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PRP platelet rich plasma hair regrowth - yesprp dr_alan_bauman 05292015

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PRP Platelet Rich Plasma is a non-surgical, non-invasive treatment for hair loss. “Cell therapy” is a relatively new frontier in medical technology which involves introducing cells into a tissue in order to treat a disease or condition. Areas of research such as stem cell processing and activation, cell multiplication, cytokines, growth factors, extracellular matrix products, bioscaffolds, platelet rich plasma (PRP), gene therapy, tissue repair and more are some of the exciting new ways in which scientists are investigating in the use of cell therapy to physicians improve outcomes and treat a variety of conditions.

Adjunctive therapies which impact wound healing like the use of hyperbaric oxygen, copper peptide solutions, phototherapy, extracellular matrix (ECM), protein soaks, etc. have been a part of Dr. Alan Bauman’s post-operative treatment regimens after hair transplantation for years. Helping the body safely “help itself” is the cornerstone of these types of treatments which often utilize natural components found in the human body. Along those lines, PRP has already been found to be a helpful adjunct successfully in use in many areas of medicine, including orthopedics, dentistry and plastic surgery for tissue repair, tissue regeneration and wound healing.
What is Platelet Rich Plasma (PRP)?
Produced in just minutes from a small quantity of your own blood, PRP contains a wide variety of the body’s own natural growth factors which may be helpful in accelerating tissue regeneration, improving healing time and stimulating hair growth. Platelets are cell fragments that are normally found in the blood and play a key role in blood clotting and are a natural source of growth factors. Special medical equipment is used by your physician to separate a platelets from a small sample of your own blood and prepare them for use. Once applied and activated, platelets release their stores of powerful growth factors and other molecules.

What Growth Factors are found in Platelet Rich Plasma (PRP)? The platelets collected in PRP are activated by thrombin and calcium chloride to induce the release of these growth factor proteins and other cytokines:

• platelet-derived growth factor
• transforming growth factor beta
• fibroblast growth factor
• insulin-like growth factor 1
• insulin-like growth factor 2
• vascular endothelial growth factor
• epidermal growth factor
• interleukin-8
• keratinocyte growth factor
• connective tissue growth factor

HOW IS PRP MADE?
PRP is made from a small sample of your own blood. The FDA-approved process concentrates the platelets found in the blood sample and separates them from other blood components. These concentrated platelets contain huge reservoirs of growth factors and wound healing factors. Growth factors are natural components of your body whose potential benefits can now be harnessed using modern medical technology. For hands-on PRP training classes v

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PRP platelet rich plasma hair regrowth - yesprp dr_alan_bauman 05292015

  1. 1. Alan J. Bauman, M.D. Diplomate, American Board of Hair Restoration Surgery YES PRP Certification & Training May 30th, 2015 
 PLATELET RICH PLASMA
 FOR HAIR REGROWTH ABHRS
  2. 2. CONFLICTS OF INTEREST • The following conflicts of interest pertain to this presentation: NONE
  3. 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 Alan J. Bauman, M.D.
  4. 4. VIDEO: PRP HAIR REGROWTH ON ABC http://hai.rs/hairprp-placenta
  5. 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. 6. HAIR & SKIN ANATOMY: THE PILOSEBACOUS UNIT
  7. 7. HAIR GROWTH CYCLE
  8. 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”
  9. 9. HAIR: Beauty & Youth
  10. 10. • Fear/anxiety ~ Sickness or Illness • Low Self-Esteem/Self-Confidence • Feel Older / Less Attractive • Camouflage/Compensate • Avoid Social Situations HairLoss
  11. 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. 12. NORMAL MINIATURIZED 60X & 30X “HAIRCAM” DERMOSCOPY
  13. 13. SEVERE DEPLETION: HAIR TRANSPLANTATION
  14. 14. SEVERE DEPLETION: MEDICAL HAIR PROSTHESIS
  15. 15. HAIR LOSS: ALOPECIAAREATA (AA) • Autoimmune • Small / Circumscribed • “Spot baldness” • 1-2% of cases spreads to the entire scalp • Standard Tx’s: • Steroid injections • Microtrauma
  16. 16. MEDICAL HAIR LOSS TREATMENTS:
 PRESERVE AND ENHANCE HAIR FOLLICLE FUNCTION MODALI TY 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]
  17. 17. PLATELET RICH PLASMA FOR HAIR REGROWTH
  18. 18. 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
  19. 19. 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.
  20. 20. PLATELET RICH PLASMA STAND-ALONE TREATMENT FOR HAIR REGROWTH • Autologous • Bedside • Out-patient • Quick; “lunch-hour” • Non-Invasive • Painless Local Anesthesia • No Downtime • Low risk • Hair Growth www.HairCoach.netYES PRP at Bauman Medical
  21. 21. VEGF
 VASCULAR ENDOTHELIAL GROWTH FACTOR Bouhanna/Amgar
  22. 22. 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
  23. 23. PRP FOR ANDROGENETIC ALOPECIA Bouhanna/Amgar
  24. 24. PRP FOR ALOPECIAAREATA PreTx 8 weeks 4 months
  25. 25. PRP FOR ALOPECIAAREATA PreTx 8 weeks 4 months
  26. 26. PRP HAIR REGROWTH IN 38YO FEMALE AGA
 BEFORE & AFTER 9MOS
  27. 27. PRP HAIR REGROWTH 36YO MALE AGA
 BEFORE & AFTER 9MOS
  28. 28. 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
  29. 29. 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
  30. 30. ACELL/MATRISTEM ECM • Porcine Bladder Matrix • Micronized powder • Collagen • Basement membrane • Bio-scaffold
  31. 31. BIOD-RESTORE - PLACENTAL TISSUE ECM • 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 BioD-Restore™ is a cryopreserved amnion allograft from the placenta of live, healthy donors.
  32. 32. BIOD-RESTORE • Multipotential Tissue Matrix • Structural allograft derived from human amnion • Chemical compounds, growth factors, residual cells • Regeneration • Immune privileged • Multipotent cells
  33. 33. 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
  34. 34. 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)
  35. 35. 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
  36. 36. 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
  37. 37. 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.
  38. 38. UPCOMING
 PRP HAIR GROWTH & HAIRCHECK™ WORKSHOPS Friday June 19th -or- Friday Septembe 25th 9am-5pm Boca Raton • Hair Loss Diagnosis & Evaluations, Treatments & Tracking • Hands-on HairCheck Measurements • Hands-on PRP+ECM hair regrowth procedure • Course Director: Alan J. Bauman, M.D. • Certificate, Starter Kit & Ongoing Support • andres@baumanmedical.com or www.HairCoach.net for info/registration and future events
  39. 39. 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
  40. 40. PRP VIDEO PLAYLIST http://hai.rs/prphairgrowthvids
  41. 41. 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 Thank You!!

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