PRP: is it worth all the hype?

Celebreties are raving about it, doctors are promoting it for many things, but is it really worth the hype?

In short, PRP is not FDA approved for anu Dermatologic or Cosmetic indication. There are several small studies that concluded that there is benefit when treating androgenic alopecia. That being said, larger, well-designed studies are needed. For other indications, such as photo-rejuvenation, studies are even more poorly designed.

There is a good scientific basis for why PRP may help a variety of conditions. Unfortunately, due to a lack of good clinical studies further research is needed. So the answer to the question of whether is is worth the hype is maybe. 

Often, PRP is combined with another procedure–laser resurfacing+PRP, or Restylane+PRP. When doing so, it is difficult to know if the PRP is adding any benefit.

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Hair loss treatments – for men and women

According to a recent article, all treatments that were evaluated were effective in treating hair loss.

For men, 2% minoxidil, 5% minoxidil, low light therapy, and finasteride were all effective.

For women, 2% minoxidil was effective. Unfortunately, other treatments were not evaluated for women.

Recommendations from Dr. Bader: In my experience finasteride is most effective in men with a high compliance rate. ┬áThe original 1mg dose was actually pulled out of thin air–no studies to find the most effective dose with the least amount of side effects was used to come up with this dose. I have found that 1mg may not be enough for some patients. 1.25mg (a quarter of a 5mg tablet) works well and some require a 2.5mg dose once or twice a week. I have found that this higher dosing has a greater effect on those who do not get the desired result with a minimal increase in side effects.

For women, I recommend that 5% minoxidil used once daily. This dosing schedule was recently FDA approved, not that this matters. One can buy the 5% minoxidil for men or women, whichever is cheaper. The product is the same. The only difference is the instructions that come with the product. Men are instructed to use the product twice daily. Studies have shown that 5% minoxidil twice a day is no more effective than 2% minoxidil twice a day. For this reason, once a day dosing is recommended for women, not that there is substantially greater risk of using the product twice a day. Side effects from this product include low blood pressure and increased facial hair growth in some. I recommend using the product at night, when one is less affected by lower blood pressure. One should get out of bed slowly to ensure they do not get lightheaded.

Devices that help retain hair when undergoing chemotherpy for breast cancer

The DigniCap Cooling System was FDA approved in 2015 to prevent hair loss, which may be of benefit to those undergoing chemotherapy. The FDA has just approved a second system, the Paxman Scalp Cooling System, for reducing hair loss in breast cancer patients undergoing chemotherapy.