Hair regrowth without oral meds or surgery? What is the science?
There are many new injectable and infusion therapies that are starting to show usefulness as a standalone treatment.
When it comes to hair treatments – combining multiple treatments at once ALWAYS seems to yield better results. PRP was an early one of these (https://pubmed.ncbi.nlm.nih.gov/25111436/), as was exosomes (which are no longer FDA approved for injection), but additional data is now available on the effects and the improved treatment regimens that have been developed.
For instance;
1) Dutasteride mesotherapy involves shallow micro-injections superficially in the scalp with the intent of reducing systemic absorption while providing localized benefit. It has also been used with vitamins and peptides and is just starting to have more evidence suggesting benefit, particularly for the crown area. The protocol for this therapy is injections every 3 months for one year. Patients like this because few side effects have been reported, and they are usually trying to get improvement in the crown without taking a pill, but it does seem to work better WITH oral medications, and ONLY if there is some hair remaining diffusely in the area. https://onlinelibrary.wiley.com/doi/full/10.1002/jvc2.518
2) Microneedling is widely used for multiple skin improvements, but for hair the needles must be deeper than most microneedling (2mm versus 0.5mm) to effectively stimulate hair growth. Microneedling can also be used with or without medications to enhance the result. The microneedling that helps most with hair, has a depth of 2-2.5mm and a wedge-shaped needle to stimulate stretch receptors (or a hollow core to deliver a substance like minoxidil to the scalp). Patients choose microneedling when they are trying to stimulate the scalp’s own regenerative process by creating micro-wounds that the body heals by releasing growth factors.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11499218/
3) Peptides: Here’s what doctors want you to know about injectable peptides – they are not new! Insulin is a peptide, as are GLP-1 drugs. So, if an injectable peptide were to stimulate hair regrowth, the most likely candidate is GHK-Cu, which involves copper (the “Cu” in the name) because it supports blood supply, has anti-inflammatory properties, and promotes the proliferation of the cells needed for hair growth. Unfortunately, even though wellness centers and social media influencers market these products, there is so little data that the FDA has not approved them for injection in the US; furthermore, they are often sold on the gray market, where contamination or other safety issues may go undetected. We have used copper peptides topically in hair transplant for over 20 years to help with post-operative wound healing and skin regeneration, but in the USA it is only available for topical applications (i.e. NOT injection), so we can add it after microneedling for appropriate patients.
https://pubmed.ncbi.nlm.nih.gov/18644225/
4) Combined Regenerative Treatment (CRT): All of these together (i.e., combined with PRP, dutasteride, minoxidil, and peptides like GHK-Cu or other medications) are known as Combined Regenerative Treatment (CRT).https://pubmed.ncbi.nlm.nih.gov/40225275/
This therapy option has shown promising results and is a more aggressive approach for the whole head. CRT is used monthly for 5-6 months, followed by maintenance sessions every 3-6 months. This localized injection approach delivers high local concentrations of medications and growth factors, along with microneedling, which may reduce side effects.
5) Alma TED: A needle-less treatment using much of the same medications, with growth factor delivery to hair follicles, is called TED (TransEpidermal Delivery). Patients love this because it feels like a monthly head massage. This is a good alternative because the growth factors and amino acids are known quantities, unlike PRP and exosomes, where the quantities are unknown or variable. It is also non-invasive and painless because it does not require needles to deliver growth factors and amino acids to the hair follicle to help it grow thicker, which it seems to do even in rare cases of “scarring” hair loss. The currently suggested treatment regimens consist of one treatment per month for 4-6 months. The use of ultrasound to create micro-channels to help absorption of drugs into the skin is exciting technology, and you can read more about it here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251463/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637104/
You can use any of these treatments in combination with photobiomodulation (low-level light/red light therapy) and oral treatment. You’ll need at least 6 months and up to 18 months to see results. Dr. Wasserbauer and her staff are happy to review the pros and cons of all these treatments and help you decide which will work best for your case!