Like slow-boiling a frog that doesn’t feel the heat until it’s too late, my personal hair loss went relatively unnoticed for years. Yes, I had observed that my hair was gradually thinning in the front since my mid- to late-twenties, but it wasn’t until I had to remove a gnarly clog from my shower drain on a weekly or more basis that I realized how sparse my hair had become. My once-lush summer ponytails had somehow reduced in diameter to a size somewhere in between that of a nickel and quarter. And, whenever I caught a glimpse of myself in the sun or under a bright overhead light, I saw more scalp than hair at the beginning of where my left part used to be.
As the problem became more severe in my mid- to late-thirties, I not only noticed it, but became obsessed with finding a solution. I gobbled biotin supplements to no avail (though my nails looked lovely!), and tried a slew of over-the-counter shampoos, conditioners, drops, sprays, and mousses; but they never seemed to slow down any of my shedding. All I could do was watch helplessly as more and more strands entangled themselves in my fingers during each wash or comb, not knowing where else to turn.
[Editor’s note: As always, talk to your doctor before starting any new supplement or treatment.]
As luck would have it, within weeks of starting my new role on the SpotlyteTM; editorial team, the topic of platelet-rich plasma (PRP) injections came up, which I had never heard of before. At first, I was slightly nauseated at the thought (Why would anyone want to be injected with their own blood?), and quickly dismissed them as a hokeypokey fad that would soon be laid to rest in the expanseless graveyard of once-all-the-rage beauty trends. However, ironically, as Spotlyte’s resident fact-checker, I was soon faced with an unavoidable truth during my research: PRP is no hocus pocus. In fact, it’s been clinically proven and FDA-cleared for a range of issues.
Famous athletes such as Tiger Woods and Rafael Nadal have been treated with PRP injections to help heal sprains and chronic injuries, among other maladies. In dermatology, PRP’s multifaceted benefits have been clearly documented for a variety of rejuvenation from improved skin texture, tone, and appearance of fine lines and wrinkles to helping to treat sun damage, acne scarring, and (hooray!) hair loss.
The process works by straining out plasma from an individual’s blood, which contains five to 10 times more growth factors than their regular blood; the PRP is then injected back into the person to spur regeneration in the treated area. Upon learning all of this, and repeatedly being tasked with fact-checking its benefits for numerous articles, I became dead-set on giving it a try.
After researching an experienced provider, I booked a consultation in the NYC office of Michele Green, MD, a board-certified dermatologist. Intimidating as it was to think about having my own blood drawn, strained, and injected back into me (in the scalp, no less), the mood in the office with Dr. Green and her assistant Dita Kosi felt light-hearted and even a bit fun.
Dr. Green left the room for a moment, and I asked Kosi if she’d seen a lot of PRP treatments before. She confirmed that she had, then her smile faded briefly as she bluntly said, “It hurts.” However, just as fast as reality and her brutal honesty smacked me in the face, she brightened up again and continued happily conversing as she prepped the room. Surprisingly, in the short time it took for Dr. Green to re-enter the room, I was easily distracted, even smiling and joking around with them again.
We then got down to business and Dr. Green looked over the intake paperwork I had filled out. “Let's go over all the medical history,” she said. “How long have you had high blood pressure?” I shared that I was diagnosed pretty young, at 30, so nearly 10 years ago. “Is that when they put you on medication for it?” she inquired, to which I confirmed it was.
She briefly inquired about my family’s medical histories, including the fact that both my mother and father have hair loss, then circled back to ask when I first started experiencing it. When I mentioned it began in my twenties, but got significantly worse in my thirties, it was if Occam’s razor itself sliced open an Aha! moment in my mind as I spoke. Dr. Green looked on knowingly, connecting the not-so-far flung dots that neither I (nor my general practitioner) had put together. One of my prescriptions can have the side effect of hair loss, and the past near decade of being on it aligned suspiciously well with the accelerated thinning. I couldn’t believe I hadn’t been able to see it sooner!
Add to that the side effects of certain birth control I was on that can also contribute to increased shedding. Ditto, a slightly raised testerone level which was uncovered in my last full blood panel. [Counterintuitively, although testosterone can cause hair to grow in certain places, it is also what dihydrotestosterone (DHT) comes from, a common culprit behind hair loss.]
In only a few minutes, Dr. Green had uncovered the perfect confluence of events behind my hair loss, each of which could cause it on its own, let alone when supercharged altogether. Heredity, was a factor, but medication and hormones were also to blame. She recommended talking to a cardiologist about changing out one of my blood pressure medications for a different one that doesn’t have the side effect of hair loss.
Still stunned at the simplicity of the likely reasons for my long-standing hair loss enigma, I barely noticed as Dr. Green stood to begin inspecting my hair. Despite my concerns largely being the top and front of my hair, she confirmed the thinning was more widespread than I had even known. “You know, it's thin at the back, too — it is a little bit everywhere.” She asked if I took any vitamins, and when I couldn’t remember the name of the ones I tried, she asked if they were Nutrafol® ($88) or Viviscal® ($38), noting that, “Viviscal is really good [for treating hair loss].”
Onwards she inspected, explaining, “So, it's thinner here [at the top], but it's actually a little bit thin everywhere. There’s a little bit more [at the back], but your hair is just really, really thin.” Confirming I was a candidate for PRP was therefore fairly clear, but Dr. Green mentioned a step further I could try to really help: a laser cap. She said that because I have more than just female pattern baldness (which is typically exemplified by thinning at the temples, on the top, and along the hairline and part), and have diffuse hair loss (which is thinning all around), the laser cap could be another good option to look into.
Following what to me were holy grail-level revelations and advice, the PRP procedure finally began. After adeptly drawing a couple of vials of blood, Dr. Green gently put them in a centrifuge to separate the various components, including the growth factor-rich plasma. While the machine spun and whirred for about 10 minutes, we discussed everything from current events, books, and movies to the doctor’s daughter. The spinning vials eventually wound down to a stop, and as Dr. Green removed the ones with my PRP, she showed me the different layers that my blood had been divided into: an opaque yellow-ish liquid at the top, followed by a more dense thin layer of creamy white, and nearly black-looking red at the bottom.
“That's why you spin it down, because that's just the discarded blood cells,” she explained, pointing to the dark red sludge at the bottom. “The serum [with growth factors] is what comes out of the red blood cells — the part that you want, the good stuff.” The silky white layer was white blood cells. I was fascinated.
“This has all the growth factors,” Dr. Green went on, indicating the top portion. “This [at the bottom] has nothing; these are like anteshell, [like] the outside of the peanut.” Using a small syringe, she siphoned out the top layer for injecting. Although the mood in the room felt akin to a friendly get-together — only with a sharp needle about to come alarmingly close to my head — the moment of reckoning had arrived.
Kosi offered me a squeezy ball to distract from the pain of the injections. Though I tried to assure them I generally had a high pain tolerance, I’m not sure I wholeheartedly believed myself in the moment — the words it hurts kept reverberating through every reach of my brain. “The only reason the squeezy balls are here is because people used to break Dita's hands,” Dr. Green joked. And, like a one-two punch comedy routine, Kosi agreed: “Yes. That's why I'm not giving my hand anymore.”
Dr. Green asked that I lean the top of my head towards her so she could clean my scalp and start injecting the PRP, which I abided by, clenching my eyelids shut in anticipation, suddenly desperately wanting that squeezy ball. It was at the first prick that I realized that the straightforward honesty of warning me about the treatment’s discomfort was actually in itself a therapeutic strategy: I was expecting so much pain that when the needle actually made contact with my scalp, it was nowhere near as unpleasant as I thought it would be. If anything, it reminded me of getting nicked by a stray kitty claw whenever my childhood cat would knead my hair — uncomfortable, yes, but far from intolerable.
Within minutes, the procedure was over, and Dr. Green dabbed some loose droplets of blood away. “You are done, my dear,” she said. “That wasn't so bad. [Are you] okay?”
It really wasn’t so bad, I replied, I was fine.
“Dita's going to massage it in now, okay?” Kosi chimed in, “That's the good part.”
“She's the good one, if you haven't figured that out,” Dr. Green self-deprecatingly quipped, laughing.
Dr. Green instructed me not to wash my hair or use any hair product for the rest of the day and the next day. When I asked how often you should get PRP injections, she suggested once a month for the next few months. She explained that usually people need four treatments spaced a month apart, then twice annually, although there are people who only have it done once. “[But] you should [look into changing your blood pressure medication] as soon as you can,” she recommended. “It would make everything grow faster.” I beamed at the prospect.
Kosi placed a hand on my shoulder and leaned in. “You survived, my friend,” she said, then broke into applause and cheers with the doctor. “Encore! Encore!” Dr. Green exclaimed, as she pumped her arms, topping off the whole experience as one more of comradery than clinicality.
Three months after my first PRP injection, another (more positive) confluence of events has happened. I’ve started taking hair growth supplements, seen a cardiologist who did change one of my blood pressure medications, and I do believe some of the growth factors took hold. I may be far from having a luscious mane, but I definitely lose less hair in the shower. And, I can just start to see and feel slightly fuller hair in my once-balding areas. Whether it was one of the above, or a combination of all three, I’ll take it. There’s a ray of hope, and I’m not letting go.
Complimentary treatment was provided to the author for the purpose of writing this article.