Platelet Rich Plasma (PRP) Therapy | Dr. Joseph Greco Ph.D. Answers Your Questions

[Dante666]

Hello dr. Greco, I have another question for you. You said that you have no problem utilizing in PRP in a younger patient just beginning to miniaturize in the crown or vertex. But could you do it in someone who is beginning to miniaturize in the hairline (like me)? I just want to slow down my hairloss, which is just at the beginning.

Btw, can you tell us the cost of the treatment?

Thanks.

[Dr Joseph F. Greco]

Dr. Greco,

Incredible results for treating injuries. Thank you for your research in PRP therapy and sharing it with the hairloss community. And what a pleasant surprise to see that you are treating Dr. Cooley for a tennis elbow injury. I have a similiar situation in my left shoulder as I injured it last September. Very slow to heal, it's the tendons and/or ligaments that I injured. Chronic pain and now more a nerve sensation down the arm.

Back to hairloss and PRP therapy.

1) Since MPB is a genetic disposition and not an injury, how can PRP reverse "the progression" aspect of the disease?

2) Does PRP reduce the production levels of DHT?

3) Does PRP enhance the hair follicle's resistance to DHT?

4) And just to confirm, this therapy would be ongoing for a lifetime since the disorder is progressive over a lifetime?

5) How many partcipants are in your ongoing study and any distinctions that we need to be aware of? How many females are in the trial group?

6) Will you be treating other forms of alopecia with PRP?

7) How frequent will you be releasing your clinical findings for treating MPB and where will you be publishing them?

8) Just out of curiosity, do you have MPB or does it exist in your family history? And if so, do you plan on doing PRP therapy yourself or possibly are already doing it?

9) How practical is it for this therapy to get into HT practices and clinics?

10) Here's my biggie question. Does your theory suggest that if the young men who are diagnosed with MPB early, and they get on PRP therapy, that they may never need surgical hair restoration?

Thank you for your great questions. Regarding, “does PRP reduce DHT”? We do not know this. Do other approved FDA non DHT blockers like Rogaine reduce DHT? We do not know this. Does Low level light therapy reduce DHT? We do not know this. Basically, medicines and other therapies have different mechanisms of action other than lowering levels of DHT, but are approved because they have demonstrated some positive results.

First, this study was prompted after utilizing PRP in hair restoration to determine if traumatizing (inducing Stat-3) and infusing high concentration of growth factors would have any effect on non transplanted hairs. The study was never intended to create a procedure or replace any traditional FDA approved therapies, but the study created even more intriguing questions.

Why did hair in the treatment group reverse for up to eight months? What turned on the dormant follicular stem cells in the Alopecia Areata patient whose condition was getting worse?

Was creating Stat-3 along with infusion of highly concentrated growth factors inhibiting DHT? Honestly, we do not know. We are only observing and trying to understand.

Knowing that PDGF promotes angiogenesis and mitogenesis and based upon previous independent research by (Takakura et al, 1996) who demonstrated that PDGF signals are involved in both epidermis-follicle interaction and the dermal mesenchyme interaction required for hair canal formation and the growth of dermal mesenchyme, respectively.

In 2001,Yano et al identified VEGF as a major mediator of hair follicle growth and cycling providing the first direct evidence that the improved follicle revascularization a) promotes hair growth and b) increases follicle and hair size. It was these excellent independent studies that we based our study upon.

What we do know is that first generation PRP is safe and has a wide variety of applications in medicine. The next generation of autologus platelet rich plasma is the addition of an extra cellular “matrix” (ECM) and independent studies conclude that, “GF–ECM complexes may well be the most effective and efficient method to stimulate cell proliferation, as well as tissue healing or regeneration”. (Clark et al, 2008)

A great deal of further study is warranted in cellular therapy to fully understand what is going on. We are in the process of investigation a large study with a highly respected scientific research hospital that will include hundreds of patients.

I have no problem utilizing in PRP in a surgical hair procedure or in a younger patient just beginning to miniaturize in the crown or vertex that cannot take traditional therapy because of side effects or in combination with FDA approved therapies because it is safe.

Personally, I have had three hair transplants and have been on Propecia for 8 years. I have had cellular therapy and in twenty five years of being in medicine have never seen some of the things I have seen with this therapy.

Regenerative medicine is the future of medicine and we are only beginning to understand how it works. PRP is only the first generation and the future of hair multiplication will include some combination of GF/ECM complex, stem cells and cultured hair cells.

[geminidb8]

Will PNP Therapy Help Scarred HT Patients?

Dear Dr Greco: First off congratulations on your work with P.N.P. Therapy. I believe that your efforts are to be commended. My question is Will this type of treatment help those who have been scarred in the donor areas (Strip method) of Previous hair transplants? Also will it help in cases of Scalp Reduction scars? Thanks and again congratulations in your progress of this type of treatment. Sincerely : David.

[iwannakeephair1674]

is there any way that I can get this done soon? I'm willing to fly anywhere and pretty much pay anything to get this done. Please tell me if you are interested in doing this with me and I will give you my email address and you can use me for whatever experimentation/publicity if you wanted, I don't care. I am 21 with good looking hair, although I do have some miniturization. I have been taking Finasteride for almost 2 years, while using the laser comb, and DHT blocker shampoos. If you need any pictures of me currently I will be more than happy to post some.

Destin

[Dr Joseph F. Greco]

If this reverses miniturization for 8 months and you take Propecia, wouldn't it help slow down the hair loss even more? Also, if the effects only last 8 months (as what I keep reading in the blog), couldn't you just go again and again every 8 months to a year and still have the benefits?

Thanks
Destin

Destin I think that the combination is great and there is no negative in doing both, especially if someone has seen a leveling after being on Propecia for a long time.

Absolutely no harm in doing it sooner and it may be advantageous because you are only infusing your own growth factors and protein. We just have the initial data from this small study and will be doing expanded studies in larger studies.

[Dr Joseph F. Greco]

Will there be some specific protocol that all clinics must follow to ensure that the plasma is the right concentration and how would you know if you are receiving the correct concentration in the first place before you pay your money?

Winston that is a great question. It is difficult because depending on the processing equipment and the way that it is processed platelet counts will vary. Also, depending on the amount of PRP that is processed concentrations can vary. However most processing equipment will achieve four time baseline platelet count or over 1 million platelet per microleter, which is considered the theraputic range established by Dr Robert Marks (University of Miami).

We are fortunate in that my partner, Robert Brandt, is one of the pioneers in PRP therapy so he has produced a standardized training protocol that if followed will yield consistent platelet ranges.

[Dr Joseph F. Greco]

Hello dr. Greco.

- Is your treatment useful on the hairline?
- How much density?

Thanks.

Hello Dante, actually that is one of my five sons names. Like Propecia and Rogaine it will not work in the hairline as well as it does in the vertex or posterior crown.

[Winston]

Will there be some specific protocol that all clinics must follow to ensure that the plasma is the right concentration and how would you know if you are receiving the correct concentration in the first place before you pay your money?

[Delphi]

Thank you for answering our questions Dr. Greco and thanks' to Spencer Kobren and the moderators of this site for providing this great service to all of us. This forum rocks!

I’m also very excited about this treatment since it is not a drug and it comes from our own bodies. Who cares if you have to go in a couple of times a year to get your head pricked and injected, I would go every week if I could keep my hair!

[HelpROGER]

So if it works for a person, all you would have to do is go in for treatments every 6 months or so. Sounds better then Propecia if it works for you.

[iwannakeephair1674]

If this reverses miniturization for 8 months and you take Propecia, wouldn't it help slow down the hair loss even more? Also, if the effects only last 8 months (as what I keep reading in the blog), couldn't you just go again and again every 8 months to a year and still have the benefits?

Thanks
Destin

[Dr Joseph F. Greco]

Can the infusion of platelet rich plasma (PRP) help to reverse or slow the process of Androgenic Alopecia?

I just posted the study we did on my blog so you can read the results of the study. It demonstrated that the treatment group increased hair diameter when compared to controls at 4 months and 8 months. All we can do is slow it down. I will be posting a video of the patient demonstrated in the study soon and he is now at 13 months. We plan to do another session.

Does this therapy actually reverse hair follicle miniaturization and “wake up” dormant follicular stem cells?

It does in Alopecia Areata where this occurs. This is also demonstrated in the study.

Hello Dr. Greco I think we all have many questions for you.

Does this treatment work as well or better then Propecia?

We are not saying that this therapy should replace any FDA approved therapy and it was never intended to replace any therapy. We have been utilizing PRP cellular therapy the past two years in surgery and noticed increased density sooner which prompted the study on non transplanted hair.

That being said, it is an adjunctive option for hair surgeons to utilize in surgery, especially in the vertex or crown of young patients both male and females who are thinning.

Non-surgically, we recommend it 1- in conjunction with FDA therapies, 2-in those patients that may have noticed a reversal after being on approved therapy or 3- for those patients who had side effects to Propecia or Rogaine.

Do you have to be on any medication for this to work?

No

When will it it be available?

It is available now in surgical procedures and I know Dr Cooley is using it. I have a number of hair surgeons scheduled to visit and we will share our experience with them. Any hair surgeon who understands PRP processing is able to use it.

What is very important to understand is that “not all PRP is the same”. It can be processed differently with higher concentrations of platelets and growth factors. If the PRP is not at a therapeutic level it will not work as well, so someone not skilled in processing may use it and not get the same results. Additionally, if it is used in a non surgical application and used on someone who has more extensive hair miniaturization or someone who is older it will not work as well, similar to Propecia.

We are only beginning to understand how it works in hair applications and caution must be taken and realistic expectations must be given to patients. The most important thing about this therapy is that it is safe because it is your own cells, there is no downtime and it can be used in combination with other therapy.

How many people have you treated and what were the results.

Over 300 the past two years. My partner Bob Brandt is the real guru in PRP. In the past 12 years his company has done over 28,000 PRP procedures in almost every application other than hair. It is with this background that we are studying the effects of growth factors in hair restoration.

Does it work on everyone who still has some hair?

No. Unfortunately Paul, there is no silver bullet yet.
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I will be back to answer the rest of the questions in the next couple days.

[PayDay]

I look forward reading his reply. It's very exciting if you ask me.

[tbtadmin]

Dr. Greco will be posting his responses ASAP. Thanks for your participation and feel free to add to the list if you have other questions.

[gillenator]

Dr. Greco,

Incredible results for treating injuries. Thank you for your research in PRP therapy and sharing it with the hairloss community. And what a pleasant surprise to see that you are treating Dr. Cooley for a tennis elbow injury. I have a similiar situation in my left shoulder as I injured it last September. Very slow to heal, it's the tendons and/or ligaments that I injured. Chronic pain and now more a nerve sensation down the arm.

Back to hairloss and PRP therapy.

1) Since MPB is a genetic disposition and not an injury, how can PRP reverse "the progression" aspect of the disease?

2) Does PRP reduce the production levels of DHT?

3) Does PRP enhance the hair follicle's resistance to DHT?

4) And just to confirm, this therapy would be ongoing for a lifetime since the disorder is progressive over a lifetime?

5) How many partcipants are in your ongoing study and any distinctions that we need to be aware of? How many females are in the trial group?

6) Will you be treating other forms of alopecia with PRP?

7) How frequent will you be releasing your clinical findings for treating MPB and where will you be publishing them?

8) Just out of curiosity, do you have MPB or does it exist in your family history? And if so, do you plan on doing PRP therapy yourself or possibly are already doing it?

9) How practical is it for this therapy to get into HT practices and clinics?

10) Here's my biggie question. Does your theory suggest that if the young men who are diagnosed with MPB early, and they get on PRP therapy, that they may never need surgical hair restoration?