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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.
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Dr Greco is located in New York right?Comment
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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. JGComment
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Is there any downtime after a PRP procedure? Swelling or any temporary side effects?Comment
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Dr. Greco please explain
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?Comment
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No answer for me?
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.Comment
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Seems suspious to me
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.Comment
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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, JGComment
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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.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.
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.Comment
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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.Comment
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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, JGComment
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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.Comment
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