HAIR TRANSPLANT FORUM

[forhair]

Q:I am a 31 year old male and at a stage where I still have a fair amount of hair but see some early temple thinning (despite being on Propecia for about 1.5 years). A hair loss vaccination seems the most appropriate for me at this stage as I am trying to ensure no further progression of loss some additional thickening would be a terrific bonus
however. Is this a realistic expectation to have from PRP/Acell? Is this a procedure you would recommend to someone like me?

A: I began using Acell in combination with PRP long before anyone else considered this combination.  The rationale was quite simple.  PRP is loaded with growth factors and Acell provides a scaffold with stem cell attraction for these growth factors to set up on and provide a potential sustained release of growth factors to newly activated stems cells that migrated to the region.  I based my rationale on the work that Joe Greco was doing with a natural ECM that he had manufactured from his patient’s blood.  Joe was seeing a positive influence in terms of improved coverage from existing hair due to hair shaft thickening. 

The combination has the capacity to induce improved hair shaft diameter in areas of existing hair.  I often use the microneedle roller to perturb the recipient area, but use caution with this as it can also cut hair follicles sometimes and cause temporary thinning.  I always activate the PRP with Thrombin.  Failure to do this would reduce the potential benefit from the procedure.  I’ve given re-treatments as far out as 14 months and as frequent as 8 months. 

You would not need much Acell if you are only going to treat the frontal temple area.  The PRP is around 750.00 as I recall.  I’d say about 80 to 130 for Acell.  I’ve seen results show up quickly.  I’ve also seen some that don’t seem to respond.  I’ve never seen it produce shock loss, but you can never say never.  I do have some cases of acell in the frontal area.  Some are photo protected, however. 

This is one of those treatments that does not seem to cause any harm or risk other than time and money.  When it works, it works very well.  When it does not work, we all feel bad, but at least you are the same as before. I’m not sure how long the treatments will continue working for you.  It may be they work initially or not at all.  Then again, it might really add something to what you are already doing. 

Hair loss does tend to go in stages.  You go stable for many years then suddenly, you loose quite a bit.  If you are on this edge of the plateau, and we do PRP, it might not save you from a sudden loss. 

I am looking into adding stem cells to the area also.  It is impossible to say if this will work at this time.  I am studying this option carefully as we speak.

We do have an affiliate office in Korea and in Singapore, but neither is offering Acell at this time. 

[ljpviper]

Hello Dr Cole,

I had the PRP/Acell procedure done 3 weeks ago at your office in Atlanta. I know its too early for anything significant, but I can tell you my hair is getting much darker and it appears thicker. Maybe the darker hair is tricking my eyes. I have light brown on the top and its becoming dark brown like the sides.

I had a tiny bit of shedding the first 2 weeks but no longer. Will keep you updated on my progress. Keeping my fingers crossed the next couple of months.

[ljpviper]

Sorry did not notice this in your reply, this appears what happen in my case, I often use the microneedle roller to perturb the recipient area, but use caution with this as it can also cut hair follicles sometimes and cause temporary thinning.

Thats great to know as I was a bit worried.

[drcole]

There a a few different types of rollers and there are different depth rollers. I use two different types and the 1 mm long needles. One roller has almost 4 times the number of needles. This roller can definitely cut hair shafts, weaken, them, and cause temporary hair loss. I don't like to use this roller on a scalp that has hair on it because it can cause a temporary decrease in hair on the top where you need it. When there is hair present, i will either not roll it or I will roll it with the roller that has fewer needles. The needles definitely turn on the inflammatory cascade so it is a good thing to consider using. I simply am cautious with the use of a roller because patients do not like to see hair thinning.

The first sign of hair loss is a lightening of the hair shaft color. The next is miniturization. The change in color to a darker color is a good sign.

Most home rollers are only 0.5 mm long and are better tolerated because they cause less pain. You can sterilize them at home in a baby bottle sterilizer if you like. You can also boil them.

I hope things continue to improve for you.

[ljpviper]

Hello Dr. Cole

You used the micro-needle on me, i still have hair on the top, although thin. I am quite surprised how fast this treatment can increase the hair shaft. I thought it was the color change that was making it appear thicker. I can tell, as before the treatment my hair was see through in the sun, you can no longer see my scalp. This can really be a game changer for people.

I will try to get some pictures this weekend to send to your office. Also, do you have anyone that has discontinued Rogaine and propecia/avodart after the treatment. I use both, not a bid deal to keep using, I guess it cant hurt.

[drcole]

This is all good news. Congratulations. Bravo!!!!

I am paralyzed with fear to suggest you stop medications out of the risk of long term progression of hair loss. I would much rather see you wait for a period of time to see how the treatment of Acell and PRP affects your long term "hairy" results.

[ljpviper]

Thanks Dr Cole, i will stay on the meds like you suggested. Here is something else really interesting that is happening. I noticed alot of the hairs actually multipling within the same follicle. Instead of one hair there are now 2 or 3. It appears to be happening to quite a few hairs. I know, as had single hair grafts in the hairline and behind them is my native hair. Its actually happening to both types of hair. So it appears the Acell/PRP not only thickens the shaft but must be stimulating the follicle to produce more hairs. Its coming up on 4 weeks since the procedure.


thanks for all