Il PRP (acronym for Platelet Rich Plasma) is a blood plasma concentrate, obtained by centrifuging a blood sample taken from the patient and inoculated in the affected body site, depending on the benefits we want to derive. This substance, in fact, contains 4-5 times the number of platelets normally present in the circulating blood. Aspect, this, particularly important since platelets, thanks to their ability to release large quantities of growth factorstrigger cell repair and regeneration processes.
This treatment finds application in various specialist fields – from orthopedics to dentistry, from sports medicine to dermatology – in which it is necessary to start a tissue repair process. In trichology, for example, PRP is able to stimulate the stem cells present in the hair bulb, favoring the new hair growth.
PRP hair: how does this treatment work?
«Growth factors – and some are more representative than others for hair growth, such as insulin, fibroblast, vascular and epidermal ones – stimulate stem cells at the level of the dermal papilla, which is the deepest part of the bulb hair, and of the bulge, which is the area responsible for the continuous renewal of the follicle», he intervenes Elizabeth Sorbellinispecialist in Deramtology and Venereology, expert for over 30 years in the trichological field and holder of the Sorbellini studio in Milan. «By stimulating the stem cells of these two particular areas, chemical mechanisms are set in motion capable of reduce hair loss e restart the growth processes».
In which cases can PRP be done?
PRP can be used in cases of:
- Alopecia areata. It is a sudden hair loss in small or particularly extensive patches, often linked to stress, trauma, autoimmune pathologies. Sometimes it can also involve hair from the eyelashes, eyebrows, beard or other parts of the body. It is a non-scarring form: that is, it is caused by processes that slow down hair growth but do not irreparably damage the hair follicle. Therefore, the hair can grow back.
- Telogen effluvium. It is intense and generalized hair loss, which can occur after pregnancy, taking particular drug therapies, particularly stressful periods, debilitating diseases.
- Initial androgenic alopecia. It is the most common form of baldness, affecting both sexes, with more episodes occurring with advancing age. It manifests itself with thinning hair on the temples, forehead and top of the skull, “moving” the hairline back. In these cases, the earlier a regeneration process is started, the better the results. In advanced forms, in fact, the depletion of the stem cells present in the bulb and in the bulge area also causes the stimulation induced by PRP to be less effective.
Preparation and procedure
Blood sampling
“The patient undergoes a “normal” blood draw. We generally collect four 9 cubic centimeter tubes of blood. From the 36 cc of whole blood taken, we obtain approximately 15-20 cc of plasma. A large quantity, which allows us to cover the entire affected area of the scalp without problems», continues Sorbellini.
Centrifugation and the separation phase
“After sampling, the blood is immediately subjected to 8-9 minutes of centrifugation, which allows you to separate the corpuscular component of the blood, i.e. white blood cells and red blood cells, from the liquid one, the plasma, where platelets are concentrated. The part of the plasma closest to red and white blood cells is the one richest in platelets; the part of the superficial plasma, on the other hand, is the poor one. Both can be useful for the treatment in question. The plasma is then separated and all the rest thrown away.
PRP infiltrations
Before proceeding, the specialist performs a mild local anesthesia so that the patient does not feel pain. At most, he feels a slight discomfort. “Then we proceed with the infiltrations: with very thin needles, small wheals are created on the areas of the scalp affected by the thinning and all the PRP necessary for the treatment is injected», continues Dr. Sorbellini.
Possible adverse effects after the procedure?
With the needles, which are the shortest and thinnest on the market, you go only 2-3 millimeters deep, therefore it is very rare that adverse effects occur. «At most – says the specialist – those with particularly thin or sensitive skin or those taking anticoagulant drugs can manifest small bruises on the treated areawhich disappear within a few days.
PRP hair: how many sessions are needed?
The number of sessions may vary, depending on the sex, age and pathology of the patient. «The protocol that I follow, as well as many other colleagues, initially provides for at least 3 PRP infiltrations in one yearperformed between 40 and 80 days apart. Then you do the maintenance, which can consist of only one or two sessions of PRP per year or every two years or home products such as spray gels and lotions containing synthetic growth factors. The procedure varies from individual to individual and is gradually evaluated», confirms Sorbellini.
“Once you’ve embarked on this path, hair no longer falls out, they get progressively bigger and thicker and sometimes even more colorful and bright. Growth factors, in fact, stimulate the entire pilosebaceous follicular unit, in which melanocytes are also present, responsible for coloring the hair».
Are there any contraindications?
Generally, since it is an autologous platelet implant, there are no cases of allergies or side effects, if not transient, such as the appearance of small bruises or a sensation of slight soreness. “So anyone can undergo PRPwith the exception of patients suffering from thrombocytopenia, a condition in which circulating platelets are less than 150,000 units per microliter of blood. In these cases, the quantity and concentration of platelets in the blood taken and centrifuged would be too small for the success of the treatment», explains the specialist.
The clinic must have authorization to do PRP
PRP cannot be performed in all studies. These, as regenerative dermatology clinics, must be authorized by the reference transfusion centre. “In my case it is the Policlinico di Milano,” says Sorbellini. «Every six months the personnel in charge come to check the quality standards and renew our authorization, which by law must be displayed inside the clinic», concludes the doctor.