Male and Female Pattern Hair Loss (Androgenetic Alopecia)
Telogen Effluvium (Increased Shedding)
Platelet rich plasma (PRP) for male and female pattern hair loss, thinning hair, and telogen effluvium is an effective and safe treatment using your body’s own plasma. PRP has been in use for decades in multiple medical specialties such as orthopedics, plastic surgery, and dentistry. Over the last decade its use as a hair loss treatment has become more common. Studies have shown PRP to be effective in halting hair loss, growing new hair, as well as thickening hairs that have thinned out. Currently, we are not 100 percent certain why PRP works, but believe the main reason is due to the various growth factors like epidermal growth factor and connective tissue growth factors, among others.
Not all PRP is created equal and we utilize a system that has been proven to have a platelet recovery of more than 80% with a concentration of more than 1.6 times that of the baseline. Although there is currently no agreed upon consensus of the correct concentration of platelets there are studies showing that too high a concentration of platelets can have negative effects. This is why we have chosen a PRP system that is based on data, journal published studies, and real-life experience.
The PRP process at Ocean Drive Dermatology is safe, effective, quick, and with very little discomfort. Initially, you will have a complimentary consultation with either our Board-Certified Plastic Surgeon, Alan Durkin, MD or our Dermatology Physician Assistant, Nick Woltjen, PA-C.
Obtaining PRP takes about 10 minutes in a completely closed system. The closed system means that from blood draw, to centrifuge, to injections your blood and platelets are never exposed to the environment. This is yet another reason why our system is safe and effective.
Step 1: One of our nurses will obtain only one tube of blood from either your left or right arm. You will let us know which arm you prefer or if you know one arm is easier to draw blood from or not. This is not any regular tube that we are using. This tube contains special buffers and gel separatory technology to guarantee a correct concentration of PRP.
Step 2: We then put the tube in a special centrifuge to separate the platelets. This centrifuge spins for a set number of minutes at a very specific revolution to give us high quality PRP.
Step 3: The PRP is ready for injection.
We utilize Pro-Nox Nitrous Oxide with all of our PRP injections for hair loss. Pro-Nox delivers a mixture of 50% oxygen and 50% nitrous oxide. This device is a 100% patient-controlled form of inhaled anesthesia. Simply breathe deep and in seconds there will be immediate relief of pain and anxiety. We are proud to offer this to our patients at no additional charge as part of all of our PRP hair loss packages. The Pro-Nox anesthesia leaves your body in just a few minutes after treatment. You can continue your day immediately after treatment.
Male and Female Pattern Hair Loss
Male and female pattern hair loss is very common and affects tens of millions of patients. The medical term for this type of hair loss is called androgenetic alopecia. It is typically recognizable in men by a balding patch on the crown of the scalp or as receding hair line. Most men in the 30s, sometimes younger have already noticed hair loss or thinning of the hair. Women do not usually end up with patches of hair loss, but more so a significant thinning of hair. Typically, we see this post menopause. Both male and female pattern hair loss tends to be genetic, but we believe hormones also contribute to hair loss. Genetics and hormones are not the only cause of hair loss, but the most common. Other causes of hair loss could be autoimmune, medications, illness, and even tractional alopecia which is usually caused by hairstyles that pull the hair tight.
There is not a cure for hair loss. The good news is that there are plenty of treatments for male and female pattern hair loss that have a proven track record. Ultimately, each patient responds in their own way to treatment. Sometimes the treatments are successful at growing hair and sometimes the treatments are only successful in stopping the progression of the hair loss. Most times, multiple treatments are needed for the best long-term results.
Propecia is the brand name for finasteride 1 mg tablets. Finasteride tablets have been around for a long time for the treatment of benign prostate hyperplasia (BPH) in men in the 5 mg dosage. During BPH treatment some men started to notice that they were growing hair on their scalp or that their thinning hair appeared thicker. Subsequently, research went into finasteride as a possible treatment for male pattern hair loss. During the testing phase of finasteride it was determined that 1 mg was sufficient to help halt hair loss and promote hair growth.
Propecia 1 mg tablets are taken daily and it will take a minimum of 6 to 12 months to determine its efficacy. I tell my hair loss patients that the primary goal of finasteride is to halt or slow the hair loss progression. If we can reverse some of the hair loss that is even better.
Patients often ask me if Propecia is the only thing they need to do for their hair loss. Unfortunately, hair loss is best treated by multiple modalities. Typically, I will combine multiple therapies to get the best results.
Women can also take finasteride for female pattern hair loss, typically at 5 mg daily, but must be post-menopausal or cannot have children due to the teratogenicity of the medication. Alternatively, a medication such as spironolactone may be prescribed alongside a birth control pill to those patients that are premenopausal. As is for men, it will take 6 to 12 months to determine its efficacy.
With Propecia or finasteride treatment the results only last as long as the medication is taken. Pattern hair loss will begin to take over again in about 6 months after stopping treatment.
Rogaine is a topical liquid or foam preparation in either the 2% or 5% strengths that is used for hair loss. Typically, I recommend the 5% version for both male and female hair loss. It will take a minimum of 6 months to determine efficacy of this medication. Typically, it is used twice a day. In the beginning of treatment some patients notice an increase in shedding and this is considered normal. The foam is typically easier to apply and less messy, but some patients prefer the liquid. Liquid is typically less expensive. Just like Propecia, any benefit during treatment is lost over time if discontinued.
This process causes excess hair shedding to occur and is noticeable in brushes, pillows, and around the shower drain. The good news is this hair shedding process will not cause you to go bald. This is typically a temporary shedding process that will reset within 12 months. During this time you will most likely notice shorter hairs growing along the temple areas and even along the center part line in the scalp. We usually associate telogen effluvium with a stressful event several months prior to the actual shedding process. Events such as extreme stress, loss of a loved one, starting or stopping a long term medication, surgery, anesthesia, illness etc. Usually we are able to identify an event that may have caused this process to start. Although rare, it is possible to have chronic telogen effluvium where you simply shed more than you did in the past. There are some underlying disease processes that can be checked by obtaining blood work, but typically these results are normal. Even if there is an underlying bloodwork abnormality, it is not a guarantee that was the cause of telogen effluvium. Supplements such as Biotin, Viviscal, and Biosil are all options that can be considered when treating telogen effluvium. These supplements support the hair growth cycle and help resist further shedding.