Have you done any research about on Exosomes? It seems like some major surgeons in the hair restoration world are now moving to do with some fantastic results. Can you talk a little more about the science behind this and why it could be a possible upgrade from PRP.

Interestingly, I see that PRP + microneedling procedure was done the following way (as stated in a study): “The scalp was activated by microneedling following which platelet-rich plasma was massaged on the scalp”. That brings me questions – does microneedling before PRP session + PRP injection and does weekly microneedling along with monthly PRP sessions have some benefits?

My doctor does not do microneedling that is why I’m concerned about this

Hi Rob,

thank you for the quick answer!

Best,

Henry

Hey Ozzy,

Great question. It’s common for minoxidil users to see increased hair shedding for 2-8 weeks after starting the drug. This is attributed to telogen (resting) hairs cycling back into their anagen (growth) phases, which push them out as new hairs start growing in underneath them. Was your last PRP session within that time window?

It’s possible that PRP can elicit the same response. A lot of readers here who’ve undergone PRP have reported this. Having said that, you shouldn’t see continued hair follicle miniaturization.

In either case, I’d reach out to your PRP provider. They’ll have a better perspective on their clientele, and whether shedding is normal. For what it’s worth, shedding is NOT hair follicle miniaturization. If you’re seeing the latter, that’s suggestive that the procedure didn’t work. At the same time, it’s really hard to see / judge hair follicle miniaturization within a period of weeks to months. You really need a perspective of 1+ years (or more) to gauge that.

Best,
Rob

Hey Henry,

The two purported mechanisms of the massages for improving AGA are (1) reducing scalp tension, and (2) generating acute inflammation. The chart presented in this article is just a partial picture, as I didn’t want to give readers additional information that might confuse them (since PRP likely has no bearing on scalp tension).

In terms of substituting massaging for less time-intensive procedures – this is a great question. The answer is yes! But it all depends on someone’s time availability, finances, and personal preferences. The massages seem to target mechanisms that microneedling and PRP can’t (i.e., tension relief). At the same time, you could probably achieve a similar effect as massaging by doing Botox every 4-6 months (i.e., tension relief) + microneedling once weekly (i.e., wound-healing). At the very least, the latter would likely target similar mechanisms at similar magnitudes and maybe achieve similar results.

Best,
Rob

in some of your older articles I understood that you implied that the massages were helping with AGA by relieving scalp tension and therefore reducing the cause that led to inflammation in the first place. In this article it seems you’re using another explanation, with massages working as a micro wounding procedure, similar to microneedling – so, did you change your mind on the mechanism at stake with massages? And if both massages and microneedling use the same mechanism, may I ask you what advantages the more time consuming massages would provide?

I’m experiencing miniaturized hair shedding after PRP sessions. Could it be that the PRP regrow mechanism is similar with the Rogaine where hair shedding is normal?

Hi Ibrahim,

Thanks for reaching out. The new book is more of an an educational foundation to the membership site. It links out directly to the courses, modules, questionnaires, expert interviews, forum topics, case studies, within the site. Because of this, most of the actionable advice (i.e., regrowth regimens and plans) reside inside the membership’s courses and modules – and the not the book itself. Because of this integration, the book isn’t offered separately. However, if you’d like, you can always sign up for the membership and cancel before your renewal in six months time. You’ll be able to access the book, courses, and all relevant materials.

Best,
Rob

Have you heard of stem cell treatment for hair loss? It’s similar to prp, but instead of platelets you take a small piece of tissue from your scalp or other part of the body and inject it to the scalp (https://www.healthline.com/health/stem-cell-hair-transplant#procedure). Unlike PRP, this is a one time exercise but again requires annual maintenance. Do you have any views or thoughts on this? I have read medical practitioners both supporting and slamming it.