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Rehabilitation

Therapy

Cosmetics

<hr />Natalya Sachuk – head of the Farmosa restorative medicine clinic, dermatocosmetologist, trichologist, member of the All-Ukrainian Association of Trichologists, Association of Preventive and Anti-aging Medicine, Ukrainian Academy of Dermatovenerology (Ukraine, Vinnitsa) Marina Erokhina – chief physician of the Farmosa restorative medicine clinic, dermatologist, trichologist, member of the Ukrainian Academy of Dermatovenereology, Ukrainian Society of Aesthetic Medicine, All-Ukrainian Association of Psoriasis (Ukraine, Vinnitsa)<hr /> Of course, plasma therapy is not a panacea. For example, with its help it is almost impossible to restore full hair in a completely bald person. But for diffuse (uniform hair thinning) or androgenetic alopecia, the use of plasma therapy has demonstrated the highest effectiveness. In addition, medical practice has shown that plasma therapy can not only successfully combat alopecia, but also stop the aging of the hair and skin. History of the method The method of treatment with blood products – autohemotherapy – has been used in medicine for quite a long time. The first successful experience of autohemotherapy was described in 1905 by surgeon August Bier, who used it to treat fractures by creating artificial hematomas. Subsequently, attempts were made using this method to strengthen the protective reactions of patients with infectious diseases, furunculosis, chronic inflammatory diseases of the female reproductive system, etc. Specialists who used autohemotherapy received the same type of clinical effects, noting the activation of the body’s protective and rehabilitation mechanisms: accelerated healing of wounds after injuries and surgical interventions, faster resolution of purulent processes in the skin and soft tissues, accelerated recovery in chronic inflammatory diseases, increased physical and mental performance. In 2003, Russian doctors Professor, Doctor of Medical Sciences R.R. Akhmerov and Candidate of Medical Sciences R.F. Zarudiy proposed using the potential of blood products to rejuvenate the skin by isolating and using platelet-rich blood plasma. The new technique, which was called “plasmolifting” six years ago, turned out to be multifunctional. Today there are many names and analogue technologies (Regen Lab, Glo PRP, Magellan, Harvest, PRP (platelet-rich-plasma), plasma modeling, plasmaplasty, etc.) that are used in various fields of medicine, including aesthetics. What is plasma? Blood plasma (from the Greek πλάσμα - something formed, formed) is the liquid part of the blood in which the formed elements are suspended. Blood plasma consists of water in which proteins (7–8% of the plasma mass) and other organic and mineral compounds are dissolved. The main plasma proteins are albumin (4–5%), globulins (3%) and fibrinogen (0.2–0.4%). Also dissolved in blood plasma are nutrients (in particular glucose and lipids), hormones, vitamins, enzymes and intermediate and final metabolic products, as well as inorganic ions. This must be taken into account when comparing with other treatment methods that use drugs that are far from matching the composition of such a valuable “product.” Plasma therapy method Autoplasma enriched with platelets can be used to solve a wide range of problems in cosmetology, trichology and dentistry, as well as as an independent method of treatment and as maintenance therapy. It has been proven that plasmolifting is an effective method of hemological reinforcement of the skin and its rejuvenation, treatment of acne, but the most brilliant results were achieved in the treatment of baldness and hair loss. Considering the causes of hair loss (stress, microelementosis, hormonal and somatic disorders, heredity, etc.), a trichologist is relatively limited in the use of biological stimulants for the scalp. When choosing them, a clear understanding of the compatibility of foreign substances with the characteristics of the body and the mechanisms of local reactions is required. Therefore, the newest method - the introduction of platelet-rich plasma - has a huge advantage - the compatibility of the above. At the same time, the patient’s own blood is as safe as possible for him. Already after the first plasma therapy procedure, the condition of the hair improves significantly. Hair follicles switch from a shedding or resting phase to a growth phase. Regeneration processes are stimulated, dandruff disappears, and the growth of fungal infections on the scalp is suppressed. Repeated procedures completely stop the death of hair follicles, hair thinning and hair loss, even in the case of androgenetic alopecia. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/Biotehnol_Sachuk_1.png" style="height:297px; width:650px" /> Mechanism of action What explains the growth of collagen and elastic fibers, which are responsible for the elasticity of the skin and provoke hair growth? In this case, intradermal and subcutaneous infiltration of platelet-rich autoplasma is used as a new and safe biological stimulator. It contains the most important platelet growth factors. Growth factors are polypeptides with a molecular weight of 5–50 kDa, combined into a group of trophic regulatory substances. Like hormones, these factors have a wide range of biological effects on many cells - they stimulate or inhibit mitogenesis, chemotaxis, and differentiation. Unlike hormones, growth factors are usually produced by unspecialized cells found in all tissues and have endocrine, paracrine and autocrine effects. The most important growth factors include platelet-derived growth factor (PDGF-aa, PDGF-bb, PDGF-ab), transforming growth factor (TGF-β1, TGF-β2), vascular endothelial growth factor (VEGF), epithelial growth factor (EGF), fibroblast growth factor (FGF), insulin-like growth factor (IGF). The most studied representative of the group of protein growth factors (mitogens and motogens) is platelet-derived growth factor (PDGF). Despite the enormous amount of data accumulated since the discovery of PDGF, there is no theory to explain most of its effects in vivo. Therefore, new research brings new results. Human PDGF, isolated from platelets, is a heterodimer - a protein consisting of two polypeptide chains that differ in amino acid sequence. The two different chains (denoted A and B) that make up it are connected by disulfide bonds. Homodimeric molecules are also found as minor components of serum PDGF, but the AB form is predominant in humans. The concentration of PDGF in the blood serum is maintained at a constant level (50–60 ng/ml); PDGF was not detected in platelet-free plasma. Therefore, they began to use platelet-enriched autoplasma. PDGF induces chemotaxis of leukocytes, granulocytes, macrophages; To stimulate their directed movement, an external concentration of PDGF of 1–2 ng/ml is sufficient. Connective tissue cells are involved in the process: the proliferation of fibroblasts and their directed movement, as well as the synthesis and secretion of extracellular matrix proteins are stimulated. The transforming growth factors (TGF) family includes:<ul><li> TGF-β is a powerful stimulator of collagen production;</li><li> TGF-α – stimulates fibroblasts, endothelial development, and is an angiogenic factor.</li></ul> Like epidermal growth factor, TGF-α is involved in the regulation of cell proliferation. Platelets trigger natural mechanisms of self-healing, regeneration and healing, stimulating the growth and division of new healthy cells. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/Biotehnol_Sachuk_2.png" style="height:488px; width:650px" /> Description of the procedure To obtain platelet-rich plasma, use an EBA 20 centrifuge manufactured by Andreas Hettich GmbH &amp; Co (Germany) or its equivalent. Blood sampling is carried out using a peripheral venous catheter with a diameter of at least 19G, so as not to damage the blood cells. The blood is placed in a sterile 9 ml tube special for plasma lifting, which is then placed in a centrifuge. Separately, it is worth noting the requirements for a test tube for plasma therapy: the procedure uses special tubes containing the sodium salt of heparin of a special quality and administered using a special method. Standard laboratory test tubes are not suitable, as they can cause a violent allergic reaction! During rotation in the centrifuge, the blood is divided into three main components according to density. The least dense, platelet-poor plasma is separated first, the platelet-rich plasma (sometimes called the platelet-leukocyte layer) is separated second, and the densest red blood cells are separated last. Platelet-rich plasma is plasma with a high content of platelets and white blood cells. Its volume is about 6 ml. Both platelet-rich and platelet-poor plasma are fractions of blood and contain large amounts of fibrinogen and other clotting factors. Next, the patient is injected with ready-made autoplasma rich in platelets. The area where autoplasma is administered in the treatment of alopecia is the scalp, along the parting. At the same time, it is necessary to clearly understand that the work is carried out with blood, therefore maximum protection of the doctor and the patient is mandatory. Injections of platelet-rich plasma are carried out according to the principles of mesotherapy, as well as at biologically active acupuncture points. The choice of administration regimen is determined by the attending physician, taking into account individual indications. Contraindications for use A detailed medical history, the patient’s filling out a health questionnaire and permission to perform an injection procedure are the key to the correct and effective implementation of the procedures. It is also recommended to first undergo laboratory tests that will determine the presence of an inflammatory process in the body:<ul><li> clinical, biochemical blood test;</li><li> analysis for markers (hepatitis, syphilis);</li><li> if autoimmune disorders are suspected - ATPO and immunogram.</li></ul> Contraindications are:<ul><li> severe diseases of the thyroid, pancreas (diabetes mellitus), heart, lungs, kidneys - stimulation can cause unexpected reactions;</li><li> chronic infectious diseases: hepatitis B and C, syphilis, AIDS;</li><li> bleeding disorders;</li><li> autoimmune diseases.</li></ul> Manipulations are performed with extreme caution if the patient has a predisposition to hypertrophic and keloid scars. Other restrictions include the following: pregnancy, lactation, neuroses, depressive states, mental disorders, taking anticoagulant drugs. The procedure is not performed in the presence of severely inflamed pustular formations on the skin, in case of dermatological diseases in the acute stage (for example, streptoderma, rosacea, psoriasis, etc.). It is advisable for women not to inject during menstrual bleeding. The exclusion of all contraindications to plasma lifting ensures the most comfortable and safe procedure. results Phototrichogram, microvideoscopy, dermatoscopy and photo documentation of positive results are proof that this latest biotechnological method is the most effective today for patients of a trichologist. After completing the full course (from 3 to 10 procedures), depending on the clinical picture, the growth of new, healthy hair begins, most often bypassing the vellus stage. These observations were confirmed after studies of hair density and diameter. Cellular metabolism is normalized, blood supply and nutrition of hair follicles is improved, and hair loss gradually stops completely. The hair growth phase is lengthened, after just one session the work of the sebaceous glands is normalized, seborrhea (dandruff) is eliminated, the growth of fungi and bacteria on the scalp is suppressed, the structure and diameter of the hair shafts are restored. In the case of alopecia, hair growth is observed after 10–14 weeks. Advantages of the method<ul><li> The procedure takes less than an hour. To perform it, you don’t need an operating room – a procedural one is enough.</li><li> There is no need to purchase numerous drugs for intradermal administration.</li><li> The effect of plasma therapy becomes noticeable soon after the first injection of autoplasma enriched with platelets (if, of course, the procedure is carried out correctly).</li><li> For plasma therapy, only autoplasma is used. Therefore, the risk of patient infection with HIV, hepatitis, syphilis and other blood-borne diseases is absolutely excluded.</li><li> The most important advantage is the price-quality ratio. On the one hand, the method is harmless and effective, and on the other hand, it is accessible to the patient.</li></ul> Indications for the use of plasma therapy<ul><li> Treatment of hair loss and hair and scalp diseases</li><li> Regeneration and healing of tissues after surgery</li><li> Treatment and prevention of focal and generalized periodontitis</li><li> Age-related changes (atrophy) of the skin (dryness, decreased turgor, the presence of small facial wrinkles, initial manifestations of ptosis) of the face, hands, décolleté</li><li> Skin elastosis</li><li> Photodermatosis that develops as the skin ages or after excessive sun exposure</li><li> Prevention of formation and treatment of stretch marks due to sudden weight gain</li><li> Skin rehabilitation after aggressive cosmetic procedures (chemical, laser or other peeling)</li></ul> The maximum number of clinical studies and observations on PRP (plasma therapy) is presented in the field of dentistry and trichology. In addition, to increase efficiency, plasma therapy is used in combination with laser procedures: resurfacing, laser peeling and fractional laser thermolysis, as well as with chemical peels according to indications. However, specialists always need to remember that despite its effectiveness and safety, plasma lifting cannot and should not be recommended to absolutely everyone and considered as a panacea. Conclusion Thus, plasma therapy, or the introduction of autoplasma enriched with platelets, is an absolutely safe and effective method in the treatment of alopecia. The method is non-toxic, since only autoplasma is used (without the addition of foreign substances), which accelerates natural regeneration mechanisms through growth factors contained in platelets. As a result, a person gets the maximum result by using his own regeneration potential.<hr /> First published: KOSMETIK international journal, No. 2/2012, pp. 32-35

Plasma therapy in the fight against alopecia