PRP therapy is one of the more extensively marketed treatments in the hair loss space, and patient selection — understanding who is most likely to benefit — is the key to having realistic expectations about what it can achieve.
PRP is most likely to benefit patients with androgenetic alopecia in the early to moderate stages, where follicles are still present and in the miniaturisation phase rather than having been permanently destroyed. The growth factors delivered by PRP appear to support miniaturising follicles, extending the anagen phase and improving hair calibre in follicles that are still biologically active.
PRP is unlikely to benefit patients with long-established baldness in areas where follicles have been destroyed — the growth factors have nothing active to work with. Similarly, patients with scarring alopecias (where follicles have been replaced by scar tissue) are not appropriate PRP candidates.
The combination of PRP with minoxidil has more evidence than PRP alone, and the combination with microneedling has been studied with positive results in several trials. PRP in the context of a hair transplant — either applied during the procedure to the grafts or as a post-operative treatment — has some early evidence suggesting improved graft survival and earlier growth onset, though this has not been universally adopted as standard practice.
Realistic expectations for PRP: it is unlikely to reverse established hair loss; it may slow progressive miniaturisation and improve hair quality in responsive patients; it requires repeat sessions (typically three initial sessions at four to six week intervals, followed by maintenance sessions every six to twelve months) for sustained effect; and response varies significantly between patients.
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