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A new next-gen hair loss treatment is currently being hyped, PRF. But is it truly better than PRP or just smart marketing? Today, I'll break down the science and include head-to-head comparisons of the two. I'll also share my professional take as a hair surgeon.
Hair loss patients hear all types of acronyms like PRP, PRF, PFP, and it's just all confusing. Clinics all over the place are pushing PRF as a PRP version 2.0 without any clear explanation. Patients deserve clarity before spending hundreds if not thousands of dollars more for a new treatment. Let's separate the proven treatments from the hype.
PRP stands for platelet-rich plasma. Blood is spun at high speeds with anti-coagulant included that allows us to isolate the platelets and plasma proteins. The PRP is then injected into the scalp or, in the case of facial rejuvenation procedures, into the face potentially. And instead of injecting it, some people will apply it post-microneedling. With this approach, growth factors are released immediately. And these growth factors can include VEGF, PDGF, IGF-1, and TGF-beta. And these growth factors that are released from the platelets do the following things: they can increase blood supply to follicles, they can stimulate follicle stem cells, they have the ability to reduce scalp inflammation, and they extend the hair growth phase, and that can, in turn, thicken hair. But the release profile of these growth factors when PRP is done is a fast burst within hours. Then the growth factors go out into the cells, do their work, and eventually, that process needs to be repeated after several months.
There's decades of research on PRP specifically for hair restoration, and thousands of patients have been studied. And there's strong data to support using PRP for androgenetic alopecia, which is the most common type of hair loss in men and in women. PRP has been shown in various studies to improve hair density and shaft diameter. These effects can, of course, be strengthened when something like minoxidil and/or finasteride is taken as well. PRP has been shown to be safe, and the protocols have been mostly standardized across various different systems that exist for administering PRP.
So now let's review what PRF actually is. It stands for platelet-rich fibrin. It is spun at slower speeds without the addition of anti-coagulant. This results in natural clotting, and that creates a fibrin scaffold. The scaffold traps platelets, white blood cells, and stem cells. And this leads to growth factors being released gradually over the course of days. So there's this slower growth factor release mechanism that's built into the use of PRF. And this sustained growth factor release is why many people are so excited about the use of PRF. It theoretically has more regenerative potential and can last longer if you're releasing these growth factors at a slower pace compared to just having a short burst all at once with PRP. So, it's being marketed as this like premium, next-gen option of PRP.
So, the science is logical, but, you know, theory doesn't always equate to proof. Let's talk about fibrin a little bit more. Fibrin is a protein that forms during the blood clotting process, and it creates this mesh scaffold that holds on to the platelets and other cells, and it can act as a biological guide for wound healing. And because it degrades slowly, it allows for this slower, extended activity. And like I said earlier, this sustained action is what excites many clinicians. And there is some early evidence showing the efficacy of PRF for hair loss specifically. There have been some small trials from about 2020 to 2024 that have often included less than 50 patients per study, and they tend to show modestly higher density gains compared to PRP, though often without any statistical difference. Others show completely no difference between PRF and PRP. And the total number of patients across all of these studies that have been looked at for PRF when it comes to hair loss is about 130. So, the evidence for justifying using PRF for hair loss is still in its infancy. We still need more studies with many more patients in order to power them properly to see if differences truly exist between PRF and PRP.
And the only direct head-to-head study between PRF and PRP that I could find was published in 2024. And this included 20 men with androgenetic alopecia. And they compared injected PRP versus injected PRF over four sessions with one treatment per month. And the results were as follows: hair fall reduced in 80% with PRF versus 70% with PRP. Density improved in 100% of the PRF patients versus 90% of the PRP patients. But the key here is that the differences were not statistically significant. So those 10% differences in such a small number of patients really doesn't amount to much, and it's not something that you can claim in a study conclusion that one study group was clearly better than the other. So the current comparative studies are still very small, and the follow-ups are short too. It would be nice to have studies that have lasted for one to two years rather than just three or six months. And the protocols for PRF still vary quite a bit. That includes things like spin speed, tube type, and leukocyte content. The early studies do seem to show that PRF is at least not inferior to PRP and maybe possibly modestly superior, though it's too early to tell that conclusively. And we still don't have any large randomized control trials at this point.
We should also consider patient satisfaction and real-world outcomes with these two modalities. The satisfaction has generally been shown to be very high for both PRP and PRF, with some trials showing slightly higher satisfaction with PRF. Specifically, there was an acne scar study with the PRF group reporting subjectively better results.
Let's discuss some of the potential drawbacks of PRF treatment for hair loss. For one, the clotting occurs within minutes, so you have to inject quickly. And because the consistency is gel-like, it's harder to inject the scalp more evenly. And you need larger needles to inject this gel-like substance into the scalp. And using larger needles can potentially increase pain and discomfort to the patient. And the protocols for how to actually process PRF is still not too standardized across clinics. PRF tends to also be more expensive than its PRP counterpart, and its evidence base is still small and fairly recent.
The good news is that PRP and PRF are generally considered quite safe since it's your own body's natural blood products. Common side effects can include redness, swelling, mild pain, bruising at the injection sites, and rare side effects can include the following: infection, nerve injury, or prolonged bleeding. PRF is sometimes reported as maybe being slightly less painful than PRP despite the need for larger needles at times, but for both PRP and PRF, there really aren't any long-term documented side effects that seem to be permanent and debilitating, which is a good thing. And remember that PRF and PRP are often combined with other modalities for treating hair loss like finasteride, minoxidil, low-level laser light, or microneedling. And patients will often see the best results with multimodality care.
Just as a word of caution, let's briefly discuss what PFP is. PFP is platelet-free plasma. So essentially, where the platelets have been removed and where you just see the clear, yellow, liquidy component. It's sometimes used as a placebo in trials for studying if PRP is better than plasma alone. This liquid contains plasma proteins but with no actual platelets present. And there's no evidence that that helps regrow hair. So, if you're in a clinic and the stuff that they're about to inject into your scalp looks completely transparent and yellowish, that likely lacks platelets that actually have the growth factors. And that's platelet-free plasma that you don't necessarily want back into your scalp because that's not what's going to help thicken your hair. Instead, you want that substance to be a bit thicker and to have the actual platelets in it that will thicken it up, and you shouldn't really be able to see through the liquid before it's injected into the scalp.
So, let's talk about where PRP and PRF fit in as far as all the other modalities that exist for hair restoration. PRP and PRF are in the stimulation lane. They essentially help wake up follicles, and that primarily leads to a thickening of one's hair. This is very different from the prevention lane that includes medications like finasteride or dutasteride that help reduce DHT, and that's more for preventing further hair loss. To learn more about those preventative medications, make sure you head to feelconfident.com. You can also obtain finasteride there at an affordable price. So, make sure to check it out if you're actually interested in getting on proper prevention for hair loss. And then, of course, you have the augmentation lane. Hair transplant surgery falls into that category, where you're essentially putting follicles into a new location where they've either never existed or they've thinned out so significantly that you now have this void that you're trying to fill with hair from a different area. Each therapy essentially has its own lane. No single treatment does it all. And the best outcomes come from hair doctors that can guide you and give you a customized, tailored plan to your needs. And that's exactly what we do in my clinical practice every day.
Let's talk about who the best responders are to PRP or PRF. Usually, it's best for people with early or moderate hair loss. You essentially need existing hair follicles to stimulate. It doesn't work on slick, bald scalps. Younger patients and non-smokers will often do better. And once again, it works well as a booster when paired with medications. I still see medications as first-line medical therapy. And PRP or PRF are part of the second-line options for stimulating one's hair. The key, of course, is always managing people's expectations. You have to go into these treatments expecting some degree of improved hair stability or a little bit more thickness, but you cannot go in expecting a miracle and to see, you know, 30 to 50% improved hair, or you're just going to be uh setting yourself up for disappointment.
So, PRP is well-studied, has been standardized better, and has been proven as an effective booster across the board for androgenetic alopecia. PRF on the other hand is an exciting, newer type of treatment modality. It has good, sound, logical theory behind it, and it has some early data that does appear promising, but it does not yet appear to be definitively better than PRP for hair loss. So, I still see PRP as the gold standard between the two, with PRF being the promising newcomer. So patients should be cautious about the hype surrounding PRF until we have more convincing data to support it.
So whether you're choosing PRP or PRF, hair health goes beyond injections. Feel confident's Root Defense line includes saw palmetto, pumpkin seed oil, curcumin, caffeine, and niacinamide. Our cosmetic products are backed by real science, unlike fads like onion juice and rosemary oil. And these quality products are available at feelconfident.com and now also on Amazon.
Have you tried PRP or PRF? Which one worked better for you? Do you think PRF is worth the higher price tag? Drop your experience and questions in the comments below. And don't forget to subscribe for more deep dives into hair restoration. Thank you.