I first noticed my hair starting to fall out about three years ago, shortly after I turned after 35. It didn’t start all at once, but it snowballed quickly—to the point where so many hairs were falling out every time I took a shower that it took five to 10 minutes to clean all of it up after drying what hair was left on my head. It became so exhausting—physically and emotionally—that I started putting off washing my hair because I was afraid to see how much would fall out the next time.

There are many different treatments to counteracting hair loss, including specially formulated hair serums and topicals (like Rogaine), ingesting multivitamins and supplements (especially those that include biotin/vitamin B7), or, if possible, changing your diet and/or lifestyle to reduce stress. But none of these are guaranteed to prevent hair loss or restart hair regrowth, and not everything on the market is FDA-approved. What works for one person might not work for many, many other people.

The best bet is to take action when you first start to notice significant hair loss. Much like in skin care, and health in general, being proactive with preventative measures is critical. Many of the solutions available are for fostering hair regrowth to thinning hair. When hair is gone from your head completely, it’s too late to bring it back.

After trying serums, shampoos, and all of the hair “gummies” I could find, I decided to take a more advanced approach: PRP injections.

What is PRP?

“PRP is regenerative medicine’s holy grail,” says Stefanie Rippenbaum, a nurse practitioner at Ever/Body, a cosmetic dermatology and medical spa practice with multiple locations in New York City.

PRP stands for platelet-rich plasma. Blood is mostly made up of plasma and red blood cells. A medical professional (a nurse or doctor) takes a small tube of the patient’s blood and places it in a centrifuge machine to separate the two. The plasma alone is then injected back into the patient. The shaken plasma is commonly referred to as “liquid gold” by health care professionals thanks to its high concentration of growth factors, which help with tissue healing and hair growth stimulation.

Given that the plasma is taken from the patient’s own blood sample, it is considered safe—thus, it is not necessary for extensive testing (say, compared to making a blood donation to someone else) for immediate use. When the medical professional takes the blood sample, it can be ready for use on the same patient with 10 to 15 minutes.

PRP can be used as treatment for osteoarthritis, being injected into joints to reduce inflammation. Other examples include treatment for skin rejuvenation, tendonitis, musculoskeletal injuries, and to decrease downtime with post-surgical healing.

And increasingly, it is becoming a popular method for reigniting hair growth and staving off hair loss.

“The growth factors found in our own blood can be highly effective,” Rippenbaum says. “Research shows that PRP not only decreases hair shedding and stimulates new hair growth, but it also increases the thickness of the hair follicle itself. That’s a huge win for many of my patients. I find myself recommending and performing hair PRP about five times per day at the office. It can really be life-changing for anyone battling hair thinning or shedding.”

What is the injection process like?

The injection process is not for the faint of heart, but it’s not as severe as getting an epidural, either. The medical professional should give you the option to partially numb the scalp, usually with a vaseline-like cream slathered over the desired injection spots. If you choose to get the numbing cream, note that you cannot wash your hair for a few days after the injections, and this cream typically makes your hair look very greasy.

That said, in my experience, the numbing cream was worth it. I tried the injections both with and without the numbing cream, and while I like to think I have a high threshold for pain and I’m definitely not afraid of needles, I would not go without the numbing cream again. Without any local anesthetic, the injections don’t cause so much pain as they do pressure. You can expect six to a dozen per session around the front of the scalp, around where you part your hair, and where you are losing hair the most. And after a few needle pricks, the pressure became too much for me. The numbing cream doesn’t erase the pain entirely, but you’re settled within a few minutes and any pressure or pain dissipates quickly. I recommend holding a stress ball, or as I did in my case, a very cuddly labradoodle.

Once the injections are done, again, you cannot wash your hair for a few days, and it’s recommended you don’t wear a hat or exercise during that time frame either. But otherwise, it’s an outpatient procedure, and the whole appointment shouldn’t take more than an hour, depending how busy the medical office or cosmetic spa is that day.

Courtesy of Ever/Body

What kind of results can be expected?

PRP treatments should be done once a month for three to four months. After this initial treatment plan, practitioners might bring patients back in every three to six months for singular maintenance treatments.

Results, inevitably, vary from patient to patient. But some patients could see results (new hair growth and fewer hairs on the floor after combing) within a month. I began to notice fewer hairs falling out within a few weeks of the first series of injections, but I could easily count how many hairs fell out after three to four months of injections. (Meaning, only a dozen or so hairs on the bathroom floor—not literally hundreds like before I started PRP.)

“I have seen dramatic physical and emotional transformations with PRP treatment for hair loss. Especially in people that are dealing with postpartum hair loss,” Rippenbaum says. “It’s beautiful to watch someone regain their confidence after months, perhaps years, of not feeling quite like themselves. Most of my patients see significant improvement in hair retention, new hair growth, or hair volume within the first three months of treatment.”

PRP can be used alone as a primary treatment plan. However, some practitioners will add prescription medications to the plan, too, such as finasteride, minoxidil, or spironolactone. “Many of my patients have had success with incorporating Nutrafol supplements into this regimen as well,” Rippenbaum notes.

But patients need to prepare themselves (and their bank accounts) that, much like Botox and dermal fillers, results aren’t permanent. On average, patients can expect the benefits of PRP to last for approximately a year. My first try at PRP consisted of three rounds of injections over three months, and those results lasted for about 10 months before I started to notice the hair falling out again in large quantities. But after restarting PRP during the last six months, I started to notice results much more quickly, likely as my body already knew to respond and thus, my hair loss was not longer as severe as it was three years ago.

“If a patient is not responding as well as expected, it’s important to do a deeper dive into their daily routines such as diet, products, current stress level, and family history,” Rippenbaum explains. “A more comprehensive blood panel may be drawn to look into hormone levels as well. This could help fill in any missing puzzle pieces.”

Rates vary, but on average, one appointment for injections could cost up to $1,000, and then multiply that for monthly appointments over the course of three month as well as subsequent followups, based on what your provider recommends. Depending on the medical practice and diagnosed cause behind the hair loss, some insurance plans might cover at least part of the treatment costs, and you should look into whether or not flexible and health savings accounts could also be applied.

So far I’ve gone through two rounds of PRP over two years. Would I do it again? Absolutely. Nothing worked for my hair loss and regrowth as well as PRP did. The results were as promised and I don’t feel like crying after washing my hair anymore. But I want to stress that is what worked for me, and I don’t know if it is something I will continue to do forever.

As with anything that concerns your personal health and well being, before trying something this invasive (and this expensive), you should consult a trusted medical professional first.