So to begin with, it’s clear that you have very aggressive pattern at a young onset.
And so, in our practice and we treat patients all over the world for hair loss using this
treatment called Hair Regeneration. And I’ll explain to you a little bit about it in the
context of what PRP does.
Now PRP, just to review, is a concentration of the wound healing and growth factors needed
when you have an injury. And when concentrated, can be applied for a variety of indications.
In our practice, we use it for acne scars, for wrinkles, for under eye dark circles,
to help with the incisions and wound healing. And in respect to hair loss, it has been many
times proven that PRP can stimulate growth in hair loss and the dermatology literature
is recognizing the benefits and a lot of ideas are being generated about the mechanisms which
are clearly more complex. But the basic idea is that PRP can help people with hair loss.
The challenge is how sustainable is the treatment of PRP and will it really last as long as
its potential.
And this is where our treatment which we developed starting about 7 years ago called Hair Regeneration
evolved out of our use of PRP with a material called extracellular matrix or Acellular matrix.
This is a wound healing technology which leverages your body’s own adult stem cell activity
for tissue repair. So for example, if there’s a muscle injury, it helps muscle regrow as
opposed to scar tissue. Now this is fascinating and when we were doing this initially, we
were doing this to help hair grafts heal better during hair transplants. It’s well known
that every hair graft that is transplanted doesn’t make it and results can vary. So
we want to improve the outcomes of the hair transplants with Acellular matrix. We want
to also improve the wound healing of the donor area incisions. Well, a side-effect resulted
which was that thinning hairs appear to get thicker.
From that point forward, I made a decision to pursue the possibility of leveraging this
method to help people with thinning hair. It became clear to me that the majority of
the people who seek hair transplant are not bald people. They’re people who have thinning
hair and they’re losing hair and they’re trying to keep up with the loss. Well, if
we can thicken existing thinning hair, well, we can actually move the clock back and actually
improve the overall volume. And over several years, we clearly demonstrated with our method
that we can actually not only get the coverage of a hair transplant but in many cases, we
can exceed the coverage of two hair transplants. It’s a bold statement to make but it is
true.
Now that being said, in the context of your situation, we’ve established with Hair Regeneration
treatment that people of all ages with our protocols, we’re able to get about 5 years
at least of stability and improvement. Basically, we’re able to reactivate hair that’s not
growing, stimulate the growth of thinning hair into thicker hairs, induce the shedding
of thinning hair and replace that with thicker hair. And very importantly, we’re actually
able to stop the progression.
However, I have looked at people from different lenses and when I think of a variable that
currently is being challenged because of concerns of the drug finasteride, I’m looking at
patients in a way as it relates to possibly relative DHT sensitivity. So when I see a
young person losing hair very aggressively, it is possible that your hair is very DHT
sensitive. DHT stands for dihydrotestosterone. Testosterone is converted into dihydrotestosterone
or DHT by an enzyme called 5-alpha reductase. Now what happens is hair follicles that are
susceptible to DHT will actually miniaturize. So you have to ask the question: why is it
when you are in your 20s, you’re losing hair while 80% of your contemporaries are
not? And one possible variable in that explanation is relative DHT sensitivity. So in my practice,
I do counsel patients to consider taking finasteride as a way to diminish the DHT dose on their
hair so that’s something that PRP cannot do is affect DHT levels.
Now that being said, there is an opportunity with a treatment like we have called Hair
Regeneration to do something that a DHT blocker does not do and that is to stimulate hair
growth. What I believe is occurring with Hair Regeneration is we’re effectively prolonging
the growth cycles. In some ways, we refer to it as like extending the warranty on the
hair. Now there’s a challenge, of course when people have aggressive hair loss like
you do and there are going to be people that don’t necessarily respond. But I think that
in your position, it’s probably in your best interest to do everything you can to
slow down your progression as well as to stimulate growth to get maximal coverage.
Unfortunately, even though you are 4 years away from a hair transplant in this situation,
hair transplant isn’t the perfect solution because the rate of hair loss, in your situation,
is likely to rapidly exceed the rate in which placement can provide reasonable coverage
based on what the degree of loss that you’ve experienced in that past 3 years and you’re
only 21-years-old. So it’s important that you understand the limits of the surgical
option as well as try to learn more about how to maximize the longevity of your hair
and maximize your coverage. Hair loss is unfortunately much more complex and we have limited number
of tools.
Hair Regeneration has essentially became a new category that allows our patients who
come to us from all over the world to improve the longevity of their hair growth cycles
and maximize the coverage. And for many patients, actually defer having a transplant. So learn
more about these options and I think the earlier you seek attention, the sooner and better
it is for you based on this rapid progression.
So I hope that was helpful, I wish you the best of luck and thank you for your question.