FDA Approved Treatments for Hair Loss
There are currently two treatments approved by the FDA for the miniaturization of hair-follicles from androgenic alopecia.
Finasteride (Propecia)- The American Hair Loss Association notes finasteride is a prescription oral treatment for male pattern baldness. It reportedly reduces the active levels of DHT in your body to prevent miniaturization of hair follicles. Women should not take oral finasteride due to its risks. In addition, many men who are prescribed Finasteride to be taken orally by tablet experience significant side effects which reduce life quality. These side effects include loss of libido, erectile dysfunction, hypogonadism, gynecomastia, and sexual dysfunction.
Minoxidil- An over the counter topical treatment that has been used since the 1990’s to treat baldness in men and women. It reportedly promotes new hair growth by increasing cutaneous blood flow to shrinking hair follicles. It is generally safe and can be effective by itself if used during the early onset of alopecia.
Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Finasteride acts by reducing dihydrotestosterone levels, thereby inhibiting miniaturization of hair follicles in patients with androgenetic alopecia (AGA). Oral finasteride is associated with side effects such as decreased libido, sexual dysfunction, and gynecomastia. Topical finasteride can be considered for hair density maintenance after initial improvement with oral finasteride, thereby obviating the indefinite use of oral finasteride. Topical finasteride may absorb less systemiacally than oral finasteride, therefore reducing the side effects associated with oral finasteride.
PRP therapy has established itself to be effective as a medical treatment modality in the specialty fields of oral surgery, neurosurgery, plastic and cosmetic surgery, sports medicine and orthopedics. It has been used extensively in these specialties for the last twenty years with generally positive outcomes and success. In the field of hair restoration, evidence supports PRP therapy as a promising treatment option to promote hair growth.
Platelet rich plasma (PRP) is a concentrated blood sample that contains high levels of platelets, a critical component of the wound healing process. Platelets contain growth factors that are responsible for stimulating tissue generation and repair. Growth factors derived from platelets are responsible for soft tissue repair, bone regeneration, development of new blood vessels, and stimulation of the wound healing process. Platelets can theoretically cause growth of the hair follicles by stimulating the stem cells and other cells in the microenvironment of the hair follicle. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.
PRP Specific Growth Factors that influence hair growth include:
- Platelet-Derived Growth Factor (PDGF)—promotes blood vessel growth, cell replication, skin formation
- Transforming Growth-Factor-Beta (TGF-b)—promotes growth of matrix between cells, bone metabolism
- Vascular Endothelial Growth Factor (VEGF)—promotes blood vessel formation
- Epidermal Growth Factor (EGF)—promotes cell growth and differentiation, blood vessel formation, collagen formation
- Fibroblast Growth Factor-2 (FGF-2)—promotes growth of specialized cells and blood vessel formation
- Insulin Like Growth Factor – (IGF)—a regulator of normal physiology in nearly every type of cell in the body
Inside the Platelets are many intracellular structures such as glycogen, lysosomes and alpha granules. These granules within the PRP contain clotting and growth factors that are eventually released during the healing and repair process.
Step 1: Harvest
A small amount of blood will be drawn from the arm. The specific amount of blood which will be drawn depends on the amount of PRP needed for your treatment
Step 2: Separation and Platelet Concentration
Immediately following the phlebotomy your blood will be processed to recover the highest percentage of platelets with corresponding growth factors and high concentration of stem cells.
Step 3: Activate
PRP is activated.
Step 4: Platelet Injection
A topical numbing block will be applied to the top of your head. At this time your provider will inject the Platelet Rich Plasma (PRP) at specific intervals and depth to ensure the entire treatment area has been thoroughly exposed to the PRP.
PRP Safety and Contraindications:
PRP has been used successfully in other medical and surgical disciplines for many years. The decision to use PRP is a personal decision and should be made after careful research, consideration and consultation with a physician. PRP is safe and natural because the procedure concentrates the good cells from your own blood and injects them directly back into the area where it is needed. PRP is immunologically neutral and poses no danger of allergic, hypersensitivity or foreign-body reactions.
Who is a good candidate for PRP Hair Restoration?
In the medical treatment of male and female pattern baldness (androgenetic alopecia), PRP can be injected into the balding scalp to potentially stimulate thin (miniaturized) hair to grow into thicker (terminal) hairs. Patients with thinning, but not totally bald, areas would be the best candidates.
Who is not a good candidate for PRP?
Patients with history of heavy smoking, drug and alcohol use. Medical diagnosis such as platelet dysfunction syndromes, thrombocytopenia, hypofibrinogenaemia, hemodynamic instability, sepsis, acute and chronic Infections, chronic liver disease, anti-coagulation therapy, chronic skin diseases or cancer, metabolic and systemic disorders.
If the hair follicles are entirely lost, the treatment will not work. Patients who have lost their hair follicles require hair transplant surgery.
After the initial treatment, a second treatment is recommended at 4 weeks at minimum. You may then wish to repeat treatments every three months for the first year. After the first year, treatments are administered every 6-12 months depending upon your response.
Other treatments include:
- Andro Block Level 2- For mild to moderate hair loss
- Minoxidil 5%/Azelaic Acid 12.5% 60ml
- Andro Block F- For noticeable hair loss
- Minoxidil 5%/Ketoconazole 2%/Azelaic Acid 12.5%/Finasteride 0.1% 60ml
Prevention and Re-Growth
- Latanaprost Topical Foam 30ml
- Finasteride/Latanaprost Topical Foam 30ml
- Oral Biotin/Finasteride combo (5mg/1mg)
- Vitamin supplementation with biotin, iron, zinc, and increased protein intake are helpful as well.