PRP Therapy: How It Works, Safety and How to Choose

In short: PRP (platelet-rich plasma) therapy uses a concentrate of your own platelets, taken from a small blood sample, and injects it where tissue needs repair. Platelets carry growth factors, proteins that signal nearby cells to multiply, move in and build new blood vessels. It is used for tendon, ligament and muscle injuries, and in skin and scalp care. A doctor's assessment and careful screening come first.

What is PRP?

Platelets are tiny cell fragments in your blood. Their best-known job is to help blood clot when you are cut. Healthy blood has about 1.5 to 4.5 lakh platelets in every microlitre (a millionth of a litre).

Plasma is the pale yellow liquid part of blood. Platelet-rich plasma is plasma in which the platelets have been concentrated. To be called PRP, it should hold about four to five times the platelets of normal blood.

Because PRP comes from your own blood, it is called autologous, meaning "from the same person".

What does PRP do in the body?

Growth factor stores. Each platelet holds 50 to 80 small storage sacs called alpha granules, containing more than 30 proteins. These include growth factors such as PDGF (platelet-derived growth factor), TGF-beta (transforming growth factor beta), VEGF (vascular endothelial growth factor) and EGF (epidermal growth factor).

Release on activation. When platelets are activated, as happens after an injury, they release these proteins quickly. They then keep making and releasing more for the rest of their short life.

Signals to repair. Growth factors attach to receptors (docking points) on nearby cells. The signal tells cells to multiply, to mature into specialised cells, to move into the area, and to form new small blood vessels. This is part of the body's normal healing response. PRP aims to deliver a concentrated dose of those signals to one spot.

In tendons and ligaments. Tendons join muscle to bone, and ligaments join bone to bone. PRP places platelet growth factors directly at the injured area.

In the scalp. Hair follicles have stem cells near their base that carry receptors for several platelet growth factors. VEGF supports the small blood vessels around a follicle during its growing phase.

How is PRP prepared and given?

1. A small amount of blood is drawn from your arm into a sterile tube that stops it clotting.

2. The tube is spun in a centrifuge, a machine that separates blood into layers by weight.

3. The platelet-rich layer is collected. Indian dermatology recommendations favour spinning twice, to concentrate the platelets further.

4. The PRP is injected into the injured tendon or ligament, the joint, the skin or the scalp.

Not all PRP is the same. Platelet concentration varies between preparation methods. For skin and scalp use, the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) recommends 1 to 1.5 million platelets per microlitre. PRP can also be "leukocyte-rich" or "leukocyte-poor", meaning it keeps or removes most white blood cells. Experts still debate which type suits which use.

For the scalp, IADVL advises injecting PRP at a controlled depth. Spreading it on the surface with microneedling does not reliably place it deep enough to reach the follicles.

What does research show for injuries and recovery?

PRP is used for tendon, ligament and muscle injuries, such as tennis elbow, Achilles tendon problems and shoulder tendon tears. It is also applied during some surgical repairs, such as rotator cuff (shoulder tendon) and knee ligament repair.

A 2014 Cochrane review, a rigorous independent evidence summary, looked at 19 small trials with 1,088 people across eight conditions. It found no clear difference in function between PRP and comparison treatments. It found a small short-term drop in pain, of about one point on a 10-point scale. The review combined different injuries and preparation methods; its findings cannot predict an individual patient's response. The reviewers called for standard ways of preparing PRP.

This is why how PRP is made, and who receives it, matter so much. You can read more about SOMA's approach to pain and recovery.

Can PRP be used for knee pain or thinning hair?

Knee pain has several causes. A doctor must establish the diagnosis before discussing treatment options.

Thinning hair also has many possible causes, from hormones and thyroid function to nutrition and stress. Platelet growth factors interact with follicle cells and surrounding blood vessels. These biological actions do not guarantee a particular hair-growth outcome. A doctor should look for the cause first.

What should a doctor screen for first?

These are screening points for a doctor to consider, not a complete list:

• low platelet count, or a platelet or bleeding disorder

• blood infection (septicaemia), recent fever, or another current illness

• low haemoglobin (the oxygen-carrying protein in red blood cells)

• cancer, especially blood cancers

• long-term liver disease or another serious whole-body illness

• heavy smoking, or alcohol or drug use

• regular use of blood thinners, anti-inflammatory painkillers such as ibuprofen, or high-dose steroid tablets

Indian recommendations suggest blood tests first, such as haemoglobin, platelet count and screening for blood-borne infections.

Side effects. The side effects most often reported are pain during the injection, redness, swelling and bruising. These usually settle within hours to a few days. Any injection carries a small risk of infection, so PRP must be prepared and given in sterile conditions. The 2014 Cochrane review detected no statistically significant difference in reported adverse events.

How do I choose a PRP clinic safely?

Ask these questions before you start:

1. Will a doctor examine me and confirm the cause of my pain, injury or hair concern first?

2. Have I been screened, including blood tests, before treatment?

3. How is the PRP prepared, and is it done in sterile conditions?

4. What platelet concentration does your method produce, and is it checked?

5. Is the PRP leukocyte-rich or leukocyte-poor, and why for my condition?

6. For the scalp, is it injected at a set depth, or only spread on the surface?

7. How will my progress be measured, and over what time?

If a clinic cannot answer these, choose another.

How does a SOMA doctor decide what is right for you?

At SOMA, a doctor looks at the whole picture first. Pain, slow recovery and thinning hair can each have several causes, including inflammation, weight, muscle strength, hormones, thyroid function, nutrition and stress. Which tests you need depends on what the doctor finds.

SOMA doctors assess your concerns and may recommend PRP when clinically appropriate. You get a clear plan, with what to measure and when, as one part of a plan built around you.

SOMA centres in Mumbai and New Delhi

SOMA doctors see patients at two centres:

• Mumbai: A-507, Kohinoor Square, N.C. Kelkar Marg, Shivaji Park, Dadar West, Mumbai 400028. Phone +91 98671 94033.

• New Delhi: E-354, Greater Kailash II, New Delhi 110048, serving Delhi NCR and Gurugram. Phone +91 87969 92001. More about the New Delhi centre.

The New Delhi centre is independently operated under licence from SOMA Longevity Sciences, and its own doctors lead care there. Both centres follow the same SOMA assessment and diagnostic standards. Online consultations are also available. Contact either centre.

Questions people ask

What is PRP therapy?

PRP therapy concentrates platelets from a small sample of your own blood and injects them where tissue needs repair, such as an injured tendon. Platelets release growth factors, proteins that signal nearby cells to multiply, move in and form new blood vessels, as part of the body's healing response.

Is PRP used for sports injuries?

Yes. PRP is used for tendon, ligament and muscle injuries, and during some surgical repairs. A 2014 Cochrane review of 19 small trials found a small short-term drop in pain and no clear difference in function. The review combined different injuries and preparation methods; its findings cannot predict an individual patient's response.

Can PRP be used for knee pain?

Knee pain has several causes. A doctor must establish the diagnosis before discussing treatment options.

Is PRP therapy safe?

Common side effects are pain during the injection, redness, swelling and bruising, which usually settle within days. It does not suit everyone, for example people with low platelets, a bleeding disorder or a current infection. A doctor should screen you first, including blood tests.

Where can I discuss PRP in Mumbai or Delhi?

Start with a doctor's assessment rather than a salon. Doctors at SOMA's centres in Dadar West, Mumbai and Greater Kailash II, New Delhi assess your concerns and may recommend PRP when clinically appropriate.

Sources

1. Dhillon MS, Behera P, Patel S, Shetty V. Orthobiologics and platelet rich plasma. Indian Journal of Orthopaedics 2014;48(1):1–9. https://pubmed.ncbi.nlm.nih.gov/24600055/

2. Dashore S, Chouhan K, Nanda S, Sharma A. Preparation of platelet-rich plasma: National IADVL PRP Taskforce recommendations. Indian Dermatology Online Journal 2021;12(Suppl 1):S12–S23. https://pubmed.ncbi.nlm.nih.gov/34976877/

3. Sharma A, Chouhan K, Bhatia S, Dashore S. Platelet-rich plasma in androgenetic alopecia. Indian Dermatology Online Journal 2021;12(Suppl 1):S31–S40. https://pubmed.ncbi.nlm.nih.gov/34976879/

4. Nanda S, Chauhan K, Shetty V, Dashore S, Bhatia S. Platelet-rich plasma in aesthetics. Indian Dermatology Online Journal 2021;12(Suppl 1):S41–S54. https://pubmed.ncbi.nlm.nih.gov/34976880/

5. Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. Platelet-rich therapies for musculoskeletal soft tissue injuries. Cochrane Database of Systematic Reviews 2014;(4):CD010071. https://pubmed.ncbi.nlm.nih.gov/24782334/