PRP, Stem Cell & Scalp Micro-pigmentation

There are many options to stop or slow down hair loss and even regrow your own hair. It is important to consult Dr Shah and Dr. Sameea, who are hair specialists and will devise a medical plan to address your specific type of hair loss.

Platelet Rich Plasma
There is a lot of talk in orthopedics, sports medicine, dentistry, neurology, ophthalmology, and cosmetic surgery about platelet rich plasma (PRP). Your platelets are small particles in the blood that when stimulated, adhere to damaged tissue (like blood clot, or traumatized tissue) and release a number of different factors, including growth factors (i.e, vascular endothelial growth factor, platelet derived growth factor, transforming growth factor, fibroblast growth factor, insulin like growth factor, epidermal growth factor, connective tissue growth factor, keratinocyte growth factor, etc). The process includes taking about two vials of whole blood, just like when you get a blood draw. That blood is spun in two stages and the platelet rich portion is purified into about 3 cc of a yellowish material.

PRP Therapy
That is then injected into the affected areas. It is used commonly for sports injuries, where it speeds healing of the joint or tendon injury. PRP has been used on professional sports figures with injuries; anything to get them back on the field. However, my interest in PRP is purely cosmetic. A number of physicians are using PRP in cosmetic surgery. The two most common uses have been for stimulating collagen in the skin and stimulating hair growth on the scalp. For wrinkle reduction, animal studies show that sun damaged skin treated with PRP had less wrinkles, thicker dermis, and greater proliferation than controls. In humans, physicians inject PRP, and look for improvement of wrinkles in about one month and it can continue to improve for up to 2 months. The procedure would be repeated until full correction is achieved. The final results can last for 18 months.

For hair growth, PRP has been shown to decrease the hair sleep time and stimulate growth (anagen). One study showed that scalps treated with PRP and then implanted with hair grafts had a higher density of hairs compared to the side of the scalp only getting the grafts without PRP pre-treatment. One study followed both men and women with male and female pattern alopecia, and showed that after three treatments of PRP (every 2 months), their hair shedding was reduced. However, more advanced hair-loss was not helped by PRP. Another study found PRP effective for alopecia areata, which is very exciting and opens new ways of treating this difficult condition. I feel this is an exciting tool we have. I feel it can help stimulate collagen in skin, especially around the eyes and lips. For hair, it gives a third option after Rogain and Propecia. I like to use PRP before placing hair grafts and I feel the grafts survive and thrive better.

Hair Transplantation and Shock Loss

Shock loss is due to the loss of normal hair whether it is from donor site or recipient area during a hair transplantation. It can occur with both Follicle Unit Extraction (FUE) and strip procedures. Usually if it occurs it will take place in the recipient area.
It occurs due to the following:

Anesthesia: Excessively long procedures taking longer than 12 hours can induce shock loss more likely.
The repeated use of: lidocaine, marcaine, and perhaps most importantly epinephrine can affect nourishment of the hair
Traumatic harvest: In strip surgery, traumatic harvest can induce shock loss.
Recipient area trauma: During the incision making process the hairs are either crushed or cut and damaged during the process.

“Stem Cell” Therapy
Autolagous fat transplantation into the scalp
“Stem Cell” Therapy refers to mesenchymal stem cells that are harvested by suctioning fat from the abdomen, which has a hight concentration of stem cells and mixing the fat cells and breaking it up into small particles. This mixture is either injected by itself or mixed with PRP for reintroduction into the scalp. It is thought that mesenchymal cells release growth factors that might stimulate hair growth. The procedure is done in the office under local anesthesia. It takes 30 minutes to do. After the procedure, avoid getting the area wet for 2 days. The donor area can be tender for a few days. The procedure can be repeated every 6 months.

Scalp Micro-Pigmentation
Scalp micro-pigmentation (SMP) is a tattoo process, where Dr. Shah and Dr. Sameea use their artistic eyes and hands to blend and thicken areas of scalp that do not have hair with dots of pigmentation injected into the surface of your scalp in a hair-like pattern. Special pigment is applied to the scalp and micro-needles are used to deliver the pigment in precise amounts. The needle is very small, so there is less pain than you would experience with a tattoo. The final look mimics a stubble look. The procedure is done under local anesthesia and can take one hour per square inch. The area will be presentable within 24 hours and looks best in a few days after healing. A touch up procedure is usually needed to blend the area into normal scalp. Scalp micro-pigmentation is used for multiple purposes, including patchy alopecia, scar cover from previous hair transplantation, an alternative to hair transplantation and in conjunction with hair transplantation to give shadowing.