Platelet Rich Plasma (PRP)

Category: 3

Platelet Rich Plasma, or PRP, is used for a wide variety of conditions. PRP contains a large number of growth factors, making it a potent agent to improve the healing and regeneration of any type of tissue. 

PRP is produced from your own blood. It is a concentration of one type of cell, known as platelets. Platelets and the liquid plasma portion of the blood contain many factors that are essential for cell recruitment, multiplication and specialization that are required for healing. Growth factors contained in the PRP bind to receptors in the cells, which causes an increase in stem cells and their activity. This produces a regeneration of the tissues, which can continue for up to one month. This results in the development of new, healthy tissue that is permanent.

In order to prepare the PRP, a blood sample is taken, and then the blood is put into a centrifuge and the platelet rich faction is concentrated into a small amount of serum. This serum is then given through some form of an injection into the areas being treated.

There are only a few medical conditions in which PRP should not be used. These are decreased platelet numbers or function, instability of the circulatory system, and local or systemic infections.

There are also a couple of other things that can cause some issues. You should not take aspirin or other similar medications (Advil, etc.) within 48 hours of the treatment. Also, you should not use steroids (Prednisone, etc.) for two weeks, or have had a steroid injection in the area in the last month.

Because of its potent effect on healing and regeneration, PRP is being used for many conditions. Listed below are the most common types of treatments provided. 

Tendons, Ligaments, and Muscles

Any kind of injury to these tissues can be treated with PRP. These include, but are not limited to, tennis elbow, rotator cuff strains, partial ligament tears, Achilles tendon problems, degenerative disorders, chronic injuries and pain, etc. In many cases, surgery can be totally avoided or delayed.

Another therapy used for these types of conditions is Prolotherapy. However, it has been shown that PRP is a stronger, more bioactive therapy and requires fewer treatments. In addition, unlike Prolotherapy, no chemicals or drugs are used in PRP.

Hair Loss (Alopecia)

Hair loss is a common condition, and can be caused by several factors. Male pattern baldness, or androgenetic alopecia, is the most common type in men, accounting for about 95% of hair loss. Genetic factors account for about 80% of this condition. About 50% of men in their 50’s will be effected. Men and women experience androgenetic alopecia with equal frequency.

Hormones do play a major role in androgenic alopecia, due to either high androgen content or low estrogen as evidenced by the fact most female patterned baldness occurs after menopause. This is the most common form of hair loss and it can be corrected to varying degrees. Other hormonal, environmental, and genetic factors also may be involved, and a full medical evaluation should always be done.

Female Pattern Hair Loss (FPHL) has a strong genetic predisposition. There are many genes that contribute to this condition, and these genes could be inherited from either or both parents. 

It is not clear if androgens (male sex hormones) play a role in FPHL, as the majority of women with FPHL have normal levels of these hormones, while others do have high levels.The majority of women affected by FPHL do not have other underlying hormonal abnormalities, while another group of women will have hormonal disruptions. It’s therefore strongly advised that a complete panel including female and male sex hormone levels as well as thyroid function be done for both men and women.

FPHL can affect women in any age group but it occurs more commonly after menopause. The role of estrogen is uncertain even though FPHL is more common after menopause, suggesting that estrogens maybe stimulate hair growth. There are many treatments that can help, but FPHL cannot be cured. It can, however, usually be well controlled.

PRP is an excellent therapy for any type of hair loss. There are two types of injections that can be used. The first is a traditional needle and syringe, in which the PRP is injected into the skin. The second type is microneedling, or collagen induction therapy. This is a minimally invasive treatment to rejuvenate the skin. A device with fine needles creates tiny punctures in the top layer of the skin, which triggers the body to create new collagen and elastin. Microneedling works best when combined with PRP. Injections and microneedling can be done together or by themselves. Best results are obtained if they are combined and done together.

At each session, a topical anesthetic will be applied to the area while the PRP is being produced. Once the PRP is completed, it is spread on the skin and/or used for injection. Injections are done first, then microneedling is done once the PRP serum is applied.  It is suggested that three treatments be done one month apart from each other, and results can take 2-8 months to occur.

The earlier treatment is sought the better the outcome, as people in the early stages of hair loss are more likely to receive the best possible outcomes. Also, smaller areas of balding or thinning hair rather than large spots are more likely to receive better outcomes. In addition, success rates using a combination of therapies with PRP do much better than PRP by itself. Other therapies can include vitamins and minerals, medications, herbal remedies, and red light therapy. These will be determined on an individual basis for each person.

Aesthetic Treatments

PRP can be used on almost any area of the body to help with a multitude of problems. Some of the applications include scars of any type, wrinkles and skin rejuvenation, acne, cellulite, stretch marks, and hyperpigmentation. PRP has been shown to have overall rejuvenating effects on the skin, such as improving skin texture, tightening fine lines and wrinkles, and increasing skin volume by the increased production of collagen and elastin.

There are many advantages to PRP that make it far superior to surgery or a face lift. PRP is natural and non-toxic, and since we are using your own tissue, any allergy issues are eliminated. PRP is done in the office and requires no general anesthesia.  Other benefits include minimal down time, very little risk of complications, a short recovery time, and rapid, natural looking results with long-term benefits.

As in the treatment for hair loss, therapy can be done with injections, microneedling, or a combination of the two. Prior to treatment an anesthetic cream will be applied to the area. After treatment, your skin will be red and flushed, similar to a mild to moderate sunburn, for anywhere from 12 hours to three days. You may also experience mild swelling, tightness, and/or mild peeling. These effects are temporary and typically resolve within three days. You might also notice a tingling sensation while the cells are being activated. 

Total healing time depends on the depth of the treatment, skin type, and skin condition. Healing time will be longer if injections are done in addition to the microneedling. Some people can heal completely in 24 hours. Ice or cold compresses can be applied to reduce swelling if required. In addition, I recommend topical agents to enhance the effects of the treatment.

You will typically notice an immediate glow, but visible improvement will take about 2-4 weeks and can continue for up to 6 months. You will notice improved skin tone and texture within two to six weeks after every treatment. Depending on the condition which is being treated, three to eight sessions may be required every 4 to 12 weeks.

Sexual Dysfunction

A more recent application of PRP is that of treating sexual problems for both men and women. In women, it is used for lowered sexual desire and difficulty in achieving sexual arousal and orgasm, dyspareunia (pain with intercourse), and urinary stress incontinence.

The O-Shot,  or Orgasm shot as it is sometimes referred to, involves two to four tiny injections in the vaginal area. A numbing cream is applied to the areas 10 – 20 minutes before the injections so that they are painless. 

Benefits can include greater arousal from clitoral stimulation, stronger and more frequent orgasms and an increased ability to have a vaginal orgasm, increased sexual desire, a tighter vaginal opening, younger and smoother vaginal skin, increased natural lubrication, and decreased pain if dyspareunia has been a problem.

Improvement in sexual sensation and function is usually noticed between 3 weeks to 6 weeks after treatment, and these improvements can continue for up to one year.

For men, the treatment is called the P-shot (Priapus Shot) or the M- PRP shot. This treatment can strengthen and increase the length and girth of the penis, increase blood flow so that there is increased sensitivity, and can decrease the “refractory period”, which is the time needed between being able to achieve subsequent orgasms. In addition, it will help other therapies work better, such as Viagra or Cialis, if they are still needed. It promotes erections that are firmer, larger, more frequent and longer lasting.

It also promotes the release of many growth factors, stimulating the rejuvenation of tissues comprising the penis. This is one of the factors that makes it useful to treat a condition called Peyronie’s disease, which is a problem caused by scar tissue that forms inside the penis, and can make the penis bend upward or to the side. 

As above, a numbing cream is applied to the area 10-20 minutes before the injections are done. There are very few side effects, unlike most other therapies. The only one encountered is about a 10% chance of scar formation or hematoma (bleeding) after the treatment. The results are almost immediate, and can last for 18 months or more, depending on the condition being treated.

Arthritis and Joint Pain

PRP is very useful in any joint problem. Injections are done directly into the joint, and can be done as often as needed, but at least 2-3 treatments are usually required. PRP can help heal both the cartilage and the bone in any joint, and typically results in a large reduction in pain.

Herniated Discs

The approach is very similar to the one used for joints. In this case, the PRP is injected next to the discs that are herniated. In both this and the treatment for joints, I suggest that a few Discosan treatments be done before using PRP. This approach is often able to reverse the herniation and avoid surgery.

Other Conditions

PRP can be applied to any tissue that can benefit from its healing and regenerative effects. This includes such conditions as burns, wounds, non-healing fractures and other types of trauma or damage.