Low-level laser and PRP for thinning, what do you think? Any experiences?

[Tubman]

Long-time lurker, first-time poster. Great info on this forum, really learned a lot.

 

What do you guys think about low-level laser treatment and/or PRP for thinning hair?

 

I'm 38. Became NW2.5 at age 23. No change from then. But 6 months ago, I noticed more hair in the shower. 3 months ago, my hairline and top hair has become visibly thinner. Hasn't receded, but it has lost density and thickness of each individual hair. In the last 3 months, it's become stringy, wispy.

 

I've been looking at PRP and low-level lasers for helping maintain and strengthen the hair I still have before the situation gets worse. What's strange to me is that both treatments have snake-oil reputations on the forums, and I can't find a lot of positive reviews on forums or youtube. But on the other hand, they both have pretty legit-seeming studies recently showing decent results.

 

I've seen posts on this forum from the mid-2000s to 2016 mocking low-level lasers. Companies like HairMax and Capillus have earned it with their horrible late-night infomercial style marketing. But a few studies in the last 3 years showing some positive results have made me think that it might be a useful treatment. The best study (https://www.ncbi.nlm.nih.gov/pubmed/24474647) shows an increase of 20-25 terminal hairs per cm2 in the treated area after 6 months of lasercomb.

 

For PRP, it also has a snake-oil reputation and I can't find a lot of actual patients on forums or youtube who claim to have gotten great benefit from it (I mean PRP as a direct treatment. In other words, not as a combination together with transplant surgery). But despite its bad rep, there have been some studies showing good benefits. For example, this study from Italy (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622412/) only had 23 patients, but was well-done and did a control on each patient with one part of each area of the guy's head getting PRP and one getting placebo. After 3 months, the PRP treated area showed a mean increase of 46 hairs per cm2 vs. a decrease of 4 in the control area.

 

With laser products, some of the studies are often funded by a manufacturer so could be suspect. But some studies aren't paid for by manufacturers and also show decent results.

 

With the PRP, most of the studies don't have these conflicts of interest. PRP has the problem that there are lots of open questions about how to best prepare it, but at least some preparation methods do seem to work for some people.

 

From reading the research, it seems like they're both treatments which need more research, but at least now it seems they have potential, have given some patients positive results, and could be useful, particularly if you don't want to start with fin or dut. But they have horrible reps and few positive stories from actual patients.

 

So what's going on?

[Swooping]

At best they will modulate your telogen/anagen ratio.

 

Telogen hair follicles have the ability to respond sensitively and promptly with anagen induction to a large array of stimuli. Think of growth factors, cytokines, immunomodulatory compounds etc (shown in many studies).

 

So it's logical that a treatment like PRP or LLLT can modulate this.

 

If you decide to go for it, I wouldn't expect anything to be honest from these treatments.

 

They definitely won't help in maintaining your hair.

[Spanker]

I think PRP is more promising than LLLT, but I think when used properly, they may help.

 

I do have interest in PRP. Dr. Cooley has been one of the biggest surgeons that is posting results that is recommended here. I think that it is best for overall and crown thinning though, and less so for just hairline issues.

 

Do some research on Cooley PRP and check out his photos.

 

I think both of these treatments are a bit of a gamble, but for a few grand, you can see if it works for you.

 

If I were doing it, I would be looking for Cooley, or at least someone that is using his protocol.

 

By far, IMO, finasteride is your best bet if you have not given it a shot.

[gillenator]

The best cases are always going to get posted and raved. What we don't know is how many do not respond favorably.

 

The jury is still out on both treatments...:rolleyes:

[Speegs]

A lot of formerly skeptical doctors are changing their tune with the laser light therapies.

 

Some reputable names on this forum included.

 

I know Dr. Gabel will judiciously recommend treatment for patients with low light lasers, especially female patients, and he wasn't always on board with it until better data was available.

 

 

[Tubman]

Interesting comment by @swooping about anagen/telogen ratio.

 

There's a good study about this effect of PRP. I think it's worth describing here in detail. But if you want to skip the details, the TL;DR is that PRP increased hair density.

 

It was conducted by the University of Catalonia in Barcelona, Spain and published last year (https://www.ncbi.nlm.nih.gov/pubmed/27035501). I think it's much better structured than most I've seen. They studied 25 patients. Each patient received 3 treatments of PRP, 1 month apart. Half the patients received treatment with PRP on the right half head and the placebo on the left half head, while the other half of patients received treatment with PRP on the left half head and the placebo on the right half head. One injection was made into each of the four corners of the top of the patients scalp; so in total, two injections of PRP and two injections of placebo were made on each patient on 3 separate times. The treating physician had to know which side was PRP and which placebo, but the analyzing physician and the patients were blinded as to which was which until the end of the study.

 

Treatments were made at month 0, month 1, and month 2. Measurements were made at month-3 (so one month after the last of the three treatments) and at month-6 (i.e., four months after the last treatment).

 

The results were solid:

 

The hair growth parameters were measured after 3 months and 6 months and compared with the baseline (before treatment) and between treatment and control areas (placebo). At baseline, there were no significant differences in hair count, hair density, terminal density, and anagen or telogen hairs between the treatment and control areas of the scalp. The results of this study revealed that the administration of PRP led to a statistically significant increase in the mean anagen hairs, telogen hairs, hair density, and terminal hair density after 3 months and after 6 months when compared with baseline.

The changes in hair density area are most striking to me. At the 3 month point, the mean density of the placebo area decreased by 0.7 hairs/cm2 (from 167.1 to 167.8), while the mean density in the treated areas increased by 14.8. The improvement was still present at the 6 month point as well, which is interesting to me because that was 4 months after the last treatment, showing that it seems to have some lasting effect. It's also notable that this improvement at both 3-months and at 6-months was small but significant in terms of terminal hair density. The range in improvement between patient results is fairly wide, but the results seem pretty solid and positive.

 

In addition to density, a change in anagen/telogen ratio is seen in the data. At the 3-month mark, the PRP-treated area increased from 62% anagen hairs to 68%, while the placebo-treated area only increased to 63.5%. What's interesting, though, is that at the 6-month point, that difference had evened out and both the placebo area and the PRP area were fairly close in their anagen/telogen ratio.

 

The authors' discussion of the possible underlying mechanism:

 

Anagen-associated angiogenesis has been suggested to be one of the most important factors in active hair growth. This study provides further support that pure PRP may prolong the anagen phase of the hair cycle, as the authors found a superior anagen/telogen ratio (%) in the areas treated with PRP than the areas treated with the placebo, when compared with baseline.

They also comment that there's a lot of differences in how PRP is prepared and it's important to find the best methods and standardize.

 

Personally, these studies seem good enough by now that I decided to give it a try. After speaking to a few clinics, I can confirm that there really is a huge range in methods to prepare PRP. It's really hard to get information from most clinics about the details of their PRP; truth is, I think most of them just buy a centrifuge and kit and don't really know a lot. There've been only a handful of PRP hair studies, but there have been a ton of studies on PRP in joints, so I'm using the info from all of that in looking for a clinic that prepares the PRP well.

 

(At some point, I've even thought of doing the PRP myself. It's not as crazy as it sounds if you're fairly comfortable with lab work. And for money, after a little upfront investment, it'd be a huge savings over time, especially as it seems that regular injections every month or so are better than just doing a one-time one-and-done injection.)

 

If anyone's interested, let me know and I'll report back once I have some info.