Every week someone asks me some version of the same question: "Should I do PRP or microneedling?" It's a fair question. Both treatments get heavy promotion, both rely on the scalp's own healing response, and both are sold as the "natural" step between a bottle of minoxidil and a hair transplant. After more than 30 years in the hair loss field, going back to when I started Regrowth.com as the first hair loss website, I've watched plenty of treatments rise and fade. PRP and microneedling are not fads, but the honest answer to "which is better" is more nuanced than most clinic websites admit.
Here's what each treatment is, what the research really shows, what it costs, and how I'd think about choosing.
PRP vs Microneedling: The Quick Answer
If you want the short version: microneedling has the more consistent evidence when it's paired with topical minoxidil, while PRP has promising but mixed evidence and far less standardization. Microneedling is also much cheaper. PRP may make sense for some people, especially under a dermatologist's care, but it is not automatically the "stronger" option just because it costs more and involves a blood draw.
Neither treatment is a cure, neither works for everyone, and neither replaces the proven foundations of treating pattern hair loss. Think of both as possible add-ons, not stand-alone fixes.
What Is PRP for Hair Loss?
Platelet-rich plasma (PRP) therapy starts with a small blood draw from your arm. The blood is spun in a centrifuge to concentrate the platelets, which carry growth factors, and that concentrated plasma is then injected into thinning areas of the scalp. The theory is that those growth factors help prolong the growth phase of follicles and improve the thickness of miniaturizing hairs.
Treatment usually involves a series of sessions spaced weeks apart, followed by periodic maintenance sessions. The exact schedule depends entirely on the clinic, which is one of the problems I'll come back to.
What the PRP research shows
- In a randomized, placebo-controlled half-head study (Gentile et al., Stem Cells Translational Medicine, 2015), the PRP-treated side showed significantly more hair count and density than the placebo side.
- However, a double-blind pilot trial in 26 women (Puig et al., Dermatologic Surgery, 2016) found no statistically significant difference between PRP and saline injections in hair count at 26 weeks.
- A review in Skin Appendage Disorders (Cervantes et al., 2018) concluded PRP looks promising for androgenetic alopecia but noted that preparation methods, injection schedules and outcome measures vary widely between studies.
So PRP may help some people, but results are inconsistent, and some of the benefit may come from the needle injury itself rather than the platelets.
What Is Microneedling for Hair Loss?
Microneedling uses a roller, stamp or pen with very fine needles to create tiny, controlled punctures in the scalp. Those micro-injuries trigger a wound-healing response, including the release of growth factors, and may stimulate dormant follicle stem cells. Microneedling also appears to increase how well topical treatments like minoxidil are absorbed.
What the microneedling research shows
- The study most often cited is a randomized, evaluator-blinded trial in 100 men (Dhurat et al., International Journal of Trichology, 2013). Men who combined weekly in-office microneedling with topical minoxidil had roughly four times the increase in hair count at 12 weeks compared with men who used minoxidil alone.
- A split-scalp study in 30 men (Aggarwal et al., International Journal of Trichology, 2020) compared microneedling alone with microneedling plus PRP. Both sides improved, but adding PRP did not produce a statistically significant extra benefit.
That second study is worth pausing on. When PRP was layered on top of microneedling, it didn't clearly beat microneedling by itself. That doesn't prove PRP is useless, but it should make anyone think twice before paying a premium for it.
Side-by-Side Comparison
| PRP | Microneedling | |
|---|---|---|
| How it works | Injects concentrated platelets and growth factors from your own blood | Creates micro-injuries that trigger healing and boost absorption of topicals |
| Strength of evidence | Mixed; some positive trials, some negative | Most consistent when combined with minoxidil |
| Where it's done | Clinic only | Clinic, or at home with lower-depth devices |
| Typical cost | Often several hundred dollars per session, rarely covered by insurance | Low cost for home devices; moderate for in-office sessions |
| Downtime | Tenderness, mild swelling for a day or two | Redness and sensitivity for a day or two |
| Main risks | Pain, bruising, headache, rare infection | Irritation, infection if devices aren't clean, scarring if overdone |
The Part Most Articles Skip: PRP Isn't One Treatment
Here's the angle I rarely see covered. "PRP" is not a single, standardized product. There is no FDA-approved PRP protocol for hair loss, and clinics use different centrifuge systems, spin speeds, platelet concentrations, activation methods and session schedules. Two people who both "had PRP" may have received very different treatments. That's a big reason the research is so inconsistent.
If you're considering PRP, ask the clinic:
- What system do you use, and what platelet concentration does it produce compared with normal blood?
- How many sessions do you recommend, and what does maintenance look like after the first year?
- How will you measure my progress? (Standardized photos or trichoscopy, not just "how it feels.")
- Who performs the injections, and is a physician involved in my diagnosis?
- What will you recommend I use alongside PRP to treat the underlying cause?
A good clinic will welcome those questions. A clinic that only wants to sell a package of sessions is telling you something.
Which Should You Choose?
Start with a diagnosis. Pattern hair loss, telogen effluvium, iron deficiency and other causes need different approaches, and neither PRP nor microneedling will fix a thyroid or nutritional problem. The American Academy of Dermatology recommends seeing a board-certified dermatologist to find the cause first.
From there, here's how I'd think about it:
- Microneedling may suit you if you're already using topical minoxidil, you want an affordable add-on with reasonable evidence, and you're willing to be careful about hygiene and technique.
- PRP may suit you if you're working with a dermatologist, you can afford ongoing sessions, and you understand the evidence is mixed. Some people choose PRP after a transplant or when they can't tolerate other treatments.
- Combining them is common in clinics, but as the 2020 split-scalp study showed, the extra benefit of PRP on top of microneedling isn't clearly proven.
Whatever you choose, it works best on top of a proven base. Topical minoxidil is FDA-approved for pattern hair loss and is the treatment microneedling has been studied with most. If you use a topical, a spray format such as the Regenepure Precision 5% Minoxidil Spray makes it easier to reach the scalp through existing hair. Follow the product label, and ask your dermatologist how to time topicals around microneedling sessions, since applying anything to freshly needled skin can increase irritation. Prescription options such as finasteride are a conversation to have with your doctor.
For a broader look at where each option fits, see my guide on how to regrow hair, and my roundup of new hair loss treatments for what's coming next.
Safety Notes
- Avoid microneedling over active scalp infections, open sores, psoriasis flares or inflamed skin.
- Never share microneedling devices, and clean or replace them as the manufacturer directs.
- Deeper needling should be done by a trained professional, not at home.
- People with bleeding disorders, those on blood thinners, and anyone with a platelet disorder should talk to a doctor before PRP.
- Give any treatment at least 4 to 6 months before judging results, and take consistent photos so you can compare fairly.
FAQ
Is PRP better than microneedling for hair loss?
Not clearly. PRP has some positive trials and some negative ones, while microneedling has more consistent results when combined with minoxidil. In one head-to-head split-scalp study, adding PRP to microneedling did not significantly improve results.
Can you do PRP and microneedling together?
Yes, many clinics combine them, and some apply PRP right after microneedling. It's generally considered safe under professional care, but the added benefit over microneedling alone hasn't been firmly established.
How long do results take?
Most studies measure results at 3 to 6 months. Hair grows slowly, so plan on several months before deciding whether a treatment is working.
Do results last if I stop?
Generally, no. Pattern hair loss is progressive, and gains from PRP or microneedling tend to fade without maintenance and an ongoing treatment plan.
Are PRP and microneedling good for women?
Both are used for female pattern hair loss, though the evidence in women is more limited. My guide to hair regrowth for women covers the options in more detail.
This article is for educational purposes and is not medical advice. Talk to a board-certified dermatologist or your doctor before starting any hair loss treatment.