Ask anyone who has ever done even a single treatment of platelet-rich plasma (a.k.a. PRP) to regrow their hair, rejuvenate the skin, or help heal an injury about their results, and you'll almost always be greeted with a resounding, ‘It's a game-changer!’ The standard PRP method has been around for years across medical specialties and involves drawing a sample of blood and separating the plasma from the rest. Just like everything else in the world of aesthetics, there are always new advancements that make way for bigger and better treatments and results – and PRP is no exception. Enter: so-called ‘supercharged’ PRP. Here’s what you need to know.
PRP has gained a significant following in the last few years and quickly rose to aesthetic stardom. Initially, it was an adjunct for wound healing. But, once skin-rejuvenating vampire facials (i.e. microneedling with PRP) made their way into our living rooms — you can thank Kim Kardashian for that — and onto social media feeds, they started to be an in-demand, top-performer in doctor's offices from coast to coast. And then Kim’s sister Kourtney let us all in on her PRP for hair loss treatments after a too taut ponytail caused a bald spot, officially mainstreaming one of PRP’s most effective use cases.
Platelet-rich plasma is a blood plasma-based protein solution packed with platelets and some white blood cells and growth factors. Extracting the PRP from blood allows the growth factors to assist in healing and rejuvenating purposes. Originally, PRP was used in orthopedics to speed recovery from injuries and then made its way to skin and hair applications, says Macrene Alexiades, MD, a board certified dermatologist in New York City. Now, almost every surgical and pain specialty utilizes PRP to help heal injuries (especially joint and spine), rejuvenate tissue, speed healing, and reduce surgical pain and scarring, notes William Yates, MD, a board certified surgeon and hair restoration specialist in Chicago.
In aesthetic medicine, its fandom stems from the fact that it offers non-surgical rejuvenation. “Minimally invasive PRP has become increasingly popular in recent years since it is a natural way of addressing signs of aging,” says Samuel Lin, MD, a board certified plastic and reconstructive surgeon in Boston. While fillers and neurotoxins are great (don't get us wrong, we love them), for those who aren’t too keen on the idea of injecting a foreign substance into their skin or are simply looking for additional options, PRP offers a natural alternative since it uses your own blood. Beyond the skin-boosting benefits, PRP injections are also a godsend for anyone experiencing hair loss, thinning, and impeded growth.
Regardless of the treatment area, the basic principles of a PRP procedure are relatively the same from one to the next. First, blood is drawn from the patient's arm and put into a centrifuge where it spins out and separates the platelets from everything else in the blood. The centrifuge portion of the treatment is as significant as administering the solution itself because the concentration of platelets can vary greatly and impact efficacy (more on that in a minute).
For PRP to become activated and put healing into action, there must be an injury of some kind. For example, Dr. Yates explains that injecting PRP with a needle into the scalp puts the wheels in motion for the powerful growth factors to do their thing. The growth factors contained within the PRP are the secret sauce since the platelets quickly and effectively regenerate the skin and heal injured tissues. The platelets are a rich reservoir of growth factors that have many benefits, including combating hair loss, restoring the synovial fluid in the joints, and stimulating collagen in the skin, says Michelle Henry, MD, a board certified dermatologist in NYC. “Traditional PRP is less concentrated than the supercharged version in terms of the platelets and, in theory, it has fewer growth factors,” she notes.
All About Supercharged PRP
Not all PRP is created equally. PRP versions vary based on the concentration of platelets within the solution, says Miguel Mascaró, MD, a double board certified facial plastic and reconstructive surgeon in Delray Beach, FL. “That means that in order to see an effect, there needs to be a concentration that is four times over baseline,” he explains. The potency obtained in standard centrifuge machines average a PRP solution with about five to six times platelet concentration. Its more powerful cousins — the so-called ‘supercharged’ versions of PRP — can feature 10 times the platelets or more. The more concentrated form of PRP provides additional benefits due to its higher levels of growth factors, which signal the body's cells to swarm to the area and speed up the healing process, says Audrey Kunin, MD, a board certified dermatologist in Kansas City, MO.
But it’s not just the processing that supercharges the PRP. It’s also what’s added into the solution. “Traditional PRP contains mainly platelets and plasma, with some residual white and red blood cells left over from the PRP preparation process,” Dr. Lin explains. “The ‘supercharged’ version of PRP – which may mean that the PRP has undergone more processing than traditional PRP to be more concentrated and contain less white and red blood cells – refers to the addition of stem cells, often taken from fat, to the PRP mixture.” As Dr. Alexiades shares, the fat is “mechanically broken down and the stromal cells are obtained and then mixed with the PRP for a highly concentrated mixture.”
Patients need not worry about how rich the platelet count is within the concentration — your provider will take care of that. Dr. Yates says there are hundreds of devices on the market that claim to deliver PRP. “The truth is that most only deliver PPP (platelet poor plasma) versus platelet rich plasma,” he cautions. “The difference is the concentration of platelets and other cells derived from the centrifuge — the system concentrates the platelets at least four to six times the normal blood count.” Systems that only concentrate one to two times the average blood count are less effective. “Plus, they don't deliver the same healing results, requiring more frequent treatments,” he adds.
Supercharged PRP Treatments
To create a more potent version of PRP, a sample of blood is taken (just like in traditional treatments). “This blood is processed using a centrifuge to isolate the PRP, and, in the case of supercharged PRP, the PRP is processed further to concentrate it and remove any residual blood cells,” Dr. Lin explains. This is where the extras are mixed in. “Surgeons may add a patient's stem cells to the PRP,” he notes. Stem cells and nano-fat are retrieved from a separate liposuction procedure. Finally, the PRP is administered through targeted injections or topically as part of a microneedling session.
So, how are doctors going about pulling the most out of a single blood draw and putting it to good use? It all comes down to the technology used, of course. “There are currently two companies, Regen®, which is my favorite, and Eclipse® that have perfected their tubes that ‘pull out’ the PRP fraction and have demonstrated, through diligent science, that their PRP is very high quality,” Dr. Alexiades says. Because of the healing properties, some providers are using supercharged PRP for regenerative medicine, too. Scientific data shows a connection in animal studies between PRP and fat survival after fat transfer.
Is More Powerful Always More Desirable?
Before you cast aside traditional PRP procedures and disregard devices that have less power than their ‘supercharged’ counterparts, we’re here to tell you that all methods can be effective. It really comes down to what your doctor offers, the concerns at hand, and the inherent quality of the blood and its plasma. Dr. Mascaró, for example, prefers to use higher concentrations over baseline for most patients when doing hair restoration or anything that requires more cellular turnover and growth factors. “This may also be the case in laser resurfacing and during facial fat grafting and facelift surgery,” he says. But, during most microneedling sessions, he sticks with “more traditional PRP concentrations.”
The science is still evolving on exactly what potency is best for what purposes. “There is ongoing research regarding the optimal concentration of PRP,” Dr. Lin shares. “For some musculoskeletal uses, a higher concentration of platelets in PRP is preferred and … in a study of 10 patients, supercharged PRP shows to be effective for improving male pattern baldness.” But, in other cases, lower platelet concentration may be effective enough.
For cosmetic applications — particularly hair growth — there may not be enough evidence to make everyone a ‘supercharged’ believer. Dr. Lin says that while there are few studies on supercharged PRP, its applications and benefits are likely similar to standard PRP. What's still up for debate is the longevity of the results and if a more potent concentration of PRP, plus the presence of fat-derived stem cells, leads to longer-lasting results. Only time will tell.
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