Best Delivery Method for Hair Restoration
Androgenetic Alopecia is the most common form of hair loss in both men and women. Hair loss causes significant clinical, psychological and social consequences.
Androgenetic alopecia is characterized by progressive thinning of the hair to blading due to the influence of androgens, particularly dihydrotestosterone. This is the most common cause of hair loss in both sexes with distinct patterns of expression in each.
Current treatments for androgenetic alopecia include pharmacological agents, surgical interventions, light-based therapies and newer biologic treatments such as platelet rich plasma and exosomes.
Causes and Genetic Influence in Androgenetic Alopecia
The primary cause of androgenetic alopecia is a genetic predisposition with autosomal dominant inheritance. One needs to look at the parents and note their hair patterns later in life and contemplate one’s own probable destiny. The inheritance of genetic predisposition to hair loss is caused by the hair follicles sensitivity to androgens, particularly, DHT which causes the hair follicles to miniaturize and shorten the growth phase of hair development. The major growth phase is the anagen phase. Although this condition is typically a problem of aging, it can occur at any age with male pattern baldness showing initial signs in late teens or early twenties.
Hair Growth Phases and Follicle Signaling
Hair follicles undergo phases of growth(anagen), rest (telogen) and shedding (catagen), each of these phases are tightly regulated by molecular signals originating from various cell types within the follicle. Among these cells, dermal papilla cells, hair follicle stem cells and keratinocytes play key roles in the regulation of hair follicle growth. One of the most important signaling pathways is the Wnt/B-Catenin Signaling Pathway. This pathway is critical for the regulation and cycling of hair follicle development. Regenerative treatments, such as platelet rich plasma and exosomes, have been found to stimulate this pathway. Then, enhancing the proliferation of hair follicle cells and inhibiting apoptosis, facilitating the transition of hair follicles from the telogen to anagen phase.
Hair Loss in Men: Norwood-Hamilton Scale
In men, androgenetic alopecia affects approximately 50% of the population by age 50. Starting with the recession of the hairline and thinning at the crown, this condition follows a predictable pattern known as the Norwood-Hamilton scale which categorizes the stage of hair loss. This scale begins at stage 1 which is minimal hair loss to stage 4 which is severe baldness.
Hair Loss in Women: Ludwig Scale
In women, androgenetic alopecia is less common affecting about 40% by age 70. Rather than the pattern seen in men, the condition in women manifests as diffuse thinning across the crown and widening of the part. The Ludwig scale is employed in women to classify female pattern baldness.
Pathophysiology of Androgenetic Alopecia
The pathophysiology of androgenetic alopecia is multifactorial involving genetic factors and hormonal imbalances. These alter the normal hair cycle. Additionally, factors such as stress, diet, systemic diseases may influence the loss but are not the primary cause.
The key player in the development is dihydrotestosterone, a potent androgen derived from testosterone. DHT binds to androgen receptors on the hair follicles causing them to shrink and shorten the growth phase of the hair cycle. This leads to progressive miniaturization of the hair follicles and the growth of thinner, shorter less visible hair shafts. Most treatments are aimed at blocking the action of DHT.
Current Treatment Options for Androgenetic Alopecia
Pharmacological Treatments
Minoxidil – Minoxidil is a topical treatment that promotes hair regrowth by enhancing blood flow to the hair follicle and stimulating follicular activity. Currently, it is used in both men and women and its effectiveness is varied. It may take several months of consistent use before visible results are noted. Once it is stopped, the alopecia returns so it must be used continuously. Side effects are many including topical, gastrointestinal, edema and blood abnormalities.
Finasteride – Finasteride is a 5-alpha reductase inhibitor that reduces the chemical conversion of testosterone to dihydrotestosterone. It has been shown to be effective in reducing hair loss and promoting hair growth in men but limited effectiveness in women. The side effects are decreased sexual function, decreased interest in sex, diarrhea, headache back pain and many more. Depression is also reported.
Dutasteride – Dutasteride is a more potent 5-alpha reductase inhibitor that has shown promise in hair loss, but its use has been limited due to severe side effects.
Low Level Laser Therapy – LLLT is not a pharmacologic therapy but the use of red light to stimulate the hair follicles, promoting hair growth. Very little if and side effects and widely available.
Surgical Treatments
Hair transplantation consists of follicular unit extraction and follicular unit transplantation. This procedure removes hair from a donor site on the patient and is transplanted into the balding area. Although it can be an effective solution to balding, it is expensive and requires significant recovery time. It carries all the potential side effects of any surgical procedure including overall failure of the grafts to stabilize and regrow.
Platelet Rich Plasma for Hair Regrowth
Platelet Rich Plasma is an autologous blood concentrate that is rich in growth factors, cytokines and bioactive proteins. PRP has been employed in thousands of published studies to regenerate damaged tissues. PRP has been used as a regenerative treatment for androgenetic alopecia. It promotes tissue regeneration and stimulates hair follicle activity and increases blood flow to the follicle. PRP enhances hair follicle activity and production.
Studies have demonstrated significant improvements in total hair count and density following PRP therapy. There was also proven reduction in hair shedding.
Platelet Rich Plasma contains many growth factors. These include vascular endothelial growth factor, platelet derived growth factor and fibroblast growth factor among those carried in the alpha granules on the platelets. These growth factors stimulate the anagen phase of the hair cycle, promoting follicular regeneration and improving the health of the hair follicles.
Platelet Rich Plasma is delivered by injection or micro needling into the scalp in multiple sessions.
Exosomes in Hair Regeneration
Exosomes are small extracellular vesicles that play a significant role in intercellular communication. They carry and transfer proteins, lipids and RNA between cells. Exosomes contain various bioactive molecules including growth factors, cytokines and RNA which modulates cellular pathways and processes such as inflammation, proliferation and differentiation. When applied to the balding area of the scalp, exosomes stimulate dormant hair follicles to exit the telogen phase and return to the anagen phase of growth.
Studies on balding treatments with exosomes proved that exosomes injections significantly improved density and stimulated regrowth in patients with androgenetic alopecia. Exosomes are tolerated well and have an extremely low side effect profile.
Regenerative therapies are the best science-based treatments for hair restoration. They are extremely well tolerated, extensively studied and efficacious for hair restoration.
That said, what is the best method to implement platelet rich plasma and exosomes into the scalp?
Study: Microneedling vs Injection for PRP Delivery
Local Injection versus Topical Microneedling of Platelet Rich Plasma for Androgenetic Alopecia: A Systematic Review
Arch Plast Surg 2025 Mar 11;52(2):59-68 | PMID 40083615
Aim: Autologous platelet rich plasma has gained popularity for hair restoration due to its effectiveness and safety. PRP could be administered through direct local injections to the scalp or applied topically with the aid of microneedling therapy. This systematic review aims to elaborate on the effectiveness of PRP administered with syringe injection and topical PRP with microneedling combination for the treatment of androgenetic alopecia.
A review found a total of 108 articles and studies. After criteria was applied 12 articles were selected for the review.
Summary: All studies concluded that the combination of microneedling and topical PRP to treat androgenetic alopecia appears to yield more superior outcomes in several parameters than injected PRP. It also had a better safety profile with almost no reported adverse outcomes. Therefore, it is evident that microneedling could facilitate PRP penetration into the targeted hair follicles with excellent clinical results.
Conclusion: The use of microneedling to facilitate topical PRP application in androgenetic alopecia cases displayed significantly better results in hair density and hair count than the use of syringe injection.
Additional Supporting Studies on PRP and Exosomes for Hair Loss
Platelet Rich Plasma Effectiveness in Treating Androgenetic Alopecia: A Comprehensive Evaluation
Cureus 2025 Jan 13;17(1): e77371 | PMID 39944453
Conclusion: Platelet Rich Plasma is a viable therapeutic option for treatment of androgenetic alopecia particularly for increasing hair density and thickness.
Systematic Review of Exosome Treatment in Hair Restoration: Preliminary Evidence, Safety and Future Directions
J Cosmet Dermatol 2023 Sep;22(9):2424-2433 | PMID 37381168
Conclusion: Exosomes are small extracellular vesicles with potential roles in modulating the hair growth cycle and are an emerging therapy for patients with alopecia. A growing body of evidence suggests its therapeutic potential.
Juventix Regenerative Medical’s Tools for Hair Restoration
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet Rich Plasma Kits are FDA cleared and designed for safety, sterility and effectiveness. Our kits are scientifically manufactured to produce a platelet concentrate, devoid of red blood cells with a minimum number of leukocytes that are critical to the regenerative process.
Juventix Regenerative Medical offers a patented LED Activator to activate the platelet and begin the regenerative process. This activation is a critical step in the release of growth factors, cytokines and bioactive proteins from the alpha granules on the platelets and is accomplished with LED light. This negates the use of chemical additives such as Calcium Chloride, Thrombin or Collagen. This mode of activation by LED light provides sustained growth factor release versus older methods of activation while adhering to the minimal manipulation standards of the FDA. The activation should be accomplished after the swirl of the centrifuged product to maximize the number of captured platelets.
Juventix Regenerative Medical has a vast array of regenerative products for the treatment of androgenetic alopecia.
- PRP Kits and LED Activator
- Exosomes supplied by our collaboration with Evolutionary Biologics of New York
- Derma Mend LLLT for red light treatments
- Nanopen Pro is a customizable microneedle system for many skin conditions including hair restoration
- Radiance RF which combines microneedling with radiofrequency
- Apollo Duet and Peptide Serums which provide the benefits of microneedling without the needle combined with radio frequency and temperature controls which can cool, or heat as needed for different conditions
Juventix Regenerative Medical offers solutions to the many needs of the regenerative professional. Juventix provides the newest “cutting edge” products and devices at a fraction of the cost of other manufacturers and distributors.
The regenerative marketplace is exploding and transforming daily for both men and women. With the Juventix line of products and our experienced staff, Juventix Regenerative Medical will support and guide any regenerative professional in providing enhanced outcomes and increased patient satisfaction.
RESTORE, REVIVE, REGENERATE – JUVENTIX REGENERATIVE MEDICAL
Regenerative Regards,
Dr. Robert McGrath
