PRP for hair in women: who is it for, and what is checked first?

Why does thinning look different in women?

Because in women hair usually thins diffusely, not in bald patches. In men, hereditary balding usually starts at the temples and the crown. In women the front hairline is usually preserved, and the change shows as a widening part, scalp showing through on the top of the head and a ponytail that gets thinner⁵³. Under magnification there is variation in hair thickness, more thin hairs, and fewer hairs per follicular unit⁹.

The scale used to describe the female pattern is the Ludwig scale, which divides thinning into three grades according to how far it spreads over the top of the head¹⁰. PRP mainly suits the early and moderate grades, when there are still follicles to strengthen. What a widening part means is explained on the widening part page.

What did studies find about PRP in women?

Two randomized trials in women found an improvement compared with placebo. In a trial in which 30 women received PRP in one area of the scalp and saline in another, hair density and hair thickness improved in the PRP area, and the improvement was maintained at six-month follow-up¹. Another randomized trial in women with hereditary balding found an increase in hair density in the PRP group compared with the control group².

In a multicenter trial that compared PRP, iPRF and CGF in 74 women, hair counts rose in all three groups, and the increase in the iPRF and CGF groups was larger¹¹. Meta-analyses of PRP trials in hereditary hair loss report an improvement in density, but note that preparation methods and protocols differ between studies¹²¹³. The practical meaning: PRP is a relatively well-supported option for women, but the individual response varies, so results are measured.

What is checked before PRP?

First, understand why the hair is falling out. In women there are several common causes that can cause thinning or make it worse, and each has its own treatment:

• Iron. A meta-analysis found an association between iron deficiency and non-scarring hair loss in women, so ferritin is checked⁴.
• The thyroid gland. Both an underactive and an overactive thyroid can cause diffuse hair loss¹⁴.
• Excess androgens. When thinning comes with irregular periods, acne or excess body hair, hormones are tested and polycystic ovary syndrome is considered⁶.
• Telogen effluvium. Increased shedding after childbirth, illness, surgery, dieting or stress, which usually starts two to three months after the trigger¹⁵¹⁶.

What the tests actually include is described on the blood tests for hair loss page. A trichoscopic examination helps tell hereditary hair loss apart from telogen effluvium, and sometimes shows that both are present together⁹.

PRP after childbirth: when does it make sense?

Hair loss after childbirth is usually temporary and does not always need treatment. The shedding usually starts a few months after delivery and settles on its own¹⁵. But sometimes it reveals hereditary thinning that was already there, and then the hair does not return to what it was¹⁷. If the shedding does not settle, or the part stays wide, it is worth getting checked. Tell your doctor about breastfeeding or pregnancy before any treatment; the decision whether and when to treat is made together in consultation. More details on the hair loss after childbirth page.

PRP during and after menopause

Menopause is a common time for thinning to get worse. The prevalence of female pattern hair loss rises with age, and in a population study it was higher in older women¹⁸. At this age other causes are also checked, such as iron, the thyroid gland and medications. PRP can be part of the plan when there are still active follicles, usually together with medical treatment. What changes in the hair at this age is explained on the hair loss in menopause page.

How is PRP combined with minoxidil and spironolactone?

PRP strengthens the follicle, and the medications act on the underlying mechanism. The European guideline for treating hereditary balding recommends topical minoxidil for women⁷, and a Cochrane review found minoxidil effective in female pattern hair loss⁸. Low-dose oral minoxidil was studied in a large multicenter study, with a good safety profile¹⁹. Spironolactone, a medication that reduces the effect of androgens, is used in women when needed, after an evaluation and under medical supervision²⁰²¹.

At the clinic, PRP is usually given as part of a combined plan: medical treatment at home, a PRP series, and sometimes mesotherapy or phototherapy (LED) at the end of the treatment. The comparison between PRP and minoxidil is on the PRP or minoxidil page, and minoxidil for women on the minoxidil for women page.

Who is PRP less suitable for?

When there are no active follicles, when the hair loss is of a different type, or when there is a medical condition that calls for caution. In scarring hair loss, such as lichen planopilaris or frontal fibrosing alopecia, the treatment is different. Alopecia areata has other treatments. With a severe drop in platelets, a platelet function disorder or an active scalp infection, PRP is not suitable. Women who take medications that affect blood clotting should mention it before the treatment. The full list is on the who PRP for hair is not suitable for page.

How is it done at Dr. Dana Buchbut's clinic?

Diagnosis first, then a plan that fits your stage of life. At the clinic, the treatment is performed by Dr. Dana Buchbut herself, physician (M.D.). Before the series she performs a computerized trichoscopic examination, reviews the blood tests, and builds a plan suited to your age, stage of life and type of hair loss. For women who prefer to avoid medications, or who did not get along with them, there is sometimes a place for other blood-derived methods or for Regenera Activa (autologous micrografts). The injection is done under local anesthesia, and it can also be made more comfortable with cooling, vibration and nitrous oxide ("laughing gas"). The clinic is in Beit HaRofim (medical building), 11 HaBarzel St., Ramat HaHayal, Tel Aviv.

The information on this page is general educational information only and is not a substitute for an examination, diagnosis or personal medical advice. The decision on treatment is made only after an examination.