Video Presentation of PRP Injection Procedure for Hair Loss

[tbtadmin]

The patient shown participated in the original PRP/hair loss study. This video depicts his second procedure at 11 months.

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[Andyman79]

New to all this but keen to expand my knowledge, I noticed that Dr Greco was using a '1mm microneedle' in this proceedure, do you think something like the Nanogen Scalproller, which I think is 0.5mm, would have an effect in prp?

I can kind of understand the benefit of using a microneedle in a clinic but is there any real benefit for home use?

Many thanks

Andy

[pdouble]

This procedure is good, though properly it will not bring back hair once the follicure is dead, but it may help heal the daying once. QUESTION: HOW MUCH DOES THE PROCEDURE COST?? DOES ANY ONE KNOWS.

[Dr Joseph F. Greco]

New to all this but keen to expand my knowledge, I noticed that Dr Greco was using a '1mm microneedle' in this proceedure, do you think something like the Nanogen Scalproller, which I think is 0.5mm, would have an effect in prp?

I can kind of understand the benefit of using a microneedle in a clinic but is there any real benefit for home use?

Many thanks

AndyGood question Andy. I look at the micro needling as both a stimulation devise and a delivery devise. It will initiate the Stat 3 and if patients are using a topical I think delivers the product into the scalp better. JG

[Andyman79]

Good question Andy. I look at the micro needling as both a stimulation devise and a delivery devise. It will initiate the Stat 3 and if patients are using a topical I think delivers the product into the scalp better. JG

Many thanks for your reply Dr Greco,

So, in principal, the potential additional benefits of using a scalproller may make it worth thinking about for use with topical solutoins at home?

[Dr Joseph F. Greco]

Many thanks for your reply Dr Greco,

So, in principal, the potential additional benefits of using a scalproller may make it worth thinking about for use with topical solutoins at home? I think so Andy I have recommending this to my patients for quite some time. JG

[Dr Joseph F. Greco]

This procedure is good, though properly it will not bring back hair once the follicure is dead, but it may help heal the daying once. QUESTION: HOW MUCH DOES THE PROCEDURE COST?? DOES ANY ONE KNOWS.
That is correct it will only work on hair that is there. However, in Alopecia Areata, where the stem cells are dormant and hairs are not seen, 70% of the patients in our study it did grow hair back in the PRP treated group. The procedure cost $800 to $1K. in my clinic. Thank you. JG

[brentipold]

That is correct it will only work on hair that is there. However, in Alopecia Areata, where the stem cells are dormant and hairs are not seen, 70% of the patients in our study it did grow hair back in the PRP treated group. The procedure cost $800 to $1K. in my clinic. Thank you. JG



Dr. greco, what would you say your success rate would be with androgenic alopecia? Also Id like to know your reasoning as to why prp would not work on someone who has just started in the thinning stages?... Ive seen people say they have had no success with it and had mostly a decent head of hair..

[Dr Joseph F. Greco]

Dr. greco, what would you say your success rate would be with androgenic alopecia? Also Id like to know your reasoning as to why prp would not work on someone who has just started in the thinning stages?... Ive seen people say they have had no success with it and had mostly a decent head of hair..

Thank you for your questions. First, what are we defining as success and what realistic expectations should patients have? A successful treatment would be some or all of the following: (1) “maintaining” existing non transplanted hair (2) noticing or having others notice an improved condition of your scalp and hair (3) a decrease in shedding of hair (4) an increase in the aesthetic density of your hair.

That being said, most patients we have treated noticed some of these. Does this work in all of patients and is everyone pleased, absolutely not, just as is the case with other therapy including hair transplant surgery. What is most important, no patients, have reported side effects or shedding post treatment with PRP we treated the past two years..

Promised or perceived unrealistic expectations would be: (1) to expect a full thick head of hair (2) to expect to grow hair in an area that experienced miniaturization for years or a bald area (3) to expect hair to look thicker if hair is cut short.

I don’t understand your question, “Id like to know your reasoning as to why prp would not work on someone who has just started in the thinning stages”? A young patient just beginning to thin is a good patient for this.

Bottom line is that physicians must explain and patients must realize this is an experimental therapy, but safe, therapy that we are beginning to understand.Thanks for your questions, JG

[brentipold]

Thank you for your questions. First, what are we defining as success and what realistic expectations should patients have? A successful treatment would be some or all of the following: (1) “maintaining” existing non transplanted hair (2) noticing or having others notice an improved condition of your scalp and hair (3) a decrease in shedding of hair (4) an increase in the aesthetic density of your hair.

That being said, most patients we have treated noticed some of these. Does this work in all of patients and is everyone pleased, absolutely not, just as is the case with other therapy including hair transplant surgery. What is most important, no patients, have reported side effects or shedding post treatment with PRP we treated the past two years..

Promised or perceived unrealistic expectations would be: (1) to expect a full thick head of hair (2) to expect to grow hair in an area that experienced miniaturization for years or a bald area (3) to expect hair to look thicker if hair is cut short.

I don’t understand your question, “Id like to know your reasoning as to why prp would not work on someone who has just started in the thinning stages”? A young patient just beginning to thin is a good patient for this.

Bottom line is that physicians must explain and patients must realize this is an experimental therapy, but safe, therapy that we are beginning to understand.Thanks for your questions, JG


I apologize for the bad wording. I guess what im trying to ask is, What is your theory on why is it not as effect as it is in some people, and very effective on others.?

[Dr Joseph F. Greco]

I apologize for the bad wording. I guess what im trying to ask is, What is your theory on why is it not as effect as it is in some people, and very effective on others.?

Great question I wish I had the answer. Same thing with Rogaine and finasteride...why do some people have great results and others no results? Again, we are just beginning to observe and understand. I have had four patients ( younger in their 20's) tell me me that "they and others" notice that their hair is darker after the treatment. While that is anecdotal it is still four people saying the same thing and others observing that their hair appeared darker. JG

[brentipold]

Great question I wish I had the answer. Same thing with Rogaine and finasteride...why do some people have great results and others no results? Again, we are just beginning to observe and understand. I have had four patients ( younger in their 20's) tell me me that "they and others" notice that their hair is darker after the treatment. While that is anecdotal it is still four people saying the same thing and others observing that their hair appeared darker. JG

Thank you for your honesty Dr. Greco. One last question I have is, do you think doing these treatments 2 month apart from one another would be more effective? I guess the first question I should have asked is have you already experimented with this..?

thanks.

[Dr Joseph F. Greco]

Thank you for your honesty Dr. Greco. One last question I have is, do you think doing these treatments 2 month apart from one another would be more effective? I guess the first question I should have asked is have you already experimented with this..?thanks.

Good question and the answer is, no!….. The reasoning is because there are distinct phases that platelets and GF's go through in this process. First, there is the Inflammatory phase that lasts 24 to 48 hours where you get a heighten immune response because the platelets, when activated with thrombin, begin to extrude the alpha granules from the platelets. Picture a platelet as an envelope filled with growth factors and when exposed to thrombin the envelope opens and the GF’s are released. They begin to send chemical signals like emails and faxes to surrounding GF’s to come back to the treated area to mobilize the army so to speak, hence we have this immune response by the body and a pro inflammatory period of 24 to 48 hours. This is a good healthy response.

Next we have the Proliferation phase. In the next two weeks or so, after the degranulation of the platelets, new fibroblasts come into the treated area and begin to lay down new collagen cells. Angiogenesis ( the formation of new blood vessels ), which is what we want, because three independent studies show VEGF (a pro angiogenic GF), which is prevalent in PRP along with leukocytes ( white blood cells that fight infection that are increased 6 to 8 times in PRP and produce VEGF) increase vascularity to the follicle and when that happens, “ the follicle and follicle unit get bigger”. This continues for the next 4 to 6 weeks after the proliferation phase and this is called the Remolding phase when mitogenesis or the (formation of new cells occurs).

So you see this is a natural process of the body to heal itself and we need to give it time to work. When we do Orthobiologic injections to repair torn tendons, ligaments and muscles this is the same process and how it works. Hope this explains why we don’t like to rush nature. This is truly Regenerative Medicine. JG

[brentipold]

Good question and the answer is, no!….. The reasoning is because there are distinct phases that platelets and GF's go through in this process. First, there is the Inflammatory phase that lasts 24 to 48 hours where you get a heighten immune response because the platelets, when activated with thrombin, begin to extrude the alpha granules from the platelets. Picture a platelet as an envelope filled with growth factors and when exposed to thrombin the envelope opens and the GF’s are released. They begin to send chemical signals like emails and faxes to surrounding GF’s to come back to the treated area to mobilize the army so to speak, hence we have this immune response by the body and a pro inflammatory period of 24 to 48 hours. This is a good healthy response.

Next we have the Proliferation phase. In the next two weeks or so, after the degranulation of the platelets, new fibroblasts come into the treated area and begin to lay down new collagen cells. Angiogenesis ( the formation of new blood vessels ), which is what we want, because three independent studies show VEGF (a pro angiogenic GF), which is prevalent in PRP along with leukocytes ( white blood cells that fight infection that are increased 6 to 8 times in PRP and produce VEGF) increase vascularity to the follicle and when that happens, “ the follicle and follicle unit get bigger”. This continues for the next 4 to 6 weeks after the proliferation phase and this is called the Remolding phase when mitogenesis or the (formation of new cells occurs).

So you see this is a natural process of the body to heal itself and we need to give it time to work. When we do Orthobiologic injections to repair torn tendons, ligaments and muscles this is the same process and how it works. Hope this explains why we don’t like to rush nature. This is truly Regenerative Medicine. JG


Okay thank you Dr. Greco, that clears things up a bit. Ive already had the treatment with Dr. Feller about 6 weeks ago. I just wanted a better explination as to why It might not works. Thanks again for answering my questions.

[glennaz]

Where can one go to find a treatment facility in the Pacific Northwest?

[Dr Joseph F. Greco]

Okay thank you Dr. Greco, that clears things up a bit. Ive already had the treatment with Dr. Feller about 6 weeks ago. I just wanted a better explination as to why It might not works. Thanks again for answering my questions.

Not all PRP is the same in that there are various ways PRP can be processed and different techniques of treatment (for instance stimulation of the scalp varies). I like the roller to stimulate the scalp and have been doing that the past two years. It can both stimulate and be used as a delivery device during the procedure and after ( for application of Rogaine for instance) by the patient.

You can have 1- Platelet Rich Plasma, 2- Concentrated Platelet Rich Plasma, 3-Platelet Rich Plasma with concentrated Protein Enriched Plasma, 4- PRP with filtered RBC's, 5-Leukocyte rich PRP, 6- Leukocyte poor PRP, 6- pure cytokines (GF's) without RBC's, WBC's or platelets ( where the GF's were activated and removed from the platelets). So you see not all PRP is the same, it can be processed in different ways to achieve a desired result and we use it in many different ways.

[Dr Joseph F. Greco]

Where can one go to find a treatment facility in the Pacific Northwest?
I'm sorry glennaz I do not know of anyone yet. JG

[mikey79]

All this looks very interesting. Now is this process (if it works on you) a permanent regrowth, or is it just a temporary solution to a long term problem?

[mikey79]

opps forgot, is this available in Canada anywhere?

[someone uk]

hi, i just want to ask
firstly does PRP produce new hair follucles or reverse the process of already regressed hair (ie vellus hair and dormant hair become terminal)

and secondly i noticed PRP when dr robert jones did administered it to himself in Canada
he used dr greco's technique and said only 1 in 36 of his patients responded to the treatment, now i know we can't say we have perfected PRP, we have only just started using it but i want to ask if you have had better results?

[Dr Joseph F. Greco]

hi, i just want to ask
firstly does PRP produce new hair follucles or reverse the process of already regressed hair (ie vellus hair and dormant hair become terminal)


and secondly i noticed PRP when dr robert jones did administered it to himself in Canada
he used dr greco's technique and said only 1 in 36 of his patients responded to the treatment, now i know we can't say we have perfected PRP, we have only just started using it but want to ask if you have had better results?

Hi someone, PRP GF's will work on the non transplanted. By increasing vascularization to the follicle three different independent studies demonstrate the follicle will get bigger.

That is quite different than our experience the past two years in both hair surgery and in our study and experience. First, how were patients evaluated by Dr Jones because a placebo would produce better than one in thirty six. I do not know what type of patients were treated and what expectations were given to those patients? The best patients are those just beginning to thin, patients who experience excess shedding or patients who have side effects to FDA approved medicines.

Not all PRP is the same in that there are various ways PRP can be processed and different techniques of treatment (for instance stimulation of the scalp varies) injection techniques also vary. As you may or may not know we use a patented formula of PRP plus a highly concentrated protein matrix that Dr Jones does not use.

Does everyone have positive results? No, just as Propecia and Rogaine We have had and continue to have positive results with this experimental, but safe therapy and we are learning more each day. Again this therapy was never intended to replace any FDA therapy, but has evolved as an adjunctive therapy for those individuals who choose it. Infusing autologus GF's and protein into scalp and stimulation is safe and produce positive results in the proper patient population.

[ThinningGuy]

Dr. Greco, two questions:

1. Is there any sort of 'local trauma' to existing hair follicles when using the 'brush' device, that may cause fallout of those hairs?

2. Is there any progress with someone on the west coast of the U.S. offering PRP therapy?

Thanks.

[Dr Joseph F. Greco]

Dr. Greco, two questions:

1. Is there any sort of 'local trauma' to existing hair follicles when using the 'brush' device, that may cause fallout of those hairs?


2. Is there any progress with someone on the west coast of the U.S. offering PRP therapy?
Thanks.

Thank you ThinningGuy. I like to call it local "stimulation" rather than trauma. We use a micro needling roller 1mm depth for scalp stimulation. There is always a chance that if you stimulate with to aggressively you can cause some temporary hair loss, but in over two years we have not had one patient have fall out from the treatment, in fact, most patients feel that within a few weeks after the stimulation and GF's infusion they have less shedding.

I do not know of anyone on the west coast at this time, but if you are interested you can call my office as we offer a fly-in discount.

[ThinningGuy]

Thank you ThinningGuy. I like to call it local "stimulation" rather than trauma. We use a micro needling roller 1mm depth for scalp stimulation. There is always a chance that if you stimulate with to aggressively you can cause some temporary hair loss, but in over two years we have not had one patient have fall out from the treatment, in fact, most patients feel that within a few weeks after the stimulation and GF's infusion they have less shedding.

I do not know of anyone on the west coast at this time, but if you are interested you can call my office as we offer a fly-in discount.

Thank you for the information.

[Frenchy]

Hi and thanks for all information.

We from Europe also follow this new technique....Stated that it is safe and not so expensive why not try...but do u offer this technique in Europe ?Or have you heard about a Doctor who will offer it ? Apparently only Dc Mwamba if u know begun some trials on specific patients...
Thanks a lot

[brentipold]

I believe Dr. Feller will be offering PRP in England...

[cas8180]

Hello Dr Greco,
I was reading through this thread and watching your videos and find them very interesting as a possible alternative to a more common technique like a hair transplant the whole thought of cutting a chunk of my scalp and dicing up my folicules and relocating them in my head with a fine needle for a couple of hours just leave me very uneasy. However my question to is I am in my late 20's and and starting to thin in the front of my scalp and noticibly starting to crown. Would and could this type of theraply increase the density and help with my thinking process? Is it even possible that something like this could help restore my hairline? I noticed that the cost of treatmeant appeared realitively inexpensive when compared to other more common treatments. Do you know what it would cost for the kind of treatment I am mentioning?

thanks
-Will

[GoodFellas]

So when would this be ready for the public?

[Dr Joseph F. Greco]

Hello Dr Greco,
I was reading through this thread and watching your videos and find them very interesting as a possible alternative to a more common technique like a hair transplant the whole thought of cutting a chunk of my scalp and dicing up my folicules and relocating them in my head with a fine needle for a couple of hours just leave me very uneasy. However my question to is I am in my late 20's and and starting to thin in the front of my scalp and noticibly starting to crown. Would and could this type of theraply increase the density and help with my thinking process? Is it even possible that something like this could help restore my hairline? I noticed that the cost of treatmeant appeared realitively inexpensive when compared to other more common treatments. Do you know what it would cost for the kind of treatment I am mentioning?

thanks
-Will

Thanks for your question. Infusing GF's with this therapy will not replace the frontal hairline and at this time hair restoration surgery is the gold standard. While we have seen some fine hairs in the frontal hair line darken and thicken, they were existing hairs. At this point, there are no shortcuts restoring the frontal hairline.

[hdude46]

Dr Greco,

I see you havent updated your blog at all recently, do u plan to do so soon? Also how did the prp study at the vatican go? thanks!

[Dr Joseph F. Greco]

Dr Greco,

I see you havent updated your blog at all recently, do u plan to do so soon? Also how did the prp study at the vatican go? thanks!

Yes, but since coming back from Rome I've had to finish a few articles and have just been quite busy. We set up the study at the Vatican's Dermatology hospital, did the training required and Dr Gianfranco Schiavone will be coordinating the study with the the Dermatology department. There was also a conference at IDI where we shared our experience with physicians from the Hospital as well as physicians from around Italy. Dr Fabio Rinaldi from Milan, who has done excellent GF/hair studies was in attendance and came to share his expertise.

[Andrew_S]

Not all PRP is the same in that there are various ways PRP can be processed and different techniques of treatment (for instance stimulation of the scalp varies). I like the roller to stimulate the scalp and have been doing that the past two years. It can both stimulate and be used as a delivery device during the procedure and after ( for application of Rogaine for instance) by the patient.

You can have 1- Platelet Rich Plasma, 2- Concentrated Platelet Rich Plasma, 3-Platelet Rich Plasma with concentrated Protein Enriched Plasma, 4- PRP with filtered RBC's, 5-Leukocyte rich PRP, 6- Leukocyte poor PRP, 6- pure cytokines (GF's) without RBC's, WBC's or platelets ( where the GF's were activated and removed from the platelets). So you see not all PRP is the same, it can be processed in different ways to achieve a desired result and we use it in many different ways.

Hi Dr.Greco,
I have just had a look at this message you posted a while back about "different" PRP. I am just about to have this treatment done here in Europe and feel a little hesitant after reading your message. These different types of PRP - are they dependent on the doctor's technique or the brand of kit being used? I have inquired about the kit type and they use something called Harvest Lab. Would this be similar to the procedure you use, or are there other elements (besides your patented matrix) that are different?

Many thanks,
Andrew

[Dr Joseph F. Greco]

Hi Dr.Greco,
I have just had a look at this message you posted a while back about "different" PRP. I am just about to have this treatment done here in Europe and feel a little hesitant after reading your message. These different types of PRP - are they dependent on the doctor's technique or the brand of kit being used? I have inquired about the kit type and they use something called Harvest Lab. Would this be similar to the procedure you use, or are there other elements (besides your patented matrix) that are different?

Many thanks,
Andrew

Thanks for the great question Andrew. The answer is both technique and equipment. The definition of PRP derived from Wikipedia; “not all PRP is the same. The strict definition of PRP is platelet concentration above baseline (published by Marx or 4x baseline). PRP may or may not contain increased concentrations of white blood cells”. This has been the standard.

My opinion based upon our research when using PRP is that a system should be at these levels and the Harvest system has been around since 1999 and is used throughout the world in surgery and non surgical applications. There are other systems that are also good and that is where you need to ask what are the levels of platelets in their system.

Just because someone uses a certain system will not directly equate to the results they produce and that depends on technique. JG

[Kaci]

Dear Dr.Greco,
I recently got PRP treatment (outside of the US) and the treatment was performed by nurses. They asked me to pick an area of my scalp I wanted the PRP to be injected. I am a woman with AGA and recently the sides of my scalp have experienced rapid thinning (rather than the top, which has been more gradual).

I mentioned this particular area of concern to the nurses, and they were about to deliver the PRP into one small portion on one side of my scalp only. They said they wouldn't have enough to do both sides (they obtained 53mL of blood and filtered 6mL of plasma - I don't know if this is the norm).

Lucky for me, I had watched a PRP treatment video posted by one of your female patients on the woman's hairloss project website. I saw that you chose to concentrate a lot on the crown area, as this is quite logically the focal point of hairloss for a woman and would allow for optimum platelet migration all over the scalp.

I told them what I had learned and they basically delivered the injections in the crown area and a little to the side of it. Nothing on my part line or towards the front of my scalp though, presumably there wasn't enough?
My questions are these:
1) Will there be platelet migration to the front/sides of my scalp if only the crown area was treated?
2) If not, would it be conceivable to get another PRP treatment quite soon which focuses on this areas? I understand why there should be at least a 4 month gap between treatments, but what about areas that were relatively untouched by the first treatment - can't they be addressed quite immediately? And why for instance, can not more blood be drawn at one go for more PRP to be obtained?

Thanks Dr.Greco - I have been so boggled with questions and frustrated with inexperienced PRP professionals that my next treatment will most certainly be with you - it's worth the overseas travel if it means I don't have to direct my own treatment!

[Dr Joseph F. Greco]

Dear Dr.Greco,
I recently got PRP treatment (outside of the US) and the treatment was performed by nurses. They asked me to pick an area of my scalp I wanted the PRP to be injected. I am a woman with AGA and recently the sides of my scalp have experienced rapid thinning (rather than the top, which has been more gradual).

I mentioned this particular area of concern to the nurses, and they were about to deliver the PRP into one small portion on one side of my scalp only. They said they wouldn't have enough to do both sides (they obtained 53mL of blood and filtered 6mL of plasma - I don't know if this is the norm).

Lucky for me, I had watched a PRP treatment video posted by one of your female patients on the woman's hairloss project website. I saw that you chose to concentrate a lot on the crown area, as this is quite logically the focal point of hairloss for a woman and would allow for optimum platelet migration all over the scalp.

I told them what I had learned and they basically delivered the injections in the crown area and a little to the side of it. Nothing on my part line or towards the front of my scalp though, presumably there wasn't enough?
My questions are these:
1) Will there be platelet migration to the front/sides of my scalp if only the crown area was treated?
2) If not, would it be conceivable to get another PRP treatment quite soon which focuses on this areas? I understand why there should be at least a 4 month gap between treatments, but what about areas that were relatively untouched by the first treatment - can't they be addressed quite immediately? And why for instance, can not more blood be drawn at one go for more PRP to be obtained?

Thanks Dr.Greco - I have been so boggled with questions and frustrated with inexperienced PRP professionals that my next treatment will most certainly be with you - it's worth the overseas travel if it means I don't have to direct my own treatment!
Hello Kaci, quite honestly, I'd rather not comment on treatments done at other clinics on a public forum. If you would like me respond I believe you have my email or can access it on my web site. Thank you JG

[gaz100]

Hi Dr Greco. Are there any surgeries in the UK that you endorse/recommend for PRP? If not the UK, are there any in Europe?

Thanks.

[ania]

hello dr. j

i have been searching through the net and i have ound there r so many injection therapies like prp, qr 678 hair growth factors, cortisone, thymu skin prduct etc. can u throw a light on these and suggest which one`s the best for diffuse hair loss in young females.

Regards.

[Dr Joseph F. Greco]

Hi Dr Greco. Are there any surgeries in the UK that you endorse/recommend for PRP? If not the UK, are there any in Europe?

Thanks. Actually, I do not know of anyone in the UK, but highly recommend Dr Fabio Rinaldi in Milan of Dr Gianfranco Schiavone in Rome. Dr Rinaldi just organized a great congress on growth factors and PRP in Dermatology in Milan last week and showed some great results as did Dr Schiavone.

[Dr Joseph F. Greco]

hello dr. j

i have been searching through the net and i have ound there r so many injection therapies like prp, qr 678 hair growth factors, cortisone, thymu skin prduct etc. can u throw a light on these and suggest which one`s the best for diffuse hair loss in young females.

Regards. Quite honestly, I can't comment on something I have no experience using. Female hair loss is so multifactorial as you know there are many causes and no cures only treatments. Therfore I can only comment on the PRP treatment we do. Depending on what your expectations are and what the underlying problem is we have had some good success in decreasing shedding and increasing aesthetic density in females while at the same time offering a safe treatment. Others are also having good success utilizing this therapy especially in Europe.

[PatientlyWaiting]

Hello Dr. Greco.

Just two questions.

1. If I get a PRP injection, how many more times I have to take the injection? I know it's once a year, but how many years? In other words, is this like Finasteride/Minoxidil where if you stop taking it, any hair you gained from it will fall off?

2. Is the price still $800-1k?

[Dr Joseph F. Greco]

Hello Dr. Greco.

Just two questions.

1. If I get a PRP injection, how many more times I have to take the injection? I know it's once a year, but how many years? In other words, is this like Finasteride/Minoxidil where if you stop taking it, any hair you gained from it will fall off?
Yes, that is correct this is a treatment and not a cure it does require follow-up treatments

2. Is the price still $800-1k? Yes that is correct, Best, JG

[hdude46]

dr greco, any updates on prp? seems like nothing has been updated for about a year or so. is it a dud? please chime in if u can.

[Dr Joseph F. Greco]

dr greco, any updates on prp? seems like nothing has been updated for about a year or so. is it a dud? please chime in if u can.

While I have not updated on this site I have been updating on my hair blog and you will see some very interesting posts, especially the last one. We have been getting very good results and others that we have encouraged have demonstrated goods results as well.

If you look at my last blog post we demonstrated a case study of a Discoid Lupus patient who was treated for two years with monthly cortisone injections by her Dermatologist until the physician refused to do anymore injections. The Dermatologist sent the patient to us as a last resort and after just one treatment she grew 90% of her hair back prior to a second treatment.

Is this a dud? Actually far from that..... Lets go back in time and see what has developed the past three years since we introduce this concept.

On May 30, 2008, in Rome, Italy I lectured on the importance of an extra cellular matrix ECM/PRP combination for hair regeneration at the ISHRS Workshop “Made in Italy”. In the March/April 2009 issue of the International Hair Transplant Forum International we published the importance of having an extra cellular matrix (ECM) with PRP to provide a “scaffold for cellular proliferation” in hair regeneration. On March 26th, 2009 I posted the photos on my blog of our patented natural protein matrix, OroGen Plus, developed by my partner, Robert Brandt, that he has used in wound care, Orthopedic, Cardiovascular and Cosmetic surgery since 2001.

Three years later, after the ISHRS Boston Meeting in 2011, it was reported that the combination of an extra cellular matrix (ECM), A Cell, a matrix made from “pigs bladder” and PRP was used to help heal donor scars and help regenerate hair. Finally, physicians ar getting we I lectured on three years ago.

Since 2008, we have demonstrated hair growth in Androgenic Alopecia
(AGA), Alopecia Areata (AA) and now in Discoid Lupus (DL) with OroGen Plus, or a natural protein matrix ECM/PRP complex made from the patients own “protein” rich plasma. Since hair is made of protein does it not seem reasonable then an “ECM complex made of your own protein” entrapping growth factors would be a natural way to regenerate miniaturized hair?

We feel the success of this complex is a combination of the powerful anti-inflammatory effects of PRP in the autoimmune disease processes like AA and DL where the stem cells are dormant and can then be “turned on” with our GF/ECM complex. In light of recent excellent studies by Garza, et al, Journal of Clinical Investigation, 2011 demonstrating the existence of stem cells in the follicles of bald scalp in AGA (Male Pattern) patients, we also feel the ECM/PRP complex may be “turning on” stem cells for a period of time in these patients.

We are now working on some other inflammatory scaring alopecia diseases like DL. You must realize that science is a process of trial and observation and we are just beginning to understand how cellular therapy works with hair. Be patient, time will tell.

One last thing, I applaud others like Drs Cooley, Hitzig, Rinaldi, Schiavone who stick their neck out in the interest of science. Whenever you are at the forefront of something new in medicine there is always skepticism and criticism, but what I have been preaching the past three years people are now appreciating.

[hdude46]

While I have not updated on this site I have been updating on my hair blog and you will see some very interesting posts, especially the last one. We have been getting very good results and others that we have encouraged have demonstrated goods results as well.

If you look at my last blog post we demonstrated a case study of a Discoid Lupus patient who was treated for two years with monthly cortisone injections by her Dermatologist until the physician refused to do anymore injections. The Dermatologist sent the patient to us as a last resort and after just one treatment she grew 90% of her hair back prior to a second treatment.

Is this a dud? Actually far from that..... Lets go back in time and see what has developed the past three years since we introduce this concept.

On May 30, 2008, in Rome, Italy I lectured on the importance of an extra cellular matrix ECM/PRP combination for hair regeneration at the ISHRS Workshop “Made in Italy”. In the March/April 2009 issue of the International Hair Transplant Forum International we published the importance of having an extra cellular matrix (ECM) with PRP to provide a “scaffold for cellular proliferation” in hair regeneration. On March 26th, 2009 I posted the photos on my blog of our patented natural protein matrix, OroGen Plus, developed by my partner, Robert Brandt, that he has used in wound care, Orthopedic, Cardiovascular and Cosmetic surgery since 2001.

Three years later, after the ISHRS Boston Meeting in 2011, it was reported that the combination of an extra cellular matrix (ECM), A Cell, a matrix made from “pigs bladder” and PRP was used to help heal donor scars and help regenerate hair. Finally, physicians ar getting we I lectured on three years ago.

Since 2008, we have demonstrated hair growth in Androgenic Alopecia
(AGA), Alopecia Areata (AA) and now in Discoid Lupus (DL) with OroGen Plus, or a natural protein matrix ECM/PRP complex made from the patients own “protein” rich plasma. Since hair is made of protein does it not seem reasonable then an “ECM complex made of your own protein” entrapping growth factors would be a natural way to regenerate miniaturized hair?

We feel the success of this complex is a combination of the powerful anti-inflammatory effects of PRP in the autoimmune disease processes like AA and DL where the stem cells are dormant and can then be “turned on” with our GF/ECM complex. In light of recent excellent studies by Garza, et al, Journal of Clinical Investigation, 2011 demonstrating the existence of stem cells in the follicles of bald scalp in AGA (Male Pattern) patients, we also feel the ECM/PRP complex may be “turning on” stem cells for a period of time in these patients.

We are now working on some other inflammatory scaring alopecia diseases like DL. You must realize that science is a process of trial and observation and we are just beginning to understand how cellular therapy works with hair. Be patient, time will tell.

One last thing, I applaud others like Drs Cooley, Hitzig, Rinaldi, Schiavone who stick their neck out in the interest of science. Whenever you are at the forefront of something new in medicine there is always skepticism and criticism, but what I have been preaching the past three years people are now appreciating.


Dr. Greco thnaks for your response. I did check out your blog and the results look promising. I think it could be worth a shot. Do you ever see prp have positive effects o scalp itchiness? i still have a good amount of hair so just halting or slowing down the process would be huge.

[PatientlyWaiting]

While I have not updated on this site I have been updating on my hair blog and you will see some very interesting posts, especially the last one. We have been getting very good results and others that we have encouraged have demonstrated goods results as well.

If you look at my last blog post we demonstrated a case study of a Discoid Lupus patient who was treated for two years with monthly cortisone injections by her Dermatologist until the physician refused to do anymore injections. The Dermatologist sent the patient to us as a last resort and after just one treatment she grew 90% of her hair back prior to a second treatment.

Is this a dud? Actually far from that..... Lets go back in time and see what has developed the past three years since we introduce this concept.

On May 30, 2008, in Rome, Italy I lectured on the importance of an extra cellular matrix ECM/PRP combination for hair regeneration at the ISHRS Workshop “Made in Italy”. In the March/April 2009 issue of the International Hair Transplant Forum International we published the importance of having an extra cellular matrix (ECM) with PRP to provide a “scaffold for cellular proliferation” in hair regeneration. On March 26th, 2009 I posted the photos on my blog of our patented natural protein matrix, OroGen Plus, developed by my partner, Robert Brandt, that he has used in wound care, Orthopedic, Cardiovascular and Cosmetic surgery since 2001.

Three years later, after the ISHRS Boston Meeting in 2011, it was reported that the combination of an extra cellular matrix (ECM), A Cell, a matrix made from “pigs bladder” and PRP was used to help heal donor scars and help regenerate hair. Finally, physicians ar getting we I lectured on three years ago.

Since 2008, we have demonstrated hair growth in Androgenic Alopecia
(AGA), Alopecia Areata (AA) and now in Discoid Lupus (DL) with OroGen Plus, or a natural protein matrix ECM/PRP complex made from the patients own “protein” rich plasma. Since hair is made of protein does it not seem reasonable then an “ECM complex made of your own protein” entrapping growth factors would be a natural way to regenerate miniaturized hair?

We feel the success of this complex is a combination of the powerful anti-inflammatory effects of PRP in the autoimmune disease processes like AA and DL where the stem cells are dormant and can then be “turned on” with our GF/ECM complex. In light of recent excellent studies by Garza, et al, Journal of Clinical Investigation, 2011 demonstrating the existence of stem cells in the follicles of bald scalp in AGA (Male Pattern) patients, we also feel the ECM/PRP complex may be “turning on” stem cells for a period of time in these patients.

We are now working on some other inflammatory scaring alopecia diseases like DL. You must realize that science is a process of trial and observation and we are just beginning to understand how cellular therapy works with hair. Be patient, time will tell.

One last thing, I applaud others like Drs Cooley, Hitzig, Rinaldi, Schiavone who stick their neck out in the interest of science. Whenever you are at the forefront of something new in medicine there is always skepticism and criticism, but what I have been preaching the past three years people are now appreciating.

Hey Dr Greco thanks for the informative response.

I am just curious as to what you mean by the bolded "turning on stem cells for a period of time", does that mean, you just can't take 3-4 different injections, you have to keep coming back for more until you don't want your hair any more?

To rephrase: Is it like Finasteride/Minoxidil, where you may get results but you have to take these injections for the rest of your life to maintain results?

[ohlife]

Hi Dr.Greco... I wouldn't mind trying PRP in the future, based on it takes off. What I was wondering was similar to the above though: I feel as though at least part of my hairloss is down to having a very dry, itchy and in general, inflamed scalp. Does PRP help the condition of the scalp as a side-effect? If so, I think it could possibly help my hairloss.

[PatientlyWaiting]

Dr Greco is located in New York right?

[Dr Joseph F. Greco]

Hey Dr Greco thanks for the informative response.

I am just curious as to what you mean by the bolded "turning on stem cells for a period of time", does that mean, you just can't take 3-4 different injections, you have to keep coming back for more until you don't want your hair any more?

To rephrase: Is it like Finasteride/Minoxidil, where you may get results but you have to take these injections for the rest of your life to maintain results?

Like any treatment therapy at this point we find that one treatment will last 8 to 10 months and you have a bell shaped curve effect with peak effect at 4 to 6 months. We are working on evtending this but some technology requires testing and medical device approval these things take time but there are some promising things. JG

[KeepHoping]

Is there any downtime after a PRP procedure? Swelling or any temporary side effects?

[UK Boy]

Dr. Greco

I was going to have PRP + Acell treatment but now I have heard that plasma is full of sex hormones - Testosterone and DHT included. I also read and have confirmed that TGF-B1 is one of the main growth factors taken from PRP. It has previously been stated that TGF-B1 is linked to follicle death and I believe that some have tried to inhibit this growth fact to help lessen hair loss. Could you please explain to me how it is safe and helpful to soak our follicles in this mixture?

[Dr Joseph F. Greco]

Is there any downtime after a PRP procedure? Swelling or any temporary side effects? No downtime KeepHoping after just wash your hair the next day. Thanks, JG

[UK Boy]

Dr. Greco

I understand that you're very busy but I'm somewhat surprised that you replied to a message today that was posted over a month ago but did not reply to my query at the same time even though it was the only other query that was left unanswered. It is very important not just for me but I think all the users of this forum to get an answer to this question.

I look forward to your prompt reply.

[UK Boy]

Doesn't that seem a bit worrying to anyone else that Doctor Greco just ignored my question even though it was one of only two that were unanswered? It's like the first time he's been on for over a month, you thought he would've given an answer to both. The lack of an answer makes me think he either can't give a suitable answer or does not want to address the question at all.

[Dr Joseph F. Greco]

Dr. Greco

I was going to have PRP + Acell treatment but now I have heard that plasma is full of sex hormones - Testosterone and DHT included. I also read and have confirmed that TGF-B1 is one of the main growth factors taken from PRP. It has previously been stated that TGF-B1 is linked to follicle death and I believe that some have tried to inhibit this growth fact to help lessen hair loss. Could you please explain to me how it is safe and helpful to soak our follicles in this mixture?

Hi UK Boy, good questions and whoever is going to do the PRP/ACell treatment for you should answer these questions. I will answer these questions as I see it in our experience.

First, you should know that "A Cell on its own has not demonstrated hair growth". Only when "A Cell is mixed with PRP" has it demonstrated increased hair density in AGA. PRP has demonstrated increased hair aesthetic density in AGA and AA. So what is the common denominator here? Answer "PRP".

The question regarding increased levels of testosterone, "Hair loss isn't caused by increased DHT levels". Best,
JG

Hair loss (related to DHT) is directly determined by how sensitive you are to androgens. Your sensitivity is determined by triplet repeat mutations in the androgen receptor gene on the x chromosome. It's the downstream effects caused by DHT binding to the androgen receptor that causes hair loss. Hair loss is multi factorial and stem cells play much more important roll in MPB than previously thought, especially since the findings of Costalaris et al 2011.

Since 2007 we have been using PRP with hair surgery and non surgically so if there were negative effects they certainly have not shown up in the past four years in our experience in almost 2,000 procedures.

The question regarding TGF b we obviously were concerned about back in 2007. Yes, TGF beta is a growth factor that has negative effect regarding hair, but in the past 4 years in two research grants we found the over all positive effect of the other GF's like VEGF and PDGF outweigh the negative ones like TGF b and EGF. If this were not true how are we and others be getting positive effects. With OroGen PLus (PRP/Natural ECM) we have demonstrated positive hair effects in AGA, AA and Discoid Lupus. Best, JG

[Dr Joseph F. Greco]

Doesn't that seem a bit worrying to anyone else that Doctor Greco just ignored my question even though it was one of only two that were unanswered? It's like the first time he's been on for over a month, you thought he would've given an answer to both. The lack of an answer makes me think he either can't give a suitable answer or does not want to address the question at all.

I believe I have answered your questions, if for some reason it did not post let me know, but I can view it on my end. Sorry about the delay in getting back. Cordially,

JG

[wilymon]

If I could throw in my two cents here. First off, thanks to doctor Greco for offering a response. Maybe it wasn't as detailed as you would've liked, but he deserves credit for taking the time to do so when it appears that no other doctors on the forum did.

Dr. Greco's response at the end reminded me of something Spencer said in December while talking to Dr. Hitzig about Dr. Cole's criticisms concerning Acell's use:

I've been in this field for like 13 or 14 years and I have seen the evolution of this field and I can't site any true clinical studies when it comes to a lot of the advancements in this field. Most of it is anecdotal, most of this is being done within the practices of leaders in this field, so I'm a little confused. I mean, to me most of everything that's being performed today in surgical hair restoration was basically an anecdotal experiment.

Dr. Greco, correct me if I'm wrong, but it seems like we're not 100% sure what's going on (with PRP) and why it's working the way it is, but the pieces of the puzzle are coming together, beginning with the anecdotal evidence in almost "almost 2,000 procedures," and continuing through scientific research that is happening right now.

Uk_Boy, I understand that you're frustrated because I am too. I'd love a definitive answer. We all would. But this is a cellular science that's finally coming into its own. Just look at the University of Pennsylvania's research from January; more and more is being learned everyday. If you're not comfortable with getting the procedure, I'd suggest waiting until more research is done that will provide you with a satisfactory answer because it doesn't seem like that research has been been done yet, or at least not to yours and a lot of people's liking. If it had, we might've had a lot more doctors jumping at PRP and eventually the combination with Acell.

I'll just offer my own anecdote: When I found out about PRP (before Acell was in the picture) I was really excited about it but I couldn't find a local doctor to do it because of a lack of research. I searched every corner of the internet with little luck. I did stumble across a couple of pages of doctors who had tried but discontinued PRP because they didn't feel it was doing enough good for their patients (though it seems like the combination with Acell is changing that). What I NEVER came across was a complaint that the PRP had caused damage. It had either helped or not helped enough to warrant offering the procedure.

[UK Boy]

Thank you both for your input. Sorry I got a bit angry Dr. Greco, as you said maybe there was a delay when your answer was posted. I've pretty much decided to wait and see the outcome on PRP + Acell they reckon we should have more info by the end of the year.

[Dr Joseph F. Greco]

If I could throw in my two cents here. First off, thanks to doctor Greco for offering a response. Maybe it wasn't as detailed as you would've liked, but he deserves credit for taking the time to do so when it appears that no other doctors on the forum did.

Dr. Greco's response at the end reminded me of something Spencer said in December while talking to Dr. Hitzig about Dr. Cole's criticisms concerning Acell's use:



Dr. Greco, correct me if I'm wrong, but it seems like we're not 100% sure what's going on (with PRP) and why it's working the way it is, but the pieces of the puzzle are coming together, beginning with the anecdotal evidence in almost "almost 2,000 procedures," and continuing through scientific research that is happening right now.

Uk_Boy, I understand that you're frustrated because I am too. I'd love a definitive answer. We all would. But this is a cellular science that's finally coming into its own. Just look at the University of Pennsylvania's research from January; more and more is being learned everyday. If you're not comfortable with getting the procedure, I'd suggest waiting until more research is done that will provide you with a satisfactory answer because it doesn't seem like that research has been been done yet, or at least not to yours and a lot of people's liking. If it had, we might've had a lot more doctors jumping at PRP and eventually the combination with Acell.

I'll just offer my own anecdote: When I found out about PRP (before Acell was in the picture) I was really excited about it but I couldn't find a local doctor to do it because of a lack of research. I searched every corner of the internet with little luck. I did stumble across a couple of pages of doctors who had tried but discontinued PRP because they didn't feel it was doing enough good for their patients (though it seems like the combination with Acell is changing that). What I NEVER came across was a complaint that the PRP had caused damage. It had either helped or not helped enough to warrant offering the procedure.

Hello wilymon, you are absolutely correct we are beginning to understand the interaction of growth factor signaling and stem cells, especially with regard to hair. This all evolved from our observations utilizing GF's in hair surgery and it is a process of scientific investigation and observation. While we want immediate answers to specific questions it takes time and money, which is not always there, to investigate. Also, with regards to specific questions in medicine you can "never say never", but based upon what you observe "here is what we see".

I have been in Hair Restoration surgery 28 years and my father was 61 years ago, so I grew up in the field and hair research is important to me. We have tried to be scientific in our approach by completing two research grants and simply report what we are finding and not sensationalize. When you are observing something for 28 years can you notice what is normal and what is different. All we can do continue to understand and get deeper into the understanding.

We have always tried not to commercialize this but keep it scientific. Unfortunately, not everyone does this and patients become frustrated when they are promised something that cannot be delivered. I was taught to be honest and get good results, especially in medicine and you will be around a long time. Don't shoot the messenger. Best, JG

[Dr Joseph F. Greco]

Thank you both for your input. Sorry I got a bit angry Dr. Greco, as you said maybe there was a delay when your answer was posted. I've pretty much decided to wait and see the outcome on PRP + Acell they reckon we should have more info by the end of the year.

Hey UK Boy no problemo amigo I think I answered your first post then took some time to respond and you only saw the first answer. Have a nice weekend. JG

[hdude46]

Dr. Greco,

With over "2000 patients" benefitting from prp why aren't we seeing any of these results. I have talked with several very respected clinics including the one who did your ht and they are not convinced there is enough evidence to begin offering it in their practice. I think that speaks volumes and I am discouraged that almost every person on this forum who has gone to you for prp (outside of destin), has not experienced any benefits from it.

Being that I am young, still have a relatively good amount of hair, am looking to have it done mostly for the crown, and have a somewhat itchy scalp that the anti-inflamatory properties of prp could possibly aid in treating, I am what you call an ideal candidate. However the one thing that keeps me away from trying it is that there is no evidence.

I know you dont like photos, but its hard to just take your word that you are seeing results without some patient testimonials or atleast some pictures that its working. Dr. Feller was all excited about this two summers ago and was posting regular updates when he started this and then all of a sudden stopped. Why? If it was working why not continue to spread the good news? Where are the happy prp patients on the forums? I cant find any.

If you can address these concerns I would greatly appreciate it.

[Dr Joseph F. Greco]

Dr. Greco,

With over "2000 patients" benefitting from prp why aren't we seeing any of these results. I have talked with several very respected clinics including the one who did your ht and they are not convinced there is enough evidence to begin offering it in their practice. I think that speaks volumes and I am discouraged that almost every person on this forum who has gone to you for prp (outside of destin), has not experienced any benefits from it.

Being that I am young, still have a relatively good amount of hair, am looking to have it done mostly for the crown, and have a somewhat itchy scalp that the anti-inflamatory properties of prp could possibly aid in treating, I am what you call an ideal candidate. However the one thing that keeps me away from trying it is that there is no evidence.

I know you dont like photos, but its hard to just take your word that you are seeing results without some patient testimonials or atleast some pictures that its working. Dr. Feller was all excited about this two summers ago and was posting regular updates when he started this and then all of a sudden stopped. Why? If it was working why not continue to spread the good news? Where are the happy prp patients on the forums? I cant find any.

If you can address these concerns I would greatly appreciate it.

Thank you for your questions and I can understand your concerns. First, as I have always done from the very beginning four years ago I only post photos of patients in studies we have done and generally show these results at conferences first where discussion can properly take place. I will be sharing our results in AGA, AA and DL at the ISHRS meeting this as well as showing results of others we are working with in the proper forum.

In 2007 we started utilizing PRP in HTP surgery and after noticing differences in surgery did the initial study sponsored by the ISHRS to see the effects of cytokines on non transplanted hair. After that we did a second research grant to study the effects of growth factors in Alopecia Areata patients. After two years of studies and noticing we did not have any negative side effects, I had no trouble offering the non surgical treatment to patients who failed on traditional therapy or who had side effects with traditional therapy. Because we have always considered this experimental, but safe, I have not and do not advertise this as a procedure and therefore do not show photos.

We are beginning to understand how cellular therapy is working and if and how GF's signal stem cells in various hair loss conditions. Of course, there is not a lot evidence when something new first comes out because we are at the forefront gathering information and evidence as you indicate with Dr Shapiro who did my HTP. That is why we wait for conferences to demonstrate our results and the results of others. Would you rather us proceed in an orderly scientific fashion or sensationalize like some others do?

Regarding Dr Feller, who I have a high professional regard, would be the first to tell you that we are using something different than straight PRP. Not all cellular therapy is the same.

After working in hair surgery 28 years and working with cellular therapy since 1998 and utilizing it with hair surgery the past 4 years I have no problem offering it to patients who have failed traditional therapy or have side effects to medicines because it has been an effective safe option. The easiest thing to do is criticize or find fault when something new is introduced. Time and scientific method will be the judge of how GF/stem cell interaction impacts hair loss solutions. Cordially, JG

[hdude46]

Thank you for your questions and I can understand your concerns. First, as I have always done from the very beginning four years ago I only post photos of patients in studies we have done and generally show these results at conferences first where discussion can properly take place. I will be sharing our results in AGA, AA and DL at the ISHRS meeting this as well as showing results of others we are working with in the proper forum.

In 2007 we started utilizing PRP in HTP surgery and after noticing differences in surgery did the initial study sponsored by the ISHRS to see the effects of cytokines on non transplanted hair. After that we did a second research grant to study the effects of growth factors in Alopecia Areata patients. After two years of studies and noticing we did not have any negative side effects, I had no trouble offering the non surgical treatment to patients who failed on traditional therapy or who had side effects with traditional therapy. Because we have always considered this experimental, but safe, I have not and do not advertise this as a procedure and therefore do not show photos.

We are beginning to understand how cellular therapy is working and if and how GF's signal stem cells in various hair loss conditions. Of course, there is not a lot evidence when something new first comes out because we are at the forefront gathering information and evidence as you indicate with Dr Shapiro who did my HTP. That is why we wait for conferences to demonstrate our results and the results of others. Would you rather us proceed in an orderly scientific fashion or sensationalize like some others do?

Regarding Dr Feller, who I have a high professional regard, would be the first to tell you that we are using something different than straight PRP. Not all cellular therapy is the same.

After working in hair surgery 28 years and working with cellular therapy since 1998 and utilizing it with hair surgery the past 4 years I have no problem offering it to patients who have failed traditional therapy or have side effects to medicines because it has been an effective safe option. The easiest thing to do is criticize or find fault when something new is introduced. Time and scientific method will be the judge of how GF/stem cell interaction impacts hair loss solutions. Cordially, JG


Dr. Greco,

Thank you for your time and candor, I appreciate it. I do still have a few questions if you don't mind.

You say you don't advertise this as a procedure and usually wait until conferences to show photos and share results, however on your website and your blog you DO advertise this procedure and show the same 2-3 photos that you advertised on this forum two years ago. I have also seen you on various news reports. I do know you have always said this is experimental but you have also talked about the results you have been getting on this forum as well as others with not much else to back up those claims. As a consumer and prospective patient I feel you are sending, possibly unintentionally, mixed messages about prp.

Like you said, "I have no problem offering it to patients who have failed traditional therapy or have side effects to medicines because it has been an effective safe option."

All I am asking is why not show some pictures of people who have benefitted from this or post some testimonials? I realize you have two on your blog (1 male, 1 female) and like I said before the same few photos, but why not more if you have treated so many patients and been using prp in htp surgery for 4 yrs now? I guess its my contention that its a little unfair to say you don't advertise, yet whether through this thread, on your blog, on your website, and through the use of those 2 testimonials and few pictures you do.

I've been trying to convince myself just to give this a try for awhile now, but have been unable to convince myself b/c ive rarely seen or heard from any patients who say 'yeah, its worked for me.' A little more evidence would go a long way. if you could respond to these concerns, I would appreciate it. Thanks!

[NTMANNN]

I'm kind of in the same boat as @hdude46, toying with the idea of an injection of PRP+ECM but I don't want to stop taking Avodart. I want the injection to see if it can add volume to my miniaturized hairs, but is this a reasonable expectation? That it will work in that way for me or does it work differently for different patients?

I want salvage as much of my miniaturized hairs as possible before I get a transplant to avoid that shock loss. Have you had patients with this gameplan? What do/would you tell them?

[HairTalk]

Dr. Greco, if I may ask, why is there such a dearth of photographic support for P.R.P.-treatments on your Web site? You mention you've performed the procedure on many patients (citing you've done so since 2007), yet you present only three before–after shots of those treated with P.R.P. injections for male-pattern baldness (the other two were sufferers of alopecia areata). Even these five images are of low resolution, and they don't suggest much in terms of treatment-efficacy.

Simply put, where's the photographic evidence, and why is it not on your Web site?

Thank you.

[Dr Joseph F. Greco]

Dr. Greco,

Thank you for your time and candor, I appreciate it. I do still have a few questions if you don't mind.

You say you don't advertise this as a procedure and usually wait until conferences to show photos and share results, however on your website and your blog you DO advertise this procedure and show the same 2-3 photos that you advertised on this forum two years ago. I have also seen you on various news reports. I do know you have always said this is experimental but you have also talked about the results you have been getting on this forum as well as others with not much else to back up those claims. As a consumer and prospective patient I feel you are sending, possibly unintentionally, mixed messages about prp.

Like you said, "I have no problem offering it to patients who have failed traditional therapy or have side effects to medicines because it has been an effective safe option."

All I am asking is why not show some pictures of people who have benefitted from this or post some testimonials? I realize you have two on your blog (1 male, 1 female) and like I said before the same few photos, but why not more if you have treated so many patients and been using prp in htp surgery for 4 yrs now? I guess its my contention that its a little unfair to say you don't advertise, yet whether through this thread, on your blog, on your website, and through the use of those 2 testimonials and few pictures you do.

I've been trying to convince myself just to give this a try for awhile now, but have been unable to convince myself b/c ive rarely seen or heard from any patients who say 'yeah, its worked for me.' A little more evidence would go a long way. if you could respond to these concerns, I would appreciate it. Thanks!

The photos you are referring to were patients, as previously stated, that were in the initial study in 2008 posted on the site. You questions have already been answered in the prior post. Cordially, JG

[Dr Joseph F. Greco]

Dr. Greco, if I may ask, why is there such a dearth of photographic support for P.R.P.-treatments on your Web site? You mention you've performed the procedure on many patients (citing you've done so since 2007), yet you present only three before–after shots of those treated with P.R.P. injections for male-pattern baldness (the other two were sufferers of alopecia areata). Even these five images are of low resolution, and they don't suggest much in terms of treatment-efficacy.

Simply put, where's the photographic evidence, and why is it not on your Web site?

Thank you.

My response to your questions are answered in a prior post. Thank you

[HairTalk]

My response to your questions are answered in a prior post. Thank you

I've just read; thank you. May I ask, then, when you feel the results of your work will be ready for presentation to the public?

[hdude46]

Dr Greco,

Is dr deyarman using the same prp procedure as you?

Also, have you noticed it improve any scalp conditions such as itchiness in any patients?

thanks

[Dr Joseph F. Greco]

I've just read; thank you. May I ask, then, when you feel the results of your work will be ready for presentation to the public? I am presenting our experiences with cellular therapy in various hair loss diseases at the ISHRS annual meeting in Anchorage and then in Paris in Oct so we will post some results of ours and more importantly others who and are doing independent studies and using cellular therapies in hair loss disease processes. Thanks,
JG

[Dr Joseph F. Greco]

[QUOTE=hdude46;29203]Dr Greco,

Is dr deyarman using the same prp procedure as you?

Also, have you noticed it improve any scalp conditions such as itchiness in any patients?

thanks[/QUOte/

No, but I believe he is having some nice results with what he is using. We are finding that there are many roads that lead to Rome.

Regarding itchiness. No question it helps reduce itchiness in scalp conditions because this is a powerful inflammatory as we are seeing in AA and DL. Thanks JG

[HairTalk]

I am presenting our experiences with cellular therapy in various hair loss diseases at the ISHRS annual meeting in Anchorage and then in Paris in Oct so we will post some results of ours and more importantly others who and are doing independent studies and using cellular therapies in hair loss disease processes. Thanks,
JG

So, we (the public) should hear/see some details of your work by around the end of 2011?

[hdude46]

[QUOTE=hdude46;29203]Dr Greco,

Is dr deyarman using the same prp procedure as you?

Also, have you noticed it improve any scalp conditions such as itchiness in any patients?

thanks[/QUOte/

No, but I believe he is having some nice results with what he is using. We are finding that there are many roads that lead to Rome.

Regarding itchiness. No question it helps reduce itchiness in scalp conditions because this is a powerful inflammatory as we are seeing in AA and DL. Thanks JG

Dr Greco,

Thanks again for taking your time to respond.

I was wondering if you could explain the differences between your prp procedure and the one dr deyarman is currently using and why both procedures, although different, are seemingly producing results. Thank you!

[hdude46]

paging dr greco...