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Should You Try Platelet-Rich Plasma Therapy?

Despite controversy and mixed results, patients and doctors are turning to this treatment for a variety of conditions


healthcare professional in blue gloves holds a centrifuged test tube showing a clear separation of blood components: dark red cells at the bottom and golden Platelet-Rich Plasma (PRP) at the top. In the blurred background, a patient waits in a clinical setting for their treatment.
Science Source Images

The first thing John* smelled was his wife’s hair. Then coffee, sautéed scallops and a pile of compost. For someone who hadn’t been able to smell anything for 45 years, it seemed like a miracle.

As a young man in his 20s, John suffered a traumatic head injury that left him with anosmia (the clinical term for loss of smell). Having tried countless treatments over the years, he figured, at 73, he would attempt one last-ditch effort to regain his sense of smell, if for no other reason than to feel that he had done everything he could. The therapy he signed on for: platelet-rich plasma therapy, or PRP.

While PRP has been around since the 1970s, it took off in the 2000s when sports medicine doctors began using it to help athletes recover from torn ligaments and soft-tissue injuries. But in recent years, PRP has emerged from the locker room. Today, it’s used to treat a wide variety of conditions, including osteoarthritis, hair loss, vocal cord scarring, erectile dysfunction, vaginal atrophy, infertility, dry eyes and skin rejuvenation in cosmetic procedures. And that is not a complete list.

For John, PRP was the silver bullet — as much to his doctor’s surprise as his own.

“I tried to discourage him because I thought the duration of his loss of smell had been too long and it wasn’t covered by insurance,” says Dr. Zara Patel, director of the Stanford Initiative to Cure Smell and Taste Loss, who treated John in her clinic. “I didn’t think he had a chance.”

But Patel was willing to give it a try.

How PRP works

At medical centers all over the country, PRP, a part of the larger field of regenerative medicine, uses the body’s healing abilities to relieve pain and repair damaged or diseased tissue.

To prepare PRP, a lab tech or doctor draws the patient’s blood and places it in a centrifuge, where it is spun to separate the blood into three layers: a bottom layer of dense red blood cells, a middle layer containing white blood cells and platelets, and a top layer of plasma.

The middle layer is isolated to create a concentrated volume of platelets that’s rich in growth factors, which can stimulate pain relief and improved function. This concentration of platelets and growth factors is then injected into the injured area. Treatment sessions usually last about one hour, and several treatment sessions are often required, spaced several weeks apart.

Promising but uncertain

Yet PRP remains controversial and not fully accepted by the medical establishment.

The Food and Drug Administration classifies PRP as an “investigational” treatment. Since PRP comes from a patient’s own blood, it is not considered a drug, and it can be legally offered “off-label” for a number of conditions.

Both the Osteoarthritis Research Society International and the American College of Rheumatology recommend against using PRP for osteoarthritis of the hip and knee, and the American Academy of Orthopaedic Surgeons supports the use of PRP on only a “limited” basis.

“There’s a lot of placebo effect,” says Dr. Joan Von Feldt, a past president of the American College of Rheumatology. “And PRP is not reimbursed by insurance, which should be a big red flag.”

In part, the reluctance to give PRP a full-throated endorsement is due to the inconsistency of study results. A randomized clinical trial published in JAMA in 2021 found that PRP injections did not significantly improve knee osteoarthritis symptoms after 12 months. But in 2025, a study published in The American Journal of Sports Medicine determined that PRP injections to the knee provided clinically significant pain relief, though the study's authors also called out the lack of standardization in PRP protocols.

Variations in preparation methods, metrics, data collection and equipment could account for some of the inconsistency. Because PRP is made from the body’s own blood, its quality is also variable.

“Your blood may have 200 platelets, while someone else’s blood may have 20,000 platelets,” says Dr. Bert Mandelbaum, an orthopedic sports surgeon and codirector of the Regenerative Orthobiologics Center at Cedars-Sinai in Los Angeles. Platelet density can fluctuate from day to day, depending on hormones, exercise and foods eaten, among other factors.

“When I prepare my patients, I tell them their own blood is their medicine, so they need to boost it as best they can,” says Dr. Alice Chen, a spine physiatrist with the Hospital for Special Surgery in Stamford, Connecticut. “I recommend they avoid toxins, alcohol and smoking for at least two weeks beforehand. I tell them to eat an antioxidant-rich diet and to reduce or eliminate sugar.”

Still, the results are hard to predict. “Some people improve dramatically, and some don’t,” says Patel. “It’s not a magic wand that cures everybody.”

And the procedure can be expensive as well as unreliable. A number of factors can affect cost, but a single procedure is roughly $500 to $2,500, with patients often returning for more treatments.

“It’s important for the physician and patient to have a realistic discussion on what the outcome may be,” says Dr. Brennan Boettcher, a sports medicine physician at the Mayo Clinic in Rochester, Minnesota. “Some people don’t like paying out of pocket for something that may not help them.”

How PRP is being used

Although PRP therapy is considered investigational, here are some of the conditions that doctors have commonly treated with it and what research says about the results.

1. Arthritic knees, torn tendons, injured ligaments

Despite recommendations against using PRP for osteoarthritis, some of the most promising results from PRP injections have come from their use for musculoskeletal conditions, primarily osteoarthritis of the knees; injuries to tendons and ligaments; and tennis or golfer’s elbow. Older patients often try them as a way to stave off knee replacement surgery.

Still, physicians who administer PRP stress that the results can be mixed and that there is no guarantee it will work.

“Some people are super responders, and some are not,” says Mandelbaum, who has been using PRP injections for more than 15 years. He currently administers a combination of PRP and hyaluronic acid, a lubricant that occurs naturally in the body.

The more severe the condition, unfortunately, the more limited the relief.

“While we do see people with bone-on-bone arthritis benefit, they are less likely to do really well,” says Boettcher. “And with soft-tissue problems like tendons, people with big tears don’t see much benefit from PRP injections. People with partial tears or fraying in tendons are more likely to respond.”

2. Loss of smell

PRP injections are a promising treatment for anosmia, which can trigger depression and have a serious impact on quality of life for people whose sense of smell is partially or completely gone.

A 2023 study by Patel and others published in the International Forum of Allergy & Rhinology found that among 26 participants with COVID-19-related smell loss, those who had PRP injections were 12.5 times more likely to improve their sense of smell than patients who received placebo injections.

Another 2025 study found that 67 percent of participants who developed anosmia following head injuries reported improvement after PRP injections.

3. Hair loss

To treat hair loss, dermatologists inject PRP into the scalp to reach the bottom of the hair follicles to stimulate the cells that play a critical role in hair growth. Although results can vary, multiple studies indicate PRP improves outcomes, especially when combined with other treatments like minoxidil (Rogaine).

But it’s not a miracle cure, says Dr. Alison Bruce, M.B.,Ch.B., the department chair of dermatology at the Mayo Clinic in Jacksonville, Florida. It tends to be most effective for individuals with early-stage hair thinning or androgenetic alopecia (pattern baldness).

PRP may be less effective for people with severe baldness, stress-related hair loss or scarring conditions that permanently damage the hair follicles.

“I discourage injections unless patients have realistic expectations, because they won’t regrow a full head of hair,” says Bruce, who mostly treats menopausal women with injections but also some men with male-pattern baldness.

Regardless, it’s important that the doctor administering PRP therapy has your complete medical history, as those who have blood disorders, active cancers or autoimmune disorders may not be good candidates for PRP injections.

But even if you’re a perfect candidate for PRP, the potential results are hard to quantify.

“There are people who do not believe PRP is effective,” says Boettcher. “While we have many high-quality trials demonstrating efficacy, we need more comparative trials that look at what dose of PRP is correct, and more trials identifying factors that can lead to someone not seeing a benefit.”

*John is a pseudonym used to protect doctor-patient confidentiality.

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