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

Can the infusion of platelet rich plasma (PRP) help to reverse or slow the process of Androgenic Alopecia? Does this therapy actually reverse hair follicle miniaturization and “wake up” dormant follicular stem cells?

Dr. Joseph Greco Ph.D. will be answering your questions concerning this possible breakthrough in the prevention and treatment of hair loss, exclusively on Baldtruthtalk.com.

Please feel free to post your questions for Dr. Greco and he will provide as much information as possible about his research and results with PRP as it pertains to hair loss.

This is a great opportunity to communicate directly with one of the foremost experts in PRP therapy for hair loss, so feel free to get involved.

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

Does this treatment work as well or better then Propecia?
Do you have to be on any medication for this to work?
When will it it be available?
How many people have you treated and what were the results.
Does it work on everyone who still has some hair?

Thanks in advance!
Paul

Hello dr. Greco.

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

Thanks.

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?

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.

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

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Originally Posted by tbtadmin

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

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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.

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

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

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Originally Posted by PayDay

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

Does this treatment work as well or better then Propecia?

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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.

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

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No

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When will it it be available?

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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.

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

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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.

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Does it work on everyone who still has some hair?

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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.

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

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.

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!

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?

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Originally Posted by Dante666

Hello dr. Greco.

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

Thanks.

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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.

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Originally Posted by 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?

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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.

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Originally Posted by 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

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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.

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

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.

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Originally Posted by 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?

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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.

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. Greco,

Thank you for your comprehensive reply even though most of it is subjective and obviously so because of it's beginning stages in treating hairloss. I am still pleasantly surprised by the results of stimulated re-growth in the patient with alopecia areata. As you and I both know, there has been little to no resolve for that disorder even though the hair follicles do eventually respond in many of the areata cases.

Well, as you say, we will know more in time. And for many patients suffering from MPB, it's also a safe auxiliary treatment that can be used in conjunction with the other FDA approved medciations.

So very possibly my last question is one in which you will be better able to reply at a later date. Understood.

Can hardly wait for future data releases by you. Keep up the awesome work.

Dr. Greco,

One other thing. I had no idea you were the recipient of three HT procedures. Congrats! How many total grafts did you have done?

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Originally Posted by gillenator

Dr. Greco,

One other thing. I had no idea you were the recipient of three HT procedures. Congrats! How many total grafts did you have done?

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I have had a total of 3500 grafts. One session in the hairline and two in the posterior crown. Dr Ron Shapiro did two.

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Originally Posted by 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

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You could because there are no side effects as nothing but your cells are used.

How soon can we expect this to be available, as for me and others, I would like to get this treatment done as soon as possible, by of course someone who knows what they are doing.

Dr. Greco,

I was just wondering if I can get this done in California? My hair seems even when I shave it with no guard on an electric shaver but when it grows it look really uneven and thin. So maybe this could help me?

Dr Greco,

Can you reveal the GF-ECM components that have been added to the enhanced PRP?
Are there any plans to add mesenchymal stem cells or cells that have been reverted to their embryonic state to the injection? If so, when do you anticipate trials may begin?

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Originally Posted by iwannakeephair1674

How soon can we expect this to be available, as for me and others, I would like to get this treatment done as soon as possible, by of course someone who knows what they are doing.

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Sorry for the delay in answering. Fill out an on line consultation from my web site and send photos of your hair "wet"... we will contact you as to our evaluation.

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Originally Posted by brando1

Dr. Greco,

I was just wondering if I can get this done in California? My hair seems even when I shave it with no guard on an electric shaver but when it grows it look really uneven and thin. So maybe this could help me?

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I am not aware of anyone yet but can keep you posted.

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Originally Posted by Costanza

Dr Greco,

Can you reveal the GF-ECM components that have been added to the enhanced PRP?

The ECM is created in a certain way the plasma protein is processed. The ECM is concentrated protein...and all yours!


Are there any plans to add mesenchymal stem cells or cells that have been reverted to their embryonic state to the injection? If so, when do you anticipate trials may begin?

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We already have pending patients and we are woking diligently daily.

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Originally Posted by Dr Joseph F. Greco

We already have pending patients and we are woking diligently daily.

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Can you estimate roughly when you may be offering MSC + PRP/GF injections should the results from the MSC patients prove successful? Are we talking about a year or so or several years?

Thanks!

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Originally Posted by Costanza

Can you estimate roughly when you may be offering MSC + PRP/GF injections should the results from the MSC patients prove successful? Are we talking about a year or so or several years?

Thanks!

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Difficult to say at this point and I don't want to speculate to be honest.

Can you detail how the patient prepares for the treatment and walk us through how you proceed in preparing the area to be treated?
Also, what size of needle roller is used?

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Originally Posted by Costanza

Can you detail how the patient prepares for the treatment and walk us through how you proceed in preparing the area to be treated?
Also, what size of needle roller is used?

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Certainly. First 60cc of blood is drawn and it takes about 15 mins to process the PRP. The area of treatment is then localized with Lidocaine. I have used various size rollers, but it is not necessary to use anything but a 1mm length roller because we do not want to traumatize the hair only lightly on the scalp. We are not trying to cause any bleeding. The PRP is then injected in the dermis about an inch apart in the treatment area and a light coating is applied on the scalp. (You will have platelet migration throughout the scalp).We like you keep the growth factors on the scalp overnight and then you can simply shampoo your hair the next day. It takes about 35-40 mins for the entire process and you may wear a hat immediately after, no bandages and no downtime.

Would it be best to cut the hair really short before treatment?

Do you treat the front of the scalp with PRP, as well, even though the best resuts are achieve on the crown?

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Originally Posted by Costanza

Would it be best to cut the hair really short before treatment?

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Not really 1 inch is fine

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Do you treat the front of the scalp with PRP, as well, even though the best resuts are achieve on the crown?

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Yes, we do if we are doing everything on top. Can't hurt as long as patients know where it has demonstrated better results.

How long after the procedure can the treated area be exposed to sun / UV light? I am usng UV light therapy for dermalogical conditions.

Dear Dr. Greco: I am wondering if this therapy would help those who have been scarred in past Hair transplant surgeries? Such as in the donor area(via strip method) or in scalp reduction scars. Congrats on you work on this. --David.

Last May I contracted a scalp fungal infection from a beauty salon that was misdiagnosed by my doctor as psoriasis. For 4 painful months I was using topical steroids in an alcohol base as treatment - which was doing nothing except perhaps making a stronger fungus, inflicting severe pain and making my condition worse.

I finally found a decent dermatologist who immediately recognized the real problem and arranged a correct treatment program. The pain, itching and flaking has now stopped, but it took a really long time to arrest the situation.

Hair regrowth has been SLOOOOW. Glacially so . . They say that now I am experiencing hair loss from stress and that my scalp suffered an injury and needs time to heal and balance out.

Under these circumstances - do you think this PRP treatment would be helpful to me? Is this effective for women and men? (I'm a woman) Thanks

Robyn,

While I wouldn't know anything about your particular situation, I would definitely contact Dr. Greco regarding this. He has done a lot of work in the PRP arena. I met with him last week and he performed the simple procedure on me. Also, I've read posts from Dr. Allen Feller and he appears to be very knowledgeable on the subject as well. I would contact him as well. Best of luck and please keep us posted.

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Originally Posted by Costanza

How long after the procedure can the treated area be exposed to sun / UV light? I am usng UV light therapy for dermalogical conditions.

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Hello Costanza, I would say that within a few days you could use UV.... it should not have any negative effects immediately after. Actually, having the high concentrations of growth factors and protein in the scalp may be helpful for your condition.

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Originally Posted by geminidb8

Dear Dr. Greco: I am wondering if this therapy would help those who have been scarred in past Hair transplant surgeries? Such as in the donor area(via strip method) or in scalp reduction scars. Congrats on you work on this. --David.

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While objective biopsy comparative studies of wounds treated with PRP have demonstrated faster healing, less scar collagen and higher tensile strength (Carter et al, 2003) for these reasons we utilize PRP in the donor area. Literally, thousands of Cardiac surgery wounds are closed yearly with PRP because of anti bacterial effects and the implications of mortality if an infection occurs.

Unfortunately, I do not feel that the use of PRP to reduce scaring years after a surgery in a donor area would be effective.