Platelet Rich Plasma (PRP) therapy uses the patient's own blood to produce a concentrated preparation of platelets and the growth factors they contain. When injected into the scalp, these growth factors stimulate follicle activity, promote angiogenesis, and support the transition of follicles from telogen (resting) to anagen (growth) phase. The leucocyte-poor formulation — LP-PRP — has emerged as the preferred preparation for hair restoration based on its more favourable inflammatory profile compared to leucocyte-rich preparations.
LP-PRP is best understood as a biologic adjunct to pharmacotherapy — potentiating the effect of dutasteride and minoxidil rather than replacing them.
LP-PRP versus LR-PRP
Not all PRP preparations are equivalent. The leucocyte (white blood cell) content of a PRP preparation has significant implications for the tissue response it produces. Leucocyte-Rich PRP (LR-PRP) contains higher concentrations of pro-inflammatory cytokines alongside growth factors. In hair restoration, this inflammatory component may be counterproductive — promoting a microenvironment less conducive to follicle recovery.
LP-PRP, prepared using a double-spin centrifugation protocol, produces a preparation with high platelet concentration but reduced leucocyte content. The available evidence supports LP-PRP as the superior formulation for hair restoration based on follicle outcomes and tolerability.
Key growth factors in LP-PRP
The therapeutic activity of LP-PRP in hair restoration is attributed primarily to the following growth factors released upon platelet activation:
- PDGF (Platelet-Derived Growth Factor) — promotes cell proliferation and angiogenesis
- VEGF (Vascular Endothelial Growth Factor) — supports perifollicular vascularisation
- IGF-1 (Insulin-like Growth Factor 1) — stimulates follicle keratinocyte proliferation
- EGF (Epidermal Growth Factor) — promotes epithelial cell growth and differentiation
- FGF (Fibroblast Growth Factor) — involved in anagen induction and maintenance
The treatment process
A small volume of blood is drawn and processed by centrifugation to produce the LP-PRP preparation. The scalp is topically anaesthetised, and the preparation is delivered by a series of small injections across the areas of concern. The procedure takes approximately 45–60 minutes in total.
Treatment details
Protocol
3 sessions initially
An initial course of three treatments at monthly intervals is recommended, followed by maintenance sessions every 3–6 months depending on response.
Downtime
Minimal
Some scalp tenderness and mild swelling for 24–48 hours post-treatment. Strenuous exercise and direct sun exposure should be avoided for 24 hours.
Onset
2–4 months
Meaningful improvement in hair density and calibre typically becomes apparent after the second or third session. Best results are seen in combination with pharmacotherapy.
Evidence and realistic expectations
The evidence base for PRP in hair restoration has grown considerably over the past decade. Multiple randomised controlled trials demonstrate statistically significant improvements in hair count, thickness, and patient satisfaction compared to placebo. However, heterogeneity in preparation methods, dosing protocols, and outcome measures across studies makes direct comparison difficult.
LP-PRP works best in patients with early-to-moderate androgenetic alopecia who still have viable follicles amenable to stimulation. It is not a substitute for pharmacotherapy in patients with progressive DHT-driven hair loss, but a valuable adjunct that addresses the follicle microenvironment directly.