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

[MG63]

Absolutely not. I would continue to use minoxidil. Especially, minoxidil, because in addition to working on the potassium channels it also increases Vascular Endothelial Growth Factor VEGF, which is how we feel the PRP is working. So anything that increases micro circulation is good.

If patients are on DHT blockers we encourage them to stay on that therapy as well.

thanks for the fast response.

[Dr Joseph F. Greco]

after PRP, do / should most patients stop using minoxidil and other topicals? Also are there products they should use or avoid?

Absolutely not. I would continue to use minoxidil. Especially, minoxidil, because in addition to working on the potassium channels it also increases Vascular Endothelial Growth Factor VEGF, which is how we feel the PRP is working. So anything that increases micro circulation is good.

If patients are on DHT blockers we encourage them to stay on that therapy as well.

[MG63]

There are very few complications with PRP since it is your own cells. However, the "absolute" contra indications, which are quite rare and should be verified with patients medical histories are platelet dysfunction syndrome, critical thrombocytopenia, hypofibrinogenemia, septicemia, sensitivity to bovine thrombin. There are "relative" contraindications such as steroid injections two weeks prior, fever, recent illness, HGB <10g/dl, platelet count <105/ul, active pseudomonas, enterococcus or Klebsiella infections. To put this in perspective, we have not had any patient with hair or ortho biologic treatment present with absolute contraindications or have any complication.

after PRP, do / should most patients stop using minoxidil and other topicals? Also are there products they should use or avoid?

[Dr Joseph F. Greco]

Hello Dr Greco,

One thing thats bothered me about PRP and using the patients own blood , is the presence of any pre-exisiting disorders or illnesses ( esp related to connected tissue like Hypermobility ) that might influence the overall results.

Are you aware of any complications or , worse results happening from patients using PRP who fit into this category i.e. whether its been done on scalp or on other areas like knees ?

thanks

helena

There are very few complications with PRP since it is your own cells. However, the "absolute" contra indications, which are quite rare and should be verified with patients medical histories are platelet dysfunction syndrome, critical thrombocytopenia, hypofibrinogenemia, septicemia, sensitivity to bovine thrombin. There are "relative" contraindications such as steroid injections two weeks prior, fever, recent illness, HGB <10g/dl, platelet count <105/ul, active pseudomonas, enterococcus or Klebsiella infections. To put this in perspective, we have not had any patient with hair or ortho biologic treatment present with absolute contraindications or have any complication.

[Dr Joseph F. Greco]

Dr Greco

There has been lots of news recently about the effectiveness of PRP in a number of studies. What does this do for its use in hair loss. http://news.google.co.uk/news?hl=en&...-8&sa=N&tab=wn

We are studying the effects on hair growth in hair surgery and hair miniaturization. Soon we will initiate a double blind randomized independent study for AGA. After being in hair surgery 27 years and doing over 400 procedures the past three years and completing two research grant studies with PRP, there is a positive difference and numerous other independent studies in hair surgery indicate that.

[helenah]

Hello Dr Greco,

One thing thats bothered me about PRP and using the patients own blood , is the presence of any pre-exisiting disorders or illnesses ( esp related to connected tissue like Hypermobility ) that might influence the overall results.

Are you aware of any complications or , worse results happening from patients using PRP who fit into this category i.e. whether its been done on scalp or on other areas like knees ?

thanks

helena

[Preston]

Hi Dr Greco ,

I would just like to know if PRP is usefull with diffuse hair loss ? can it help stopping it on the entire scalp ?

Do you know of anyone doing this therapy in europe ? maybe in England ? I live in Belgium

Thanks

[twentiesbalding]

Dr Greco

There has been lots of news recently about the effectiveness of PRP in a number of studies. What does this do for its use in hair loss. http://news.google.co.uk/news?hl=en&...-8&sa=N&tab=wn

[MG63]

thanks so much.

[Dr Joseph F. Greco]

Dr. Greco -- as a follow-up to the question regarding doctors in the Washington DC area that PRP. Since there is nobody in this area. Where are the closest doctors - North Carolina, Pennsylvania, MD, NY?

thanks.

MG63 Dr Jeff Epstein has an office in NY you could check with his office. Best, JG

[MG63]

Dr. Greco -- as a follow-up to the question regarding doctors in the Washington DC area that PRP. Since there is nobody in this area. Where are the closest doctors - North Carolina, Pennsylvania, MD, NY?

thanks.

[Dr Joseph F. Greco]

Hi Dr. Greco,
One question/concern I have about the PRP procedure is the variability of platelet count in the healthy population. The normal range is 150k-450k/ml. Therefore, for any two people that opt for this treatment, it's possible that they are getting a 3x difference of platelets injected into their scalp. Since we don't know for the certain the mechanism of action of this procedure, it's also possible that there is a threshold of platelets, where any amount of platelets below would not yield any positive results. I think this platelet count variability may be a key contributor to the difference in efficacy that we are observing with this procedure.
What are your thoughts about this?
Thanks.

Wow what a great question. Yes, that is absolutely the variable with autologus ( same person) PRP and even in that one person platelet counts will vary from one week to the next.
We have developed a homologus lyophilized (freeze dried) cytokine ( GF ) rich plasma where we can control the dose of GF's, which is the future of PRP. In other words, "GF's in a bottle", pure GF's in plasma and no cells so no antigenic reaction, that has a shelf life of 2 years. All you have to do is add sodium chloride and finito, use it, no blood draw and it is a consistent level every time!
We are currently using this is vet medicine studies and not only does it work on soft tissue and wounds, but it is very effective regenerating bone for non-union fractures. Of course, this will need FDA approval as a drug and this is our intention. JG

[Buckerine11]

Hi Dr. Greco,
One question/concern I have about the PRP procedure is the variability of platelet count in the healthy population. The normal range is 150k-450k/ml. Therefore, for any two people that opt for this treatment, it's possible that they are getting a 3x difference of platelets injected into their scalp. Since we don't know for the certain the mechanism of action of this procedure, it's also possible that there is a threshold of platelets, where any amount of platelets below would not yield any positive results. I think this platelet count variability may be a key contributor to the difference in efficacy that we are observing with this procedure.
What are your thoughts about this?
Thanks.

[Dr Joseph F. Greco]

I'd like to know this as well as I live in the same vicinity.

Sorry I do not know anyone in that area doing this therapy. JG

[Dr Joseph F. Greco]

Dr. Greco,

Sorry if this has been already asked, as I don't want to waste your time but what are the reasons that this procedure does not work on the hairline? I understand this is a new procedure and it's probably still unknown...

I'm 23 and have most of my hair thinning in the front hairline for now... about to get on Propecia to hold me down. I'm moving to Florida in the next year or two and will pretty much be a guinea pig for this as of right now it sounds like the most promising procedure currently.

I will also basically pay any amount of money to fight my hairloss.

Phatalis great question and I wish I had the answer but with all therapies the frontal hairline is the most resistant to therapy besides moving hair. It is the nature of AGA. We do treat the frontal hairline as a preventative therapy and I see some reversal, but nothing like a hair transplant result.