What is PRP?
PRP is a concentrated autologous biologically active blood product that is enriched in a range of growth factors, cytokines, and other plasma proteins. Platelets are blood particles without nucleus from the fragmentation of megacaryocytes. They live approximately 10 days. They contain alpha granules which contain growth factors. More than 60 growth factors have been identified (Mazzucco, BL, Transfusion). The degranulation and activation begins 10 minutes after activation and most are secreted in the first hour.
Growth Factors in PRP Platelet
Derived Growth Factor, Transforming Growth Factor-Beta, Vascular Endothelial Growth Factor, Epidermal Growth Factor, Insulin Like Growth Factor, Fibroblast Growth Factor, Nerve Growth Factor. Cytokines are also present.
Mechanism of Action
Extremely high concentrations of biologically active agents modulate pathways of tissue repair and inflammation in the scalp (Lynch and Bashir). PRP Preparation Peripheral blood is collected using a 19 or 21 gauge butterfly needle into specialized 22 ml vacuum tubes that contain a thixotropic gel separator and centrifuged at 1500 g for 10 minutes. This will produce approximately 10 ml of PRP that will be further concentrated by removing almost 5 mls of platelet poor plasma component leaving 5 ml of Platelet Rich Plasma.
Patient Indication for PRP Treatment
1. Primary: Androgenic Alopecia 2. Secondary: Alopecia Areata
Scalp Disorders Telogen or Chronic Telogen Effluvium, Traumatic Alopecia, Trichotillomania, Discoid Lupus, Infection,
Other Pregnancy or breast feeding, cancer or chemotherapy, keloid development, history of HgB less than 10, platelet count less than 105, local infection, hematologic/coagulation disorders, history of untreated thyroid disorders, untreated anemia, severe scalp psoriasis, history of untreated Vit. D deficiency, body dysmorphic disorder, history untreated PCOS, untreated Hyperandrogen Syndromes
Post Injection Home Care
1. Inform office immediately of any concerns. 2. Return home and take a hot shower/shampoo 3. Do not use any topical preparations for 24 hours 4. Do not color hair for 48 hours 5. Hold NSAIDs for 24 hours (Use Tylenol).
Interval of Injections
1. Initial injections: Schedule monthly for 3 to 4 months. 2.Maintenance injections: Schedule in 3 to 6 month intervals
Before and After Photos by Jeffery Rapoport M.D.