Lots of Questions About PRP (Platelet Rich Plasma) and ACell Use
I am quite interested and for many years now have been following and consulting with numerous HT doctors around the world regarding their results of using injectable hair stimulation PRP (+/- ACell) for treatment of MPB as stand-alone non-surgical treatment. HT surgery is something I am not interested at this time due to myriad of factors (e.g., DNA genetic programming resulting in possible future progressive hair loss and miniaturization of existing hairs, accelerated loss of native hairs due to the trauma of surgery, depletion of donor hair, multiple transplant procedures / sessions over my lifetime, not every person knows if they will achieve 100% satisfied result, picking right doctor is not easy as HT doctors have varying egos/costs/skills/artistry/ethics, etc). So for now I am content with only non-surgical methods and not HT surgery.
Obviously, I am not a doctor, and just another 55 year old male suffering from MPB thinning and receding hairline….but from all these years this is the information I have been able to glean regarding PRP (+/- ACell) treatment for MPB without HT surgery:
• Currently there are no scientific studies to indicate PRP (+/- ACell) works to regrow hair. There are positive anecdotal results with some enthusiastic and cutting edge HT doctors (e.g., Dr. Jerry Cooley and Dr. Gary Hitzig) but nobody can tell me what success percentage I will achieve, and will it be significant or not. Unfortunately, there is no established, standardized, or proven protocol that has been shown to be superior to any other delivery method….and each doctor is trying something different on their own through a trial-error effort to get to the point where a proven protocol will provide consistent results.
• Some HT doctors are spinning their own PRP with cheaper equipment and injecting what they claim are optimal platelet concentrates at < 5x platelet concentrates....on the other hand there's Dr. Cooley who claims optimal results using 5x or > platelet concentrates via the ANGEL system….and some HT doctors are now copying Dr. Cooley’s protocol after networking and sharing his notes @ various ISHRS meetings and conferences. Bottom line, it appears HT doctors are injecting differing platelet concentrate amounts in their practices depending on results….which again shows there is no established, standardized, or proven protocol for PRP (+/- ACell) hair injections.
• With HT surgery, as it is with PRP (+/- ACell) treatment by itself without HT surgery, it appears individual DNA genetic programming plays key role in determining overall treatment outcomes/success for each individual….and the ideal platelet concentration amount of PRP injected appears to have profound impact regarding how patients respond and their results….and presence of different cell types and growth factors also impact final results.
• Appears there is limited evidence to suggest lasting benefit with injection of PRP (+/- ACell) or growth factors, although there may be thickening of native hair follicles. It is unclear how long the benefits of treatment last and if the benefit will continue through subsequent hair growth cycles. However, all HT doctors agree on several factors regarding duration of treatment benefits: 1) underlying genetic balding pattern (e.g., PRP will last for a shorter time period for those who are DNA genetically prone to bald faster); AND 2) other maintenance treatments the patient is using (e.g., Propecia, Rogaine, LLLT or LaserCap, other topicals).
• Appears for many HT doctors/Dermatologists/Cosmetic Surgeons/Estheticians….especially in the United States….they charge excessive amount for PRP (+/- ACell) injections because they view as easy revenue steaming source due to desperation and gullibility of people with MPB issues buying into the HYPE for the next BIG THING or BALDNESS CURE….which it’s not.
With that in mind, I do have specific questions regarding personally using PRP (+/- ACell) for MPB without HT surgery. These questions may seem anal and more detailed than normal, but I have to ask because of the personal costs involved, and the fact there are still no established, standardized, or proven protocols to date for PRP (+/- ACell) hair injections for MPB without HT surgery .
• What specific protocols are you using that provide consistent results for PRP (+/- ACell) for MPB patients (without HT surgery)? Where did you receive and why did you determine to use these specific protocols?
• What centrifugal equipment are you using for PRP platelet concentrations? What PRP platelet concentration levels are you getting? What amount of PRP (+/- ACell) injections for individual patients? And how do you determine concentration level amounts of PRP (+/- ACell) injections for individual patients?
• How much do you charge for PRP (+/- ACell) injections?
• How many PRP (+/- ACell) injections per year do you recommend someone getting? Is PRP (+/- ACell) injections perfectly safe over the long haul many years from now due to stimulating cell growth? Obviously, cancers are concern for everyone and nobody wants to wake up or stimulate genetically predisposed cancer cells, etc.
• How many PRP (+/- ACell) injections for MPB (without HT surgery) have you performed to date? How long have you been performing these PRP (+/- ACell) injections in your practice?
• What is the success percentage of total PRP (+/- ACell) injection patients for MPB (without HT surgery) that actually grow more hair and increase diameter size of existing miniaturized native hairs? From these successful injections, can you measure or visually see the significant or appreciable percentage difference in overall hair growth and appearance for your patients? (e/g., 25% better stronger looking hair?/50% better stronger looking hair?/75% better stronger looking hair, etc)?
• Do you have portfolio of these patients before/after photos that I can see on-line? Even better if possible, can I contact these patients myself either via email or telephone to ask their overall impressions regarding their results?
The above text was written to my private email and is a good overview of the PRP topic, so I have included it in our blog.
I do not engage in using PRP and ACell for hair growth or in hair transplantation. We do use on occasion ACell with the patients permission for donor wound healing, but we do not charge the patient any money for this. We absorb the few hundred dollars for the ACell since we cannot positively claim its benefit. Once I see value, clinical proof, and scientific proof, I can change my mind about the offering.
I don’t believe that these treatments are anything more than human experimentation for profit, or just a profitable venture. Desperate people will spend lots of money chasing the pot of gold under a distant rainbow.
What an excellent, thoughtful post. While there is a controlled, small study suggesting possible benefit of platelet rich plasma in patients with alopecia areata (https://www.ncbi.nlm.nih.gov/pubmed/23607773) , it is really surprising (and disappointing) that so many clinicians promote costly procedures in the absence of simultaneous investigations into their safety and effectiveness. These procdures should be free and data collected as part of a general overall effort to determine the value (similar as is done with other experimental procedures), either as part of a multicenter study or less ideal, as a collection of anecdotal case histories.
I feel the need to defend some of the doctors selling this and other unproven treatments. First, I have had several PRP treatments and I do believe it has helped stabilize my hair loss. It’s no miracle cure, but it definitely seemed to decrease shedding and improve the quality of my native hair. Second, the doctor I had my treatments with did perform some small studies of his own and was very clear in describing the shortcomings of his research. He did not promise the moons and the stars, but said he does believe it is helping some of his patients slow down the progression of hair loss. Third, some of us who are not able to use current available treatments are willing to try alternatives like this until something better comes along, even while knowing the limitations. If we were to wait for every single one these treatments to go through full FDA trials, nothing would ever become available, or we would be bald by the time the treatment came to market.
Give some credit to consumers. We aren’t all ignorant fools throwing money toward pipe dreams. We are capable of analyzing these treatments, measuring our response to them, and making informed decisions. As long as the doctors selling them are honest and realistic about the potential results, then there is nothing about providing these alternatives that is akin to “snake oil.”
There is nothing wrong with experimental, unproven treatments and none of the above posts imply that patients seeking such treatments are ignorant. What the posts imply is that – as with ANY experimental , unproven treatment (and thousands are being properly studied whether drugs or devices), they should not be presented as effective but as experiments and should be free (until proven to be effective). This is no different from the thousands of patients participating in clinical trials of drugs for diseases, who are given the treatment free of charge under an experimental protocol.
How can you or anyone truly ‘analyze†such treatments when there is no data about their safety and efficacy? (I very much doubt that the practitioners of these treatments have patients sign informed consents, as with other investigational drugs, that the safety and efficacy is unproven)
In the case of Rob Roy, its positive that the physician performed a small study (probably uncontrolled), believed that the results were encouraging, and presented the info in a thoughtful way. Few physicians actually collect such data and many patients (as evidenced by many of the posts related to finasteride) also have difficulty fully understanding the nature of clinical data. Despite the shortcomings of a small study, the physician might want to write up the results for a scientific journal.
I mispspoke when I said we can “analyze” treatments. I meant to say we can analyze our own results and make a decision about whether or not a treatment works for us. Regarding your statement that these treatments should be free, how could a doctor possibly offer such a service to the public at no cost and why would they do so outside of a research study? As long as they are clear with the patients that their results are mostly anecdotal, can present them with some scientific basis for how the treatment is proposed to work, and offer a realistic and measured expectation of results, then I don’t see anything wrong with this. In fact, there are many medical treatments (prp included) that have been used successfully for a variety of conditions of many years without any large, expensive research studies and they can be very beneficial in certain cases. Of course, if the doctor is overselling a treatment purely for financial reasons, then there is clearly a problem.
PRP Is For Peoples who loss their hair from top of the scalp. We have PRP, FUE & FUT Treatments For Hair Loss and Baldness Problem.
What information is available when considering PRP treatments for hair loss if one has HSV2. Is there a risk of infecting the scalp with the injection of the platelets into the scalp.
Thanks