Combination injectables for regenerative therapy for hair loss.

Combining PRP (Platelet-Rich Plasma), exosomes, and polynucleotides as a multi-modal treatment for female hair loss and thinning represents an exciting and forward-thinking approach that targets the hair follicle environment from multiple biological angles. Here is a breakdown of how each component works, the rationale for their combination, and a suggested treatment protocol.

Overview of Each Modality

1. PRP (Platelet-Rich Plasma)

• Mechanism: Autologous growth factors (e.g., PDGF, TGF-β, VEGF) from platelets stimulate angiogenesis, dermal papilla activity, and prolong the anagen phase of hair growth.

• Use: Particularly effective in early-stage androgenetic alopecia (AGA) and telogen effluvium.

2. Exosomes

• Mechanism: Nano-sized extracellular vesicles derived from stem cells (typically MSCs) that carry mRNA, microRNA, cytokines, and growth factors.

• Use: Improve intercellular communication, reduce inflammation, and promote follicular regeneration and cellular proliferation.

3. Polynucleotides

• Mechanism: DNA fragments (often from salmon DNA) that promote tissue regeneration, reduce oxidative stress, and support fibroblast activation and hydration of the extracellular matrix.

• Use: Improve scalp health, enhance healing, and create a favourable microenvironment for hair regrowth.

Rationale for Combination Therapy

Combining these three offers:

• Multi-layered stimulation (cellular, molecular, extracellular matrix)

• Faster response times and longer-lasting results

• Improved outcomes in difficult cases like female pattern hair loss, where hormonal factors and chronic inflammation play a role.

 Suggested Protocol

Ideal Patient: Women with early to moderate androgenetic alopecia, postpartum thinning, or diffuse hair shedding (e.g., telogen effluvium).

Initial Phase (Weeks 0–12):

• Week 0: PRP + Exosomes injection (scalp mesotherapy style or microneedling)

• Week 2: Polynucleotide scalp injection or microinjection

• Week 4: PRP alone

• Week 6: Exosomes + PRP

• Week 8: PN injection

• Week 12: Evaluation and booster (depending on response)

Maintenance Phase (every 3–4 months):

• Alternating PRP + exosomes or PRP + PNs, depending on patient response and scalp condition.

Considerations

• Exosomes should be from a reputable source and thoroughly screened

• Polynucleotides should be non-immunogenic

• Pre-treatment Scalp Priming (microneedling or fractional laser) may improve uptake and results.

• Adjunct Therapies: Topical minoxidil, low-level laser therapy (LLLT), and hormonal evaluation (especially for PCOS or menopause-related thinning).

Clinical Evidence & Support

• PRP: Strong support from meta-analyses (Gentile et al., 2015–2022).

• Exosomes: Early clinical results and case series suggest improved density and thickness within 6–8 weeks.

• Polynucleotides: Increasingly studied for scalp applications; positive findings in tissue regeneration and hydration improve hair density.

• This regenerative combination represents a next-gen, non-surgical approach to female hair restoration. By addressing follicular ageing, inflammation, and poor scalp vascularity simultaneously, it offers a highly tailored, effective, and well-tolerated protocol. particularly important for women who often respond less predictably to monotherapies.