PRP and Exosomes Together: What the Combination Adds for Your Hair
Why combine PRP and exosomes in one hair protocol, how the session goes, and our programs that bring both together.
Yes, hair PRP has contraindications. The treatment is very safe because it uses your own blood, but in some situations we postpone or decline it, and point you toward something else. We check for them at every assessment. The treatment itself is described on the PRP page.
Maybe you're wondering whether your medication, your diabetes or your pregnancy rules you out. We go through the cases where PRP isn't recommended and, above all, what we offer instead.
The firm contraindications
On the blood side
Clotting disorders:
- Hemophilia, of any type
- Clotting disorders, inherited or acquired
- Thrombocytopenia, meaning platelets that are too low
- Blood cancers: leukemia, lymphoma, myeloma
Why? PRP needs platelets that work well and in sufficient number. If your blood doesn't clot properly, we can't draw safely, and we can't count on the result.
Heavy anticoagulants:
- Warfarin (Coumadin)
- Rivaroxaban (Xarelto)
- Dabigatran (Pradaxa)
- Heparin long term
Low-dose aspirin, on the other hand, is generally maintained, after assessment.
Pregnancy and breastfeeding
- Pregnancy, at every trimester
- Breastfeeding
- An immediate plan to conceive
PRP comes from your own blood, so why wait? Because no study has been conducted in pregnant women, and we apply the precautionary principle. During this period, we wait, and the nurse discusses it with you.
Once breastfeeding is over, PRP generally responds well to the hair shedding that follows delivery.
Active infection and inflammation
On the scalp:
- Severe, active seborrheic dermatitis
- Infectious folliculitis
- A scalp fungal infection
- An open wound or a recent scar
Elsewhere in the body:
- Fever or a flu-like state
- A blood infection
- Any active infectious flare
Injecting into infected tissue can worsen the infection or spread it. In these cases, we postpone the session without declining the treatment.
The situations we assess one by one
Chronic conditions
Diabetes: we are cautious when it is poorly controlled, or when there are severe complications or advanced neuropathy. Well-controlled diabetes is often compatible, after assessing your general condition and your circulation.
Autoimmune conditions: an active lupus flare, severe rheumatoid arthritis, active multiple sclerosis, Crohn's disease or ulcerative colitis in an inflammatory phase all call for a medical opinion. In stable remission, it is often compatible.
Medication
Immunosuppressants: methotrexate, long-term corticosteroids, immunosuppressants after an organ transplant.
Oncology treatments: chemotherapy in progress, radiotherapy over the area to be treated, or the recovery period after treatment.
These lists aren't meant to be read alone at home. The nurse goes through them with you, your medications in hand.
Your lifestyle matters too
PRP depends on your blood
PRP uses what is in your blood. Someone who smokes heavily or eats poorly has plasma lower in growth factors, and their result will be more limited. We're not judging you; we're explaining why we bring it up at the assessment.
What depletes your plasma
Smoking. It reduces blood oxygenation, alters platelets and their growth factors, lowers circulation to the follicle and slows healing after sessions. It is by far the heaviest factor.
A long-term unbalanced diet. It brings deficiencies in iron, zinc or B vitamins, chronic inflammation, plasma low in nutrients and platelets that perform less well.
Problem drinking. The liver produces growth factors less well, and we see multiple deficiencies, acquired clotting disorders and systemic inflammation.
Severe chronic stress. Cortisol stays permanently high, which harms hair, and both circulation and sleep suffer.
Preparing the ground rather than refusing
Rather than refusing you the treatment, we'd rather help you prepare the ground. What helps your hair helps your health too.
Ideally 4 to 6 weeks before the first session:
- Cut down on smoking: stop if you can, otherwise halve it
- Improve your diet, with more protein and vegetables and less sugar
- Correct deficiencies if bloodwork shows them (iron, zinc, B and D vitamins)
- Bring the stress down with exercise, sleep or whatever works for you
You get a better result, and your general health benefits.
When we point you toward exosomes
In which cases
Exosomes don't depend on your blood. That's why we suggest them when PRP reaches a limit.
When plasma may not be enough: heavy smoking that won't change, growth factors that decline with age, a chronic condition affecting blood quality, medication that alters platelets.
When there's a relative contraindication to PRP: hard-to-control diabetes, a light anticoagulant, a stable but present autoimmune condition.
What they change in those cases
They don't depend on you. The concentration of growth factors is the same every session, regardless of how you're doing at the time or your habits.
There's no blood draw, so no clotting question to settle before starting.
The product is prepared in a laboratory, under sterile, controlled conditions.
Exosomes are not approved by Health Canada for hair regrowth, even though their use is common in clinics. It's also a recent approach, without long-term hindsight.
The profiles where we recommend exosomes first
- You have smoked heavily for years
- You have diabetes with minor complications
- You take long-term medication
- Your work stress isn't changing this year
- PRP didn't give you what you hoped for
- You simply don't want a blood draw
The assessment
What we look at
The medical interview: your full history, your current treatments and their interactions, your habits, and what you expect from the treatment.
The examination: your general condition, the scalp (infection, inflammation), circulation and skin contraindications.
Bloodwork, if needed: platelet count, clotting tests, inflammatory markers, and glycemic control if you have diabetes.
If PRP isn't right for you
- Postpone PRP and prepare the ground, when that's the obstacle
- Move to exosomes right away
- Combine two approaches, depending on your situation
- Refer you elsewhere, when what you need is a dermatologist or a transplant
We won't point you toward finasteride or minoxidil. That's not our approach.
The questions we get most
"I take aspirin daily"
Low-dose aspirin is generally compatible. The nurse weighs the benefit for your heart against a slightly higher chance of bruising, and we adjust the monitoring.
"I have well-controlled type 2 diabetes"
If it's well controlled and your circulation is good, it's a good indication. We watch healing and your response from one session to the next.
"I smoke, and I can't quit"
No guilt needed, but PRP will give you less. In that case, exosomes are the better option. And if you can cut down, even without quitting, it helps.
"I have a stable autoimmune condition"
If you've been in remission for more than six months, it's often compatible, with regular medical follow-up and attention to any flare.
Preparing, if you are eligible
6 to 8 weeks before, on the food side:
- Protein, in a quantity suited to your weight
- Iron: red meat, spinach, lentils
- Zinc: shellfish, pumpkin seeds
- B vitamins: whole grains, nutritional yeast
On the habits side:
- Sleep, 7 to 8 hours, at regular times
- Water, 1.5 to 2 litres a day
- Movement, about thirty minutes three times a week
- Mental rest, with whatever method suits you
On supplements, only if bloodwork shows a deficiency. Vitamin D, iron and zinc aren't taken at random, and your doctor or our nurse will tell you what to take.
In short
If there's a contraindication, we explain it and offer you something else, even when that other option earns us less.
That's what the hair eligibility assessment is for. We review your medical situation and you leave with a clear answer, before you commit to anything.
To place your case before coming in, start with our hair page.
