PRP treatment

[Spanker]

So, I really haven't seen much by patients who received PRP without a transplant. Anyone know anything about these results? I know Dr. Cooley does this and has developed his own "mix", but I haven't seen any results on a large enough basis that makes it convincing (unlike transplants or propecia). Any thoughts?

[JON86]

Most on here regard it as snake oil . I saw some pretty good stand alone procedures when I was in Dr Cooley's office. He never tried to sell me on it in fact he said I didn't need it. From what he told me it can shorten the amount of grafts a person might need but is not a replacement for surgery. The problem is there are a lot of clinics doing it wrong just using it as a profit tool. Dr Cooley has done studies and published medical reports on prp. The guy that pioneered prp is a Doctor Joseph Grecko in Florida. There is a bunch of info on him online. He was featured on the radio show from that other website. From what I have seen prp is mostly used for women who can't have transplants or in someone with dupa that is a non candidate for surgery.

[hsrp10]

Hey Spanker are you thinking of having it done, or just researching the topic?

I've seen some cases where people said it made a difference while others said it made little difference or caused a shed. So I just don't know. Also aren't the effects temporary?

 

One clinic on my shortlist offers it as part of the package during HT, but I was thinking to bag it as I don't know the overall success rate.

[Spanker]

Just research. I have about a inch or less if thinning arround my ears and nape and it crossed my mind to treat that aread just for research purposes, but because it's not in a.cosmetically significant area and pretty much for reasesrch id have to get a killer deal.

 

Mynguy tells me there is some benefit if done right but snake oil if protocol is poor. It could ve useful

[MrGio-WHTCClinic]

So, I really haven't seen much by patients who received PRP without a transplant. Anyone know anything about these results? I know Dr. Cooley does this and has developed his own "mix", but I haven't seen any results on a large enough basis that makes it convincing (unlike transplants or propecia). Any thoughts?

 

I've seen some results with no surgery. Not many are actually published but a new forum section might inspire the community.

[Spanker]

Research. If I could get a killer deal I have a small band thinning around my ear and nape and would consider it for research purposes, but I dont have enough loss right now anywhere else to see a.cosmetic change anywhere else.

 

I think in conjunction wwith fin it could be beneficial as a maintenance tool if it is with someone like Cooley that has put work into his protocol, but I do think its snake oil when treated from an average dermatologist

[JON86]

Dr Cooley explained it has a lot to do with the centrifuge that is used. Problem with the bad rap prp gets is there are a lot of people doing it wrong so people think all prp treatments are the same and they are not. I wouldn't do it with anyone that didn't do research to back it up. There are some very interesting videos Of Dr Greco explaining it on the internet.

[Spanker]

I'd like to see some results from Cooley that are prp only. Maybe his rep will read this and respond.

[Dr. Jerry Cooley]

Spanker, this topic is actually very complex and I can't really do it justice with a short post. Dr. Greco taught me PRP eight years ago and I added ACell to it about 6 years ago. I've treated hundreds of patients over this time and consider it a useful option in our armamentarium. I don't consider it a miracle treatment by any means. Some people are good candidates while others are not. The best candidates are those with extensive miniaturization. I'll list some of the key points about PRP:

 

1. It is like a surgical procedure but with results that resemble medical treatments. If you take a hundred patients and treat them with finasteride or minoxidil and check them a year later, you'll see a range of results from mild improvement to great thickening, with most somewhere in between. The same with PRP. It's like a surgical procedure in that there are numerous variables which affect the outcome. Which centrifuge system is used, the platelet concentrate, whether ACell or other agents are mixed into it, how it is injected, whether it is 'activated' are just some of these variables. Know one knows for sure the best way to perform PRP and there are differing opinions.

 

2. To do a proper 'study', you need a large number of patients NOT on any other treatment (fin, min, etc), who are willing to come in every 3 months for measurements, and who would be willing to be a 'control' (ie have a placebo saline injection). Virtually none of us solo docs could actually carry out such a study in our clinics.

 

3. Just like a patient who has been on fin or min for a year may not appreciate any difference when in fact they have had significant improvement, a patient may respond to PRP but not be aware of it because it sneaks up on them over a course of a year. I've seen many examples of this. So if a patients reports on the forums that he didn't get any improvement from PRP, this may not be accurate.

 

4. Many of us who are doing PRP are in communication with other docs, sharing observations, and trying to determine the best way to perform it but there is naturally a lot of uncertainty at this time. I make it clear to my patients that it is an evolving treatment and there is much we don't know. I completely agree that some clinics out there are over marketing this and deceiving patients.

 

I'm including some PRP/ACell results (no transplant and no new fin/min treatment) which demonstrate the range of possible results from minimal to excellent improvement.

[ontop]

If you got money to blow carry on as in 12/14 months you be back to baseline, that's only if your a good candidate / responder.

 

Now saying that I do believe that PRP/Acell can be & has been a good tool for the purpose of healing of which been used for many years effectively & have shown patients recovery increased to a decent level.

[Dr. Jerry Cooley]

OnTop

 

The duration of benefit from PRP depends on many factors: 1) how the procedure is performed 2) the patient's underlying genetic rate of balding and 3) what maintenance medications they are on. So a young guy balding fairly quickly who is not on meds may need PRP at least every year to maintain thickness. But someone is who has milder genetics and is taking finasteride may only need to do PRP every three years or so. Attached is an example of an older guy who was on finasteride for years, did one PRP/ACell, and then returned four years later. You can still see some of the benefit from a single treatment even after four years. I try to explain all this to people during a consultation. Clinics which promote PRP to everyone indiscriminately are doing people a disservice and many will feel like they did waste their money.

[arussell]

If you got money to blow carry on as in 12/14 months you be back to baseline, that's only if your a good candidate / responder.

 

Now saying that I do believe that PRP/Acell can be & has been a good tool for the purpose of healing of which been used for many years effectively & have shown patients recovery increased to a decent level.

 

 

On Top,

 

This is a treatment not a cure. But the photo's above are at about 12 month or more interval so no, you do not return to baseline that soon. It would depend on some of the "variables" that Dr. Cooley alludes to. We recently had a patient come back after 4 years and although he had lost some of his initial gain he still had not returned to baseline. This can augment medication and for those unable to take meds it can really be helpful. It is all in the prospective of the patient. We offer it but will evaluate and tell you if you would benefit from doing this or not.

[Spanker]

OnTop

 

The duration of benefit from PRP depends on many factors: 1) how the procedure is performed 2) the patient's underlying genetic rate of balding and 3) what maintenance medications they are on. So a young guy balding fairly quickly who is not on meds may need PRP at least every year to maintain thickness. But someone is who has milder genetics and is taking finasteride may only need to do PRP every three years or so. Attached is an example of an older guy who was on finasteride for years, did one PRP/ACell, and then returned four years later. You can still see some of the benefit from a single treatment even after four years. I try to explain all this to people during a consultation. Clinics which promote PRP to everyone indiscriminately are doing people a disservice and many will feel like they did waste their money.

 

Thanks for the response. That's pretty amazing that the results lasted that long.

Edited December 10, 2016 by Spanker

[SADbutTRUE]

ppr can be another option in the fight against hairloss, the fact that dr cooley has results is positive, question for dr.cooley or aliene, does the treatment turn minatursed hair into terminal hair ? I have many of these hairs in my frontal third, if I can get these guys to become terminal, that would be awesome. thanks dr. cooley for responding on this thread.

[Dr. Jerry Cooley]

PRP does not create new hairs, but thickens miniaturizing hairs. The degree of thickening will vary from person to person. In my opinion, the degree of improvement and duration of effect is better when the patient is on meds (e.g. finasteride, spironolactone, minoxidil, etc). If you have a significant proportion of miniaturized hair in the front of your scalp, you may benefit from PRP. Attached is an example of a young women started on spironolactone who had PRP/ACell treatment (result at 6 months).

[SADbutTRUE]

thanks for responding dr.cooley.

[Spanker]

It would be interesting to see results over time with "good" prp being done over a period of time (annually) as a preventive measure on someone early in the process. That is the problem with r&d in the hair field: so many variables, so much time for results to come in, etc.

 

I think another issue with prp as stated above is that all protocols aren't created equally. Interesting stuff and I'm looking forward to seeing more about long term advantages from reputable clinics like Dr.Cooley's.

[Tomislav]

Spanker, this topic is actually very complex and I can't really do it justice with a short post.

 

2. To do a proper 'study', you need a large number of patients NOT on any other treatment (fin, min, etc), who are willing to come in every 3 months for measurements, and who would be willing to be a 'control' (ie have a placebo saline injection). Virtually none of us solo docs could actually carry out such a study in our clinics.

 

I read with interest your post Dr Cooley and feel that this is a key point to evaluate the effectiveness (and safety) of PRP. In the last few hours I did a Google Scholar search for "Platelet-Rich Plasma alopecia", and saw that lot of papers have been published on the subject in the last 3-4 years.

 

Although I do not have the time nor the expertise to evaluate all the papers out there, I gave a good look at some of them and I noticed a few interesting ones, all reporting positive results:

 

- This one was one of the first moderate-scale serious studies.

- This one does some sort of controlling, although by only applying PRP to half the head :eek:

- And especially this one, which does include real controls, who only received a saline solution as 'treatment' (poor guys...). Moreover the evaluation was not done visually but by digital image analysis, AND the patients were re-evaluated after 12 months (some did need to be re-treated).

 

Although I know that studies showing negative results rarely get published, I feel that these papers are very encouraging. It seems that the scientific research about PRP treatments is finally reaching maturity. If anyone has the expertise to comment on this research, I feel this would be really useful for everyone.

 

I also feel that the general scepticism I observed in this forum about PRP needs to be matched by an equal amount of optimism.

 

PS. For the moderators: Perhaps this and other threads on PRP should be moved to a new category of its own in the "Non Surgical Treatments for Baldness" section of the forum.

[Tomislav]

- And especially this one, which does include real controls, who only received a saline solution as 'treatment'.

 

After taking the time to properly read the article, I correct myself: the placebo solution was only injected over half of the head of each patient. No-one only received placebo.