Can I use Short Term PRP to Kick Start My Androgenetic Alopecia Treatment Plan?

Kick starting AGA with PRP Injections

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts related to the short term vs long term use of platelet rich plasma (PRP) therapies to treat androgenetic alopecia.

Question

I’m a 38 year old female and have androgenetic alopecia. I  went away to Europe in August and half of September and forgot to take my minoxidil with me and didn’t end up buying more while away as I though it would be okay. . (Well, it was not okay!). In total, I was six weeks off minoxidil. Now, I am shedding crazy amounts. I have now started back on minoxidil but I’m still shedding. I realize it’s only been one month since I restarted and it will take some time. I’m thinking I’d like to do PRP in October and November to help kick start this process again. PRP is a bit over budget for me to continue long term but I can afford a few treatments. Is this worth doing?

I am desperate for something to work !

Answer

Thanks for the question. Be sure to review the full and complete story with your practitioners as there are pieces here of your story that are missing and ideally I need to know more about.

In my opinion starting short term PRP for 2 months is not worth doing. There is no evidence at all that this short term strategy that you have outlined is useful - although I completely understand that it sure sounds good at first glance.

Current treatments for androgenetic alopecia don’t work like this. They don’t work “on and off” and they don’t work “start and stop.”

We can’t apply the logic of every day to the world of hair loss. If you’ve been up all night, you might have an extra cup of coffee in the morning to give yourself a bit of a boost to get through the day.

These sorts of concepts don’t apply in the world of hair follicles.

If you stopped minoxidil the first step is to get back on minoxidil as you have said.

The next step is to figure out how well the minoxidil was actually working for you before you left for your trip. If it was working really well and you were very pleased, then getting back on minoxidil may be all that is needed.

If topical minoxidil was working “just okay”, but not as good as you really would have hoped from a therapy then adding a second treatment to the plan right now would make sense. However, this second treatment must be started with the intention to use it long term. There are no short term treatments. There are no short term vitamins and no short term supplements and no short term lasers and no short term PRP and no short term pills. It’s long term only.

I can’t say what’s right for you as I have only a fraction of the information about you that I need. So let’s talk in general terms about what might be done. Possible options include adding minoxidil a second time of the day, using “more” minoxidil during the one application session you do, using oral minoxidil with the topical minoxidil, using topical minoxidil-finasteride, oral finasteride, oral spironolactone, PRP and laser.

Now keep in mind this is not a “pick and choose” list. It’s a discussion point for you and your doctors. Some of these treatments on the list may not be appropriate for a given patient at all. Only minoxidil is FDA approved and the rest are what we call off label. Some are contraindicated in women who plan to become pregnant or who might become pregnant. So these options are not right for everyone.

But any treatment you decide to add must be used long term. There are no short term kick starts or adding a bit of fuel to the plan or any of the words we like to use when describing other things we do in life.

If you start PRP, then the use should be intended lifelong. If you stop, the hair will likely protest and complain as to why it was stopped (assuming of course it was actually doing anything at all).

Now, it’s important not to wear blinders when evaluating hair loss. It’s important to always be open to a full range of possibilities as to what might be happening with the hair.

If you were using minoxidil for 10 months before leaving for Europe and you feel it really was doing nothing helpful then certainly one needs to ask why your hair is now protesting so much with all this shedding once it was stopped. Hair should not protest if a useless treatment is stopped! So if it is protesting then either minoxidil was not as useless as the patient thought - or another condition or reason for the hair loss is present now.

I would like to add that what I really need with this question is more information about the story. The full story!

We always need to be open to the possibility of stress, low iron, thyroid conditions, COVID infections, nutritional issues, weight loss and other drugs contributing to hair loss!

If a patient has been caring for a sick relative for many months from afar and then that family member passes away requiring the patient to fly from North America to Europe to attend the funeral, is it not possible that it’s the stress and trauma of this experience that is setting off the hair shedding? Of course.

What about a patient who developed COVID after they arrived in Europe and was sick most of their vacation? or developed a febrile diarrheal illness while away ..or had been dieting for 3 months before leaving for Europe and lost 13 pounds in the month before leaving or who had started a new drug for blood pressure or depression or cholesterol before leaving for Europe. Don’t you think this could also be contributing to shedding? 

Yes, yes … it absolutely could be a cause.

So, what is needed is a full story!

So all in all, I think getting back on the minoxidil has been a great plan. What needs to be decided now with your doctors is whether any other triggers might have contributed to this shedding. Blood tests may or may not be needed depending on your story. If you have been unwell while away, then that increases the likelihood that blood tests may be useful.

Next, you and your doctors need to figure out if you want to add a second treatment to the plan or not. However, this must be started with the intention to use it long term. If PRP is out of budget, then don’t use it. It often does more harm than good if used inappropriately - such as short term. There are no short term kick starts.