Androgenic alopecia (hair loss sensitive to Testosterone) is the most common type of hair loss in both men and women. Follicles are “ miniaturized” and hair gets thinner before it falls out. All the following treatments work better on recent hair loss and in areas that still have some active but miniaturized follicles. If these methods are to work there will be results in 6-9 months usually at the most 12 months. Occasionally the PRP injections will work even in cases of autoimmune types of alopecia.
Topical treatments for alopecia have been around for over 20 years in the form of minoxidil (Rogaine). This was originally a blood pressure medication and has been recently found to probably increase the circulation to the hair follicles. This is in contrast with the oral agents such as finasteride (Propecia) that are 5-alpha reductase inhibitors (they block the conversion of testosterone to dihydrotestosterone). As you can imagine the side effects of these agents orally can be significant and they can include loss of libido difficulty with ejaculation and so forth. Although topical compounds from these have been made the original minoxidil Rogaine formulations were now well received by the public probably because of the high percentage of propylene glycol used as a delivery agent. A much better formulation 82M was developed which included minoxidil at seven percent plus tretinoin (which helps the absorption of the rest of the medications), a topical steroid most commonly betamethasone and an organic 5 alpha reductase inhibitor Oleanic Acid.
We have this available as a topical agent by itself or as a shampoo with or without some of the other delivery system such as the micro-needling and micro-needling with PRP. In addition to this will also offer oral agents that are purely building blocks for the hair follicles. Essentially vitamins that the body continues to stimulate and maintained good hair growth.
Now a little bit about what happens with the PRP and with some of the other growth factor stimulation of the hair follicles. The hair follicles have been found to be stimulated by several things from low level laser treatments that are springing up all over the place to increase the blood supply through minoxidil topically or by blocking the action of testosterone on the health follicles through some of the blocking agents (as a medication or an organic compound). Most recently the stimulation of the follicles directly by platelet derived growth factors such as VEGF also known as vascular endolthelial growth factor and several others found in the platelets have adirect stimulatory effect on the numbers of hair follicles that are active and the thickness of the hair they produce!.
Individual results may vary.
Other Growth factors derived from fat cells have also been used with Microneddling and have been shown to have a stimulatory effect on the hair follicles. These are producta available "Off the shelf" without requiring a blood draw ad platelet gel preparation. These substances combined with mechanical stimulaion caused by the micronnedling itself can lead to a "perfect storm" type of effect.
Option #1 oral supplements to stimulate
Option #2 oral supplements plus a topical agent such as 82M which come by a high percentage minoxidil with tretinoin and betamethasone along with oleanic acid (to block testosterone from becoming dihydrotestosterone). The Shampoo 82 S has pure organic agents
Option #3 addition of micro-needling using 82M or another off-the-shelf hair growth stimulation with the growth factors derived from fat cells.
Option #4 is the most aggressive which includes micro-needling with PRP and any of the additional oral or topical agents post procedure. Both option #3 and #4 are spaced about 4-6 weeks apart and include a series of 3 treatments for maximum stimulation. Expect significant improvement proximal 6 weeks after the second treatment. Yearly treatments are recommended for maintenance of maximal stimulation of growth.* Not all treatments will work on everyone and sometimes we have to try different ones to maximize hair growth.
*Individual results may vary. Consult with Dr. Peña to see if you are a candidate.