Treating Hair Loss: A Comparison of Minimally Invasive Procedures

Hair loss can affect both women and men at different stages of life. Possible causes range from genetic predisposition and hormonal changes to stress, illness, or nutrient deficiencies. It is therefore important to first determine the cause and assess the condition of the scalp before beginning treatment.

Today, there are various minimally invasive, regenerative procedures available to support hair health. These include PRP and PRF derived from the patient’s own blood, traditional microneedling with the Dermapen, radiofrequency microneedling with Genius, and exosomes. These methods differ in how they work and can be used individually or in combination, depending on the patient’s specific situation.

Treating Hair Loss: The Most Important Information at a Glance

• Regenerative treatments are designed to stimulate the scalp and support the function of hair follicles that are still active.
• PRP and PRF use components of the body’s own blood, while microneedling delivers controlled micro-stimulation.
• The Genius system also uses radiofrequency energy.
• Exosomes contain cellular signaling molecules and are usually used in conjunction with microneedling.

Which method is appropriate depends primarily on the cause, the stage of hair loss, and the condition of the hair roots. Hair follicles that have already been permanently damaged generally cannot be restored using these procedures.

Why does hair loss occur?

Losing hair every day is part of the natural hair cycle. Hair loss becomes noticeable when significantly more hair falls out over an extended period, the part becomes wider, the hairline changes, or individual areas become visibly thinner.

Possible causes include:

• Genetic predisposition: Hereditary hair loss, medically known as androgenetic alopecia, is one of the most common forms.
• Hormonal changes: Pregnancy, menopause, or thyroid disorders can affect the hair growth cycle.
• Stress and Physical Strain: Prolonged stress, infections, surgeries, or severe physical strain can contribute to diffuse hair loss.
• Nutrient deficiency: Among other factors, an insufficient intake of iron or other essential nutrients may play a role.
• Medical Conditions and Medications: Certain medical conditions or medications can also affect hair growth.
• Scalp inflammation: An irritated, inflamed, or diseased scalp can interfere with hair growth.

Therefore, a treatment should not be chosen based solely on visible hair loss. The key factors are why the hair is falling out and whether the affected hair follicles are still active. A medical evaluation is particularly important in cases of sudden-onset, severe, or circular hair loss, as well as when there are scalp symptoms.

What can regenerative treatments do to address hair loss?

Regenerative treatments target the scalp and the remaining hair follicles. Depending on the method, they are designed to support local blood supply and the body’s own repair processes or to provide controlled stimuli to promote regeneration.

These treatments can help:

• to support scalp health
• to stimulate the activity of remaining hair follicles
• to have a positive effect on the hair growth cycle
• to improve hair density and hair quality
• to slow the progression of certain types of hair loss

Results vary from person to person and do not appear immediately. Hair grows slowly, which is why changes can usually only be assessed over the course of several months. Furthermore, these procedures are not a guaranteed substitute for a hair transplant if hair follicles have already been permanently lost.

Which hair loss treatment is best suited for which goal?

Procedure	Mechanism of Action	When is it a good idea?
PRP	The body’s own growth factors are intended to support the hair follicles and their nutrient supply.	When hair follicles are still active, often in cases of hereditary hair loss.
PRF	A fibrin mesh releases the body’s own growth factors into the scalp over an extended period of time.	When prolonged stimulation of the hair follicles is desired.
Dermapen	Fine needles deliver controlled stimulation and support the absorption of supplemental preparations.	To stimulate the scalp and in combination with PRP or exosomes.
Genius RF	Fine needles and thermal energy stimulate the scalp at deeper levels.	For diffuse hair loss or when a more intensive scalp treatment is recommended.
Exosomes	Cellular signaling molecules are believed to support the regeneration and communication of scalp cells.	As a follow-up to microneedling; the scientific evidence is still emerging.

The table provides a general guide. The treatment that is actually appropriate depends on the cause and stage of hair loss, as well as the condition of the scalp and hair follicles, and should be evaluated by a specialist.

PRP for Hair Loss: Regeneration Using Your Own Blood

PRP stands for “Platelet-Rich Plasma.” For the treatment, a small amount of blood is drawn and then centrifuged. This process yields a plasma fraction that is rich in platelets and the body’s own growth factors. This concentrate is then injected into the affected areas of the scalp using fine needles.

The growth factors it contains are intended to stimulate the area surrounding the hair follicles and support their activity. PRP is primarily used as a complementary treatment for hereditary hair loss, provided that active hair roots are still present.

How does a PRP treatment work?

After the blood is drawn, the PRP undergoes a special processing procedure. Several small injections are then administered into the previously identified areas of the scalp. Typically, a series of several sessions is scheduled initially. Follow-up treatments may be beneficial later on.

Since PRP uses the body’s own material, the risk of an allergic reaction is low. Temporary mild redness, swelling, tenderness, or small bruises may occur at the injection sites.

PRF for Hair Loss: How Is It Different from PRP?

PRF stands for “Platelet-Rich Fibrin.” This procedure also uses the patient’s own blood. However, the preparation process differs from that of PRP: PRF is obtained without anticoagulant additives and using a modified centrifugation process.

This results in a fibrin-rich, gel-like structure. Platelets and growth factors remain embedded in this structure, allowing them to be released more slowly and over a longer period of time.

A Direct Comparison of PRP and PRF

• PRP is more liquid and can be distributed evenly across the scalp.
• PRF has a fibrin-rich structure, which is intended to keep the factors it contains available locally for a longer period of time.
• Both procedures use the patient’s own blood and are administered via fine injections into the scalp.
• The choice depends on the findings, the treatment goal, and the individual treatment plan.

Scalp Microneedling with the Dermapen

Microneedling involves creating controlled microchannels in the scalp using fine, sterile needles. The Dermapen is an electric handheld device that allows the needle depth to be precisely adjusted to the treatment area.

The micro-stimuli created are intended to activate the skin’s natural repair processes. At the same time, the temporary microchannels that form can enhance the absorption of appropriate, concomitantly applied treatments. For this reason, the Dermapen is often combined with PRP or exosomes.

How does microneedling work?

After preparation and, if necessary, the application of a local anesthetic or cooling agent, the scalp is treated systematically. Depending on the size of the area, a session lasts about 20 to 30 minutes. Afterward, the scalp may be temporarily reddened and slightly sensitive.

Microneedling can support scalp health. However, whether it is appropriate for a specific type of hair loss should be assessed on a case-by-case basis.

Radiofrequency Microneedling with Genius

The Genius system combines microneedling with radiofrequency energy. Fine, insulated needles penetrate the scalp and deliver thermal energy at a predetermined depth. The system measures tissue resistance to ensure that the energy is delivered as precisely as possible.

While the Dermapen delivers purely mechanical micro-stimulation, Genius supplements the treatment with a controlled thermal component. This allows for more personalized control of scalp stimulation. The procedure is being considered, among other things, for diffuse hair loss and to support scalp health.

A session lasts approximately 30 to 45 minutes, depending on the treatment area, and is usually performed under local anesthesia. Temporary redness, swelling, or scalp sensitivity may occur.

Exosomes and Hair Loss

Exosomes are very small particles released by cells. They transport various signaling molecules and play a role in intercellular communication. In aesthetic medicine, cell-free, laboratory-produced exosome preparations are used.

In scalp treatments, exosomes are often combined with microneedling. The microchannels created beforehand are intended to facilitate surface penetration. The goal is to promote communication and regenerative processes in the scalp.

It is important to maintain a realistic perspective: The scientific evidence regarding exosomes and hair loss is still emerging. Many studies are small or in the early stages. Therefore, exosomes should not be viewed as a guaranteed effective standalone therapy, but rather as a potential adjunct within an individually tailored treatment plan.

Possible combinations

PRP, PRF, microneedling, and exosomes work in different ways. While PRP and PRF deliver the body’s own components directly into the scalp, microneedling creates controlled regenerative stimuli. Exosomes, in turn, are used as a complementary messenger substance therapy.

Possible combinations include, for example:

• PRP and Dermapen: The Body’s Own Growth Factors Plus Mechanical Stimulation
• PRF and Microneedling: Longer-Lasting Endogenous Factors Plus Controlled Microstimulation
• Dermapen and Exosomes: Preparing the Scalp and Subsequent Application of the Formulation
• Genius and regenerative preparations: mechanical and thermal stimulation with supplemental application of active ingredients

However, more treatments do not automatically mean better results. What matters most is that the combination makes medical sense and addresses the cause of the hair loss.

“Hair loss can have a wide variety of causes. That is why we do not base our decision solely on the visible appearance of the hair; we also evaluate the scalp, the condition of the hair, and individual factors before recommending a treatment. “

PD Mathias Tremp, MD
Specialist in Plastic, Reconstructive, and Aesthetic Surgery

Which hair loss treatment is right for me?

The choice of treatment depends on more than just the visible extent of hair loss. The following factors, among others, are important for developing a personalized treatment plan:

• Causes and Types of Hair Loss
• Stage and Course to Date
• Condition of the Scalp
• Presence of hair follicles that are still active
• Pre-existing conditions and medications taken regularly
• Previous treatments
• personal expectations

The earlier changes are examined, the easier it is often to assess whether regenerative treatments can still be effectively applied to existing hair follicles. In cases of sudden, severe, or circular hair loss, further medical evaluation may be necessary before cosmetic treatment.

Treating Hair Loss: Get Advice at Tremp Plastic Surgery

Hair loss should not be treated according to a rigid protocol. At Tremp Plastic Surgery, we therefore consider not only the areas of thinning hair but also the patient’s history, the condition of the scalp, and possible causes. Based on this assessment, we determine whether PRP, PRF, microneedling, Genius RF, exosomes, or a customized combination of treatments is appropriate.

During this consultation, we’ll also discuss what results are realistic, how many sessions are likely to be needed, and when follow-up treatments might be beneficial. Our goal is to develop a clear treatment plan tailored to your individual needs.

Note: This article is intended for general informational purposes only and is not a substitute for personal medical advice. Individual results may vary. We would be happy to advise you in a personal consultation on which approach is right for you.

Note: This article is intended for general informational purposes only and is not a substitute for personal medical advice. We would be happy to discuss whether a particular treatment is right for you—and, if so, which one—during a personalized consultation.