HairCare

    • Androgenic Alopecia: A progressive, genetically predetermined pattern of hair loss affecting both men and women. It is primarily driven by androgens, specifically dihydrotestosterone (DHT), which is converted from testosterone via the enzyme 5-alpha-reductase. The binding of DHT to androgen receptors on genetically susceptible scalp hair triggers a process known as miniaturisation, where terminal scalp hairs are gradually transformed into fine vellus hairs. This miniaturisation alters the hair cycle, shortening the growth phase (anagen) and weakening the hair shaft with each cycle until the hair eventually disappears.

    • Pattern and Prevalence: In men, androgenic alopecia, also known as male pattern baldness, accounts for 98% of hair loss cases. This distinctive pattern is characterised by hair loss in the frontotemporal corners, frontal hairline, midscalp, and crown. The severity of this pattern can be classified using the Norwood-Hamilton scale. Genetic factors, which play a significant role, have been shown to account for about 80% of the predisposition to balding, highlighting the hereditary nature of this condition and suggesting a polygenetic trait.

    • Miniaturisation Process: The miniaturisation process involves complex, androgen-mediated cellular mechanisms, including decreased proliferation of keratinocytes, changes in dermal sheath cell populations, and a reduction in dermal papilla cells through apoptosis or migration. These changes reduce the size of the follicle, directly affecting the size of the hair shaft and leading to finer hairs. Additionally, changes in the hair cycle, such as a reduced anagen phase and an elongated telogen phase, contribute to the progressive shortening and weakening of the hair.

  • Androgenic alopecia is the most common form of hair loss. Its onset and progression are influenced by genetic and hormonal factors, and its prevalence varies widely across different populations. It affects up to 80% of men and 50% of women during their lifetime.

    • Prevalence Across Ethnicities: The prevalence of androgenic alopecia varies across different ethnicities. It has the highest incidence in Caucasian men, followed by Asian, African American, and Native American men. Among Caucasian men, approximately 30% are affected by age 30, which rises to 50% by age 50.

    • Progression and Staging: In men, the progression of hair loss typically follows the stages outlined in the Norwood-Hamilton scale. However, the rate and extent of progression can vary significantly. Some men experience a gradual progression through the stages, while others may find that their hair loss halts at a particular stage. Advanced balding, classified as stage NW5 or higher, occurs in about 35% of balding men, with around 7% progressing to the most severe form, NW7.

    • Protection: Hair loss medications protect your native hair by stopping the hair loss process and thickening existing hair.

    • Correction: Hair transplantation surgery corrects areas of loss, either via FUE (follicular unit excision) or FUT (follicular unit transplantation).

    • Stimulation: Treatments such as PRP (platelet-rich plasma), microneedling or low-level laser therapy.

  • Platelet-rich plasma (PRP) for hair restoration is a treatment that utilises a concentration of platelets and growth factors derived from a patient's own blood to stimulate hair growth and improve scalp health. The efficacy of PRP in hair restoration hinges on the activation of platelets and the release of their granule content, which plays a crucial role in hair follicle rejuvenation and repair.

    • Alpha-Granules: These granules are packed with hemostatic proteins, growth factors, and cytokines essential for tissue repair and regeneration. Key growth factors include Platelet-Derived Growth Factor (PDGF), Transforming Growth Factor-beta (TGF-beta), and Vascular Endothelial Growth Factor (VEGF). In the context of hair restoration, these growth factors promote the proliferation of hair follicle cells, enhance blood supply to the follicles, and encourage the transition of hair follicles from the resting phase (telogen) to the growth phase (anagen), thereby stimulating new hair growth.

    • Dense Granules: These granules contain factors such as ADP (adenosine diphosphate), calcium, and serotonin, which are critical for platelet aggregation and the regulation of the healing process. For hair restoration, these components help to stabilise the local environment of the scalp, promote increased circulation, and create a conducive environment for hair follicle activity and growth.

    Mechanism of Action

    When PRP is injected into the scalp, the activated platelets release their granule contents, triggering a cascade of biological processes. This includes cytokine signalling and chemokine release, facilitating cell communication and attracting other cells to the treated area. Additionally, the release of growth factors promotes mitogenesis, stimulating the proliferation and activity of hair follicle cells. This process helps to rejuvenate dormant or miniaturised hair follicles, improve scalp health, and support the overall growth of thicker, stronger hair.

    PRP therapy for hair restoration capitalises on the high concentration of platelets and their potent growth factors. By injecting PRP into the scalp, the treatment leverages the natural healing properties of platelets to stimulate hair follicle activity, enhance blood flow, and promote new hair growth, offering a non-surgical solution to address hair loss and improve hair density.

  • Early Discoveries and Development

    • 1970s: Understanding Platelets' Role in Healing: Research in the 1970s revealed the crucial role of platelets in wound healing and tissue regeneration. Platelets were found to contain growth factors that promote cell proliferation and tissue repair.

    • 1980s: Development of Platelet Concentrates: The concept of concentrating platelets from blood emerged, leading to the development of platelet-rich plasma (PRP) as a therapeutic tool. Initially used in oral and maxillofacial surgery, PRP was utilised to enhance bone grafting and healing after dental procedures.

    Expansion into Various Medical Fields

    • 1990s: Introduction to Orthopaedics and Sports Medicine: PRP gained popularity in orthopaedics and sports medicine for treating tendon, ligament, and muscle injuries. It was used to accelerate healing in athletes, with notable cases in professional sports bringing attention to the therapy.

    • 2000s: Application in Cosmetic and Dermatologic Medicine: The cosmetic industry adopted PRP for skin rejuvenation, anti-aging treatments, and hair restoration. The "vampire facial," which involves microneedling PRP into the skin, became widely known.

    Advances and Refinement of Techniques

    • 2000s-Present: Refinement of PRP Preparation and Techniques: Advances in centrifugation technology allowed for more precise concentration of platelets, improving the efficacy of PRP treatments. Various protocols were developed for different medical applications, including specific preparations for orthopedics, dermatology, and surgery.

    • 2010s: Increasing Use in Hair Restoration: PRP became a popular non-surgical option for treating androgenic alopecia and other types of hair loss. Studies began to support its effectiveness in stimulating hair growth, leading to widespread use in hair clinics.

    Scientific Research and Controversies

    • 2010s: Research and Debate: While PRP has gained widespread use, its efficacy has been a subject of debate. Research continues to explore the optimal protocols, concentrations, and application methods to maximise its benefits. Differences in preparation and variability in outcomes have led to ongoing discussions in the medical community.

    Current Status and Future Directions

    • 2020s: Mainstream Adoption and Continued Innovation: PRP is now a well-established treatment in various medical fields, including orthopaedics, dermatology, and aesthetics. Ongoing research aims to standardise PRP therapies, explore new applications, and combine PRP with other treatments for enhanced results.

    • Future Directions: Potential future developments include the use of PRP in regenerative medicine, combining PRP with stem cell therapies, and further refining PRP formulations to target specific conditions more effectively.

    • Blood Collection: A small sample of the patient’s blood is drawn, usually from the arm.

    • Centrifugation: The blood sample is placed in a centrifuge, a device that spins the blood at high speeds to separate its components. This process concentrates the platelets, resulting in a platelet-rich plasma.

    • Injection: The PRP, now enriched with growth factors, is injected into the scalp at areas of thinning or balding. The injections are typically administered with fine needles.

    • Stimulation of Hair Growth: The growth factors in PRP are believed to stimulate hair follicles, prolonging the anagen (growth) phase of the hair cycle, enhancing hair thickness, and encouraging new hair growth.

    • Initial Treatment: Typically, 3 to 4 sessions are recommended, spaced about 4 to 6 weeks apart. This schedule helps to stimulate hair follicles and promote growth effectively.

    • Maintenance: After the initial series, maintenance sessions are often recommended every 4 to 6 months to sustain results and manage ongoing hair loss.

  • While generally tolerable, PRP does involve some discomfort, particularly during the injections into the scalp. The procedure begins with a simple blood draw, which causes a slight pinch. The discomfort intensifies slightly when the platelet-rich plasma is injected, often described as a series of quick pinpricks or stings across the scalp.

    To minimise pain, a numbing cream can be applied to the scalp beforehand, significantly dulling the sensation of the injections. For those with a lower pain threshold or for more extensive treatment areas, nerve blocks can also be administered. A nerve block involves injecting a local anaesthetic into specific areas of the scalp to block pain signals. This technique is highly effective, providing deeper and longer-lasting numbness, and making the procedure virtually painless.

    After the treatment, some mild soreness or tenderness may persist in the treated areas, but this usually subsides within a day or two. Most people can resume their normal activities shortly after, with only minor aftereffects.