Hair Restoration Blog

The use of growth factors to restore hair and to minimize hair loss, has been one of the latest techniques in hair restoration. Platelet Rich Plasma (PRP) which contains soluble proteins, including some growth factors, has been suggested as a treatment for hair loss, as well as many other medical conditions.  A new clinical study published in the Journal of Dermatologic Surgery, by Takikawa et al. from Japan, tries to shed some light on using PRP for the growth of hair in balding men.

What is PRP?

PRP or Platelet Rich Plasma, is the non-cellular component of blood that includes platelets and growth factors.  Plasma can be extracted from a patient’s blood in an outpatient setting. This portion of plasma which is extracted generally has a number of growth factors such as Platelet Derived Growth Factor (PDGF), Vascular Endothelial Growth Factor (VEGF) and many others. The growth factors are responsible for some stages of healing and remodeling after injuries or inflammatory conditions. This is why PRP injections have been claimed to be useful in helping many medical conditions with the healing of tissues and organs such as inflammation of soft tissues and injuries of tendons, fascias and muscles.

How is PRP prepared?

The process of harvesting PRP is rather simple, even from a non-medical point of view, which involves collecting the patient’s blood and separating plasma by spinning it in a centrifuge device. This process separates the cellular elements of blood such as RBCs (Red Blood Cells) and WBCs (White Blood Cells) from the liquid portion (plasma) that contains growth factors and platelets.

The study published by Japanese researcher featured 26 volunteers with balding and thinning scalp hair. 13 patients were treated with PRP-containing Dalteparin and protamine microparticles (D/P MPs) versus the other 13 that were treated with Platelet Rich Plasma (PRP) and saline.  The researchers tried to see the difference between the treatment of hair thinning with PRP, as well as the combination of PRP and D/P MPs. Dalteparin and protamine microparticles (D/P MPs) are carrying growth factors (GFs) in platelet-rich plasma (PRP).

Hair Quality

The quality of hair such as thickness and the number of follicles was evaluated at 2 to 3 week intervals and evaluated for a total of 12 weeks from the beginning to the end.  During this study a scalp with thinning hair was injected with PRP or saline in the frontal or sides of the scalp in volunteer individuals.

The final results were compared both macroscopically (from a big picture scale) and microscopically.  What resulted from the study indicated significant differences seen in hair cross-section, but not in hair numbers in PRP or the control group (D/P MPs). The report of this researchers indicated that addition of D/P MPs to PRP resulted in highly noticeable stimulation in hair cross-section. The Microscopic findings showed thickened epithelium (outermost layer of the skin), production of collagen fibers and fibroblasts, and increased vessels around hair follicles.
The researchers concluded that PRP&D/P MPs and PRP facilitated hair growth.

This study is a good start to focus more investigations on growth factor induced hair growth and should be completed in the future with more sophisticated research. A greater number of participants will be needed and a longer follow-up in order to reveal the long term effects of growth factors on hair restoration.

Future Studies

At Johns Hopkins Medical School, we did several studies using growth factors for wound healing.  The problem in most studies like this was that growth factors were usually very labile and were removed from the tissue very quickly.  In order to see the stimulating results on a cellular level, a continuous source of growth factors was needed.  We have attempted to overcome this problem by inducing the growth factors genes into skin cells using certain gene therapy techniques. I believe this might be a more promising path for using growth factors for hair growth or wound healing in the future.

Over the last few decades, different therapies which effect wound repair have been proposed. The connection between wound healing and hair growth was already proposed by Dr. Catsarelis at the University of Pennsylvania through the WNT pathway (some molecular process that controls would healing and hair growth). Now, we review the emerging fields of gene and stem cell therapy in hair restoration and wound healing.

Gene therapy, initially developed for treatment of congenital defects, is a new option for enhancing wound repair. In order to accelerate wound closure, genes encoded for growth factors or cytokines showed the greatest potential.

The majority of gene delivery systems are based on viral transfection (intentionally contaminating the host cells with a particular virus that insert the desired gene to the target cells), naked DNA application, high pressure injection, or liposomal vectors, etc. Embryonic and adult stem cells have a prolonged self-renewal capacity with the ability to differentiate into various tissue types. A variety of sources, such as bone marrow, peripheral blood, umbilical cord blood, adipose tissue, skin and hair follicles, have been utilized to isolate stem cells to accelerate the healing response of acute and chronic wounds.

Recently, the combination of gene and stem cell therapy has emerged as a promising approach for treatment of chronic and acute wounds. This is good news for prospective hair loss patients: the idea that similar gene therapy techniques can be used to affect the baldness gene by switching the hair loss gene off and on.

This new study was done by Branski et al. at the Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children.