1. PLATELET RICH PLASMA
FOR HAIR REGROWTH
Alan J. Bauman, M.D.
Diplomate, American Board of Hair Restoration Surgery
PRP LifeLift™ Certification & Training
September 13, 2014
ABHRS

2. CONFLICTS OF INTEREST
• The following conflicts of interest
pertain to this presentation: NONE

3. ALAN J. BAUMAN, M.D., A.B.H.R.S.
• Diplomate, American Board of Hair Restoration Surgery
• Member, International Society of Hair Restoration Surgery
• Recommended, American Hair Loss Association
• Member, American Academy of Anti-Aging Medicine (1998)
• New York Medical College
• Beth Israel Medical Center NY – General Surgery
• Mt. Sinai Medical Center NY – General Surgery
• Bauman Medical Group (est. 1997) - Boca Raton, FL
• >17,000 patients treated, >7,000 hair transplants

4. VIDEO: PRP HAIR REGROWTH ON ABC
http://hai.rs/hairprp-placenta

5. OVERVIEW
• Hair Follicle & Growth Cycles
• Hair Loss & Treatments
• PRP & Growth Factors
• PRP in Hair Restoration
• Role of Extracellular Matrix (ECM)
• ACell/Matristem & BioD-Restore
• Hair Evaluations & Measurements
• How to Prepare & Apply Scalp PRP
• Additional Educational Opportunities

6. HAIR & SKIN ANATOMY: THE PILOSEBACOUS UNIT

7. HAIR GROWTH CYCLE

8. HAIR FOLLICLE
STEM CELL SIGNALING
• Epithelial Wnt/β-catenin signaling is required for
hair matrix cell proliferation. Wnt/β-catenin
signaling is a central regulator of adult stem
cells.
• LRP inhibition permits stem cell survival; blocks
hair growth reversibly
• β-catenin is required in bulge stem cells for their
proliferation, but not survival indicating the
persistence of functional progenitors so follicles
will continue to proliferate even without β-
catenin.
• Hair Follicle ~ Fibroblast “Cousin”

10. Hair Loss
• Fear/anxiety ~ Sickness or Illness
• Low Self-Esteem/Self-Confidence
• Feel Older / Less Attractive
• Camouflage/Compensate
• Avoid Social Situations

11. HAIR LOSS: ANDROGENETIC ALOPECIA (AGA)
• Genetic Male and Female Pattern Hair Loss – most common type
• Affects nearly 100 Million Americans (est. 60M men, 40M women)

12. 60X & 30X “HAIRCAM” DERMOSCOPY
NORMAL MINIATURIZED

13. SEVERE DEPLETION: HAIR TRANSPLANTATION

14. HAIR LOSS: ALOPECIA AREATA (AA)
• Autoimmune
• Small / Circumscribed
• “Spot baldness”
• 1-2% of cases spreads
to the entire scalp
• Standard Tx’s:
• Steroid injections
• Microtrauma

15. MEDICAL HAIR LOSS TREATMENTS:
PRESERVE AND ENHANCE HAIR FOLLICLE FUNCTION
MODAL ITY TX MECHANISM
Oral Finasteride blocks Dihydrotestosterone production [♂AGA]
Topical Minoxidil K+ channel opener, vasodilator [AGA, AA]
Phototherapy LLLT, LaserCap ↑ mitochondrial membrane potential [AGA, AA]
Nutraceutical Biotin, Marine Protein Metabolic/Nutritional [AGA, AA]
Cell Therapy Platelet Rich Plasma Growth Factors, Cytokines [AGA, AA]

16. PLATELET RICH PLASMA
FOR HAIR REGROWTH

17. GROWTH FACTORS, CYTOKINES AND MORE…
• platelet-derived growth factor - PDGF
• transforming growth factor beta - TGF-B
• fibroblast growth factor
• insulin-like growth factor 1 - IGF1
• insulin-like growth factor 2 - IGF2
• vascular endothelial growth factor - VEGF
• epidermal growth factor - EGF
• nerve growth factor - NGF
• interleukin-1 – IL1-B
• Interleukin-8 – IL8
• keratinocyte growth factor
• connective tissue growth factor

18. GROWTH FACTORS & HAIR FOLLICLE CYCLING
• PDGF – stimulate growth of dermal mesenchyme, epidermis-follicle interaction (5)
• VEGF – mitotic & endothelial cells, increases vascular permeability (Yano-6)
• EGF – mitosis of epithelial cells, fibroblasts. Inhibits catagen, promotes anagen(10/11)
• IGF – anti-apoptosis (12)
• FGF – proliferation & differentiation of keratinocytes and endothelial cells. Anagen (13)
• NGF – hair cycle modulator. Stimulates hair growth (NGF-TrkA) via proliferation of
keratinocytes, NGF-p75NTR promotes apoptosis and hair follicle regression. Stress
mediator, may play a role in neurogenic inflammation, hair follicle apoptosis & premature
catagen.

19. PLATELET RICH PLASMA STAND-ALONE
TREATMENT FOR HAIR REGROWTH
• Autologous (or Allograft)
• Bedside
• Out-patient
• Quick; “lunch-hour”
• Non-Invasive
• Painless Local
Anesthesia
• No Downtime
• Low risk
• Hair Growth
www.HairCoach.net
YesPRP at Bauman Medical

20. VEGF
VASCULAR ENDOTHELIAL GROWTH FACTOR
Bouhanna/Amgar

21. LITERATURE REVIEW:
USE OF PRP IN HAIR RESTORATION
• Graft-storage media in Hair Transplantation
(Bouhanna/Amgar)
• Wound healing accelerator in Donor and
Recipient Areas (R Reese, J Cole, J Cooley)
• Improvement of ‘take-rate’ & growth in hair
transplantation (R Reese, C Uebel)
• Stand alone treatment for androgenetic
alopecia or alopecia areata. (J Greco,
Amgar, Bouhanna, Rinaldi)
Bouhanna/Amgar

22. PRP FOR ANDROGENETIC ALOPECIA
Bouhanna/Amgar

23. PRP FOR ALOPECIA AREATA
PreTx 8 weeks 4 months

24. PRP FOR ALOPECIA AREATA
PreTx 8 weeks 4 months

25. PRP HAIR REGROWTH IN 38YO FEMALE AGA
BEFORE & AFTER 9MOS

26. PRP HAIR REGROWTH 36YO MALE AGA
BEFORE & AFTER 9MOS

27. EXTRACELLULAR MATRIX (ECM)
• Extracellular part of multicellular
structure
• Structural & Biochemical support
• Injury Repair & Tissue Growth
• Wound healing / fibrosis
• Regulates intracellular communications
FUNCTIONS during injury or tissue regeneration:
• Prevents inflammation & scar tissue formation
• Facilitates tissue repair

28. WHY USE EXTRACELLULAR MATRIX (ECM) W/ PRP?
PROLONG & ENHANCE!
• Without ECM: PRP effects last ~90 days, requiring repeat treatments
• With ECMs
• PRP hair growth effects may last for up to 2 years
• PRP hair growth effects appear to be stronger

29. ACELL/MATRISTEM ECM
• Porcine Bladder Matrix
• Micronized powder
• Collagen
• Basement membrane
• Bio-scaffold

30. BIOD-RESTORE - PLACENTAL TISSUE ECM
BioD-Restore™ is a cryopreserved amnion allograft from the placenta of live, healthy donors.
• Immune privileged - Rarely evokes immune response
• Provides cells, structure and signals for repair/regeneration
• Natural scaffold / ECM for cell migration & proliferation
• Proteins, cytokines, carbohydrates, hyaluronic acid,
growth factors, chemical compounds and multipotent cells
naturally inherent in placental and amnionic fluid
• Anti-inflammatory / Anti-microbial / Anti-scarring / Anti-adhesive

31. BIOD-RESTORE
• Multipotential Tissue Matrix
• Structural allograft derived
from human amnion
• Chemical compounds, growth
factors, residual cells
• Regeneration
• Immune privileged
• Multipotent cells

32. BIOD-RESTORE
PROCUREMENT & PROCESSING:
• Prescreened donors
• Medical review
• Prenatal testing
• Behavioral risk assessment
• Blood tests
• Medical history
• Disease testing
• Aseptic recovery / sterile cesarean section
• FDA-registered tissue bank
• FDA-registered processing center

33. GROWTH FACTORS FOUND IN AMNION
• Platelet-Derived Growth Factor (PDGF)
• Transforming Growth Factor Beta (TGF-β)
• Vascular Endothelial Growth Factor (VEGF)
• Fibroblast Growth Factor (FGF)
• Epidermal Growth Factor (EGF)
• Insulin-like Growth Factor (IGF-1)

34. HAIR MEASUREMENTS & EVALUATIONS
• “HairCheck” – Cross-Section Hair
Bundle Trichometry
• HMI – Hair Mass Index
• Sensitive, scientific, repeatable,
accurate
• “HairCam” Dermoscopy – identifies
miniaturization
• Global Photos – medical ‘mugshots’
HairCam – ABC Good Morning America
HairCheck at Bauman Medical

35. HOW TO PREPARE AND APPLY PRP+ECM
• Patient Selection, treatment area identified & measured.
• Phlebotomy is performed.
• Scalp prepped w/ antiseptic shampoo and local anesthesia.
• PRP is prepared using centrifuge & YesPRP™ kit.
• If used, BioD-Restore is thawed.
• PRP is mixed gently with ECM (Acell/Matristem or BioD-Restore)
• PRP+ECM is injected intradermally into the scalp
• Mechanical (MicroPen) microneedling creates microtrauma
• Scalp is cleansed, 15min LLLT applied
• instructions given prior to discharge Dr. Bauman performs PRP on ABC Palm Beach

36. SIDE EFFECTS / SEQUELAE / FOLLOW-UP
• Tenderness / Swelling is rare
• Follow-ups can be performed monthly to track hair growth
improvements.
• Monitor hair growth using HairCheck and HairCam to observe peak
and plateau.

37. UPCOMING
PRP HAIR GROWTH &
HAIRCHECK™ WORKSHOPS
Friday September 19th -or- Friday November 14th 9am-5pm Boca Raton
• Hair Loss Diagnosis & Evaluations, Treatments & Tracking
• Hands-on HairCheck Measurements and Hands-on PRP+ECM hair regrowth procedure
• Course Director: Alan J. Bauman, M.D.
• Certificate & Starter Kit
• Email: andres@baumanmedical.com
• www.HairCoach.net for info/registration and future events

38. REFERENCES
Marx, R.E. , et al, “Platelet-Rich Plasma Growth Factor Enhancement for Bone Grafts,” Oral Surg Oral Med Oral Patrhol, 1998;85:638-646.
Antonaides, H.N., et al,”Human Platelet-Derived Growth Factor: Structure and Functions”, Federation Proceedings, 1983;42:2630-2634.
Pierce, G.F., et al,”PDGF-BB,TGF-β 1 and Basic FGF in Dermal Wound Healing: Neovessel and Matrix Formation and Cessation Repair”, Am J
Pathology, 1992;140:1375-1388.
ELISA Immuno Assay For PDGF-A, Human VEGF, TGF-β 1, and Human EGF, R&D Systems, Mpls, MN 1999.
Bauman AJ, The use of cross-sectional hair bundle trichometry in the diagnosis, evaluation and tracking of hair loss. Poster Presentation. ISHRS
ASM October 2012 Nassau, Bahamas.
Gruss, J., et.al., Human amniotic membrane: a versatile wound dressing. CMA Journal 1978; Vol.118:1237-1246
De Coppi, P. et.al., Isolation of amniotic stem cell lines with potential for therapy. Nature Biotechnology 2007; Vol.25,No.1:1274-1280

39. PRP VIDEO PLAYLIST
http://hai.rs/prphairgrowthvids

40. Alan J. Bauman, M.D.
Bauman Medical Group
Boca Raton, FL USA
doctorb@baumanmedical.com
baumanmedical.com
linkedin/in/alanjbauman
twitter.com/DrAlanBauman
facebook.com/alanjbauman