(PRP) Hair Treatment
Platelet rich plasma (PRP)
Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss.
Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.
Introduction
Platelet rich plasma (PRP) was first described in Hematology as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia since 1970.1 Nowadays, PRP has become a popular treatment for many conditions in sport medicine,2 regenerative medicine,2,3 aesthetic medicine4 and hair loss treatment5,6 as it contains a variety number of growth factors and cytokines that can accelerate wound healing and tissue restoration.
Both the device used to separate platelets and the subsequent use of the PRP product fall under the regulation of the US Food and Drug Administration (FDA).7 Any use of PRP other than blood transfusion is an “off label use” which is not prohibited by the FDA regulation if performed by a physician with the intent to practice medicine. Despite its widely application, the mechanism underlying the hair regrowth effects of PRP remains to be fully explored.
Classification of Platelet Rich Plasma
There are many variations in PRP preparations, from the type of collection tubes, power used, the number of cycles and the duration of centrifugation, components of PRP and an activation method was applied. A standardized classification of PRP called DEPA was proposed by Magalon et al, based on four components: dose of injected platelets (baseline concentration of platelets at 200×109/L), efficiency of the process (platelet recovery rate %), purity of PRP (relative composition in platelets %) and activation process,14 as shown in Table 1.
From this classification, an “AAA” DEPA score is referred to a high-concentration platelet injection (>5 billion) with minimal red blood cell contamination and well prepared with a proper method resulting in minor loss of platelets from whole blood. The last category in the DEPA classification is reporting the presence or absence of any exogenous activator, such as thrombin or calcium chloride.
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