Hair Loss Treatments in Aesthetic & Regenerative Medicine

ABSTRACT

Hair loss is a multifactorial condition influenced by genetics, hormones, inflammation, nutritional factors, and environmental triggers. Modern aesthetic medicine provides a range of minimally invasive and regenerative treatments capable of restoring hair density, improving follicular health, and enhancing patient confidence. This module presents an in-depth clinical overview of common types of hair loss, diagnostic pathways, and evidence-based treatment modalities including Platelet-Rich Plasma (PRP), mesotherapy, low-level laser therapy (LLLT), exosomes, polynucleotides, microneedling, and combination treatment protocols. It equips practitioners with the scientific foundation and practical guidelines needed for effective and safe hair restoration.

LEARNING OBJECTIVES

After completing this module, learners will be able to:

1. Identify and diagnose common types of hair loss.
2. Understand the biological mechanisms of PRP, mesotherapy, LLLT, exosomes, and regenerative therapies.
3. Develop structured treatment protocols tailored to patient needs.
4. Recognize contraindications and high-risk cases.
5. Manage complications and set realistic patient expectations.

1. INTRODUCTION

Hair loss affects both men and women across various age groups and can significantly impact psychological well-being. Advanced aesthetic medicine provides non-surgical interventions that promote:

• Follicle regeneration
• Improved microcirculation
• Reduction of inflammation
• Activation of dormant follicles
• Hair shaft strengthening

Proper diagnosis and a multimodal approach produce optimal outcomes.

2. TYPES OF HAIR LOSS & DIAGNOSTIC WORK-UP

2.1 Androgenetic Alopecia (AGA)

Most common type.
Characterized by:

• Miniaturization of hair follicles
• Shortened anagen phase
• Genetic and hormonal influence (DHT sensitivity)

Typical patterns:

• Male pattern: temples & crown
• Female pattern: diffuse thinning over crown

2.2 Telogen Effluvium (TE)

Trigger-induced shedding.
Causes:

• Stress
• Fever/illness
• Postpartum
• Medications
• Nutrient deficiencies

Reversible when trigger addressed.

2.3 Alopecia Areata

Autoimmune disorder
Patchy hair loss
May require combination therapy with dermatology oversight.

2.4 Scarring Alopecia

Permanent destruction of follicles.
Referral to dermatologist required.

2.5 Diagnostic Evaluation

Clinical Evaluation

• Hair-pull test
• Pattern mapping
• Dermatoscopy (trichoscopy)

Laboratory Investigation

Recommended tests:

• Ferritin
• Vitamin D
• Thyroid profile
• Zinc levels
• Hormone panel (PCOS, androgens if indicated)

Accurate diagnosis guides correct treatment selection.

3. PLATELET-RICH PLASMA (PRP)

3.1 Mechanism of Action

PRP contains growth factors including:

• PDGF
• TGF-β
• VEGF
• EGF

These promote:

• Angiogenesis
• Prolonged anagen phase
• Reduced inflammation
• Follicular regeneration

3.2 PRP Preparation

Factors influencing quality:

• Centrifuge type (single vs double spin)
• Platelet concentration
• Use of anticoagulants

Ideal concentration: 4–5x baseline platelet count

3.3 Clinical Protocol

• Sessions: every 3–6 weeks for 3–6 sessions
• Maintenance: every 3–6 months
• Injection depth: 1–3 mm intradermal
• Method: nappage or point-by-point

3.4 Indications

• Androgenetic alopecia (early–moderate)
• Telogen effluvium (as adjunct)
• Hair quality improvement

3.5 Advantages

• Autologous
• Safe
• Minimal downtime

3.6 Limitations

• Requires multiple sessions
• Not effective in advanced miniaturization
• Technique-dependent

4. MESOTHERAPY FOR HAIR LOSS

4.1 Mechanism of Action

Mesotherapy delivers microinjections of active ingredients into the dermis.
Formulas commonly include:

• Vitamins (Biotin, B-complex)
• Amino acids
• Peptides
• Hyaluronic acid
• Minerals
• DHT blockers

Mechanisms:

• Improved blood flow
• Nutrient delivery
• Reduced inflammation
• Follicle stimulation

4.2 Treatment Protocol

• Weekly sessions x 4–8
• Maintenance every 1–3 months
• Injection technique: microbolus or nappage

4.3 Indications

• Telogen effluvium
• Early androgenetic alopecia
• Hair shaft strengthening

5. LOW-LEVEL LASER THERAPY (LLLT)

5.1 Mechanism

LLLT stimulates mitochondria in follicular cells.
Effects include:

• ATP production
• Increased blood circulation
• Prolonged anagen phase
• Reduced inflammation

5.2 Clinical Use

• 2–3 sessions per week
• Helmet, comb, or panel devices

5.3 Indications

• AGA (male & female)
• Diffuse thinning
• Maintenance therapy

6. MICRONEEDLING FOR HAIR RESTORATION

6.1 Mechanism

Microneedling creates controlled micro-injuries:

• Increases growth factor release
• Enhances topical penetration
• Stimulates Wnt/β-catenin pathway
• Supports dermal papilla activation

6.2 Protocol

• Needle depth: 0.6–1.5 mm
• Frequency: every 1–2 weeks
• Often combined with PRP, peptides, or minoxidil

7. REGENERATIVE THERAPIES

7.1 Exosomes

Extracellular vesicles containing:

• Growth factors
• Cytokines
• mRNA
• miRNA

Benefits:

• Reduce inflammation
• Activate stem cells
• Restore follicular microenvironment

7.2 Polynucleotides (PN / PDRN)

Mechanism:

• Enhance tissue repair
• Improve blood flow
• Reduce oxidative stress
• Support hair density

7.3 Stem Cell-Based Therapies

Include:

• Adipose-derived stem cells
• Autologous cellular concentrates

Work by regenerating follicular niche.

7.4 Combination Regenerative Protocols

Examples:

• Exosomes + microneedling
• PRP + PN
• PRP + microneedling + LLLT

Combination therapy delivers superior outcomes.

8. TOPICAL & SYSTEMIC ADJUNCTS

8.1 Topical Minoxidil

• Vasodilator
• Increases anagen duration

Forms:

• 2%, 5%,

8.2 Finasteride / Dutasteride

5α-reductase inhibitors
Used in male AGA (and selected female cases)

8.3 Multivitamins & Supplements

Beneficial in deficiency-related cases:

• Iron
• Vitamin D
• Zinc
• Biotin

9. COMBINATION APPROACHES

9.1 Examples of Integrated Treatment Plans

Male AGA (Early Stage)

• PRP every 4 weeks x 3
• Oral finasteride
• Minoxidil topical
• LLLT 2–3x weekly

Female Pattern Hair Loss

• PRP x 3
• Mesotherapy with peptides
• Topical minoxidil
• Address hormonal imbalances

Telogen Effluvium

• Mesotherapy
• Nutritional correction
• Stress management
• Maintained with PRP or LLLT

Advanced AGA

• Combined PRP + exosomes
• Microneedling every 2 weeks
• Consideration of transplantation

10. SAFETY, RISKS & COMPLICATION MANAGEMENT

10.1 PRP

• Bruising
• Mild pain
• Swelling
• Infection (rare with sterile technique)

10.2 Mesotherapy

• Allergic reactions (depending on formula)
• Swelling
• Tenderness
• Rare nodules

10.3 LLLT

Extremely safe
Occasional headaches or scalp warmth

10.4 Microneedling

• Pinpoint bleeding
• Erythema
• PIH in dark skin if overly aggressive

10.5 Exosomes / PN

• Mild redness
• Temporary sensitivity

11. POST-TREATMENT CARE

General recommendations across treatments:

• Avoid sweating for 24 hours
• Avoid hair dye for 48–72 hours
• No heavy exercise for 24 hours
• Use gentle shampoo
• No heat exposure
• Avoid anti-inflammatory medications for 24 hours after PRP

Follow-up every 4–6 weeks is essential for tracking progress and adjusting the plan.

12. KEY LEARNING POINTS

• Hair loss requires proper diagnosis before treatment begins.
• PRP is a cornerstone treatment with strong regenerative effects.
• Mesotherapy improves scalp nutrition and complements other therapies.
• LLLT enhances cellular metabolism and supports long-term maintenance.
• Exosomes and PN offer advanced biologic rejuvenation.
• Combination therapy provides superior results over monotherapy.
• Patient education and compliance determine long-term success.