Video Presentation of PRP Injection Procedure for Hair Loss

[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]

"Different" PRP

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]

"Designated area to be treated"

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]

Question for Dr 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.

[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?