Platelet rich plasma therapy sits in an interesting spot between traditional rehab and cosmetic medicine. It borrows your body’s own platelets, concentrates them, and delivers a high dose of growth factors to a precise target. When it works, it does so quietly: less swelling, steadier tissue remodeling, a clearer line from injury or aging to recovery. As someone who has planned and delivered thousands of platelet rich plasma injections across joints, tendons, scalps, and faces, I can tell you the question that matters most to results isn’t “Does PRP work?” but “How often should I do it for this problem and at this stage of healing?”
The right schedule depends on tissue biology, severity, and expectations. A knee meniscus tear isn’t a receding hairline. A rotator cuff tendon asks for patience. Under eye skin requires finesse and spacing to avoid puffiness. Below, I’ll map out what’s typical, what to watch for, and how to adjust over time, so you can set a realistic cadence and budget for platelet rich plasma therapy.
What PRP does, in plain terms
A platelet rich plasma injection is not a drug, it’s a signal. We spin your blood to concentrate platelets and plasma proteins, then place that concentrate where you want healing. Platelets release growth factors such as PDGF, TGF-beta, VEGF, and IGF-1 that help kick-start the inflammatory-to-repair cascade. In joints and tendons, that means recruiting cells that remodel collagen, control pain signaling, and improve microcirculation. In skin, it means fibroblasts wake up, collagen and elastin production rises, and texture gradually improves. For hair, PRP can increase anagen phase signaling and improve follicle density and shaft caliber.
Because it’s a signal, repetition matters, but timing matters more. Hit tissue too frequently and you inflame without remodeling. Too infrequently and the signal fades before meaningful structural change occurs. The art is spacing sessions to match the speed of the tissue you’re treating: skin turns over in weeks, tendons remodel in months, cartilage change takes longer.
The three phases: loading, consolidation, maintenance
Most platelet therapy for healing follows a simple arc. First, a loading phase to trigger change. Second, consolidation to lock it in. Third, maintenance so you don’t give back gains.
For the typical patient, that looks like this pattern with small variations:
- Loading: 2 to 4 sessions spaced 2 to 6 weeks apart, depending on the tissue. Consolidation: 1 session at 3 to 6 months after the last loading treatment. Maintenance: periodic touch-ups every 6 to 18 months for cosmetic work, or every 6 to 12 months for chronic musculoskeletal conditions, with earlier boosters if symptoms return.
That’s a broad frame. Below, I detail specific schedules for joints, tendons, hair, and skin, and the reasons behind them.
Joints and arthritis: knees, hips, shoulders, ankles
For knee osteoarthritis and other degenerative joint pain, you’re not trying to regenerate an entire joint in a few shots. You’re trying to reduce synovial inflammation, calm catabolic enzymes, and support cartilage and subchondral bone health long enough to improve function. Evidence suggests outcomes are dose dependent, but dosing in PRP means number of injections and platelet concentration, not daily milligrams.
In my clinic, a common plan for PRP injection for knees or other joints looks like three injections, each 2 to 4 weeks apart, as a loading phase. That timing respects synovial biology. It gives each platelet rich plasma injection room to work while keeping the signal steady. Patients with mild to moderate knee osteoarthritis often feel the first durable change between weeks 4 and 8. Severe arthritis can require four or more sessions in loading, or a combined approach with bracing and weight management.
The consolidation session lands around month 6, especially if you had clear benefit that started to taper. Think of this as shoring up gains rather than starting over. After that, maintenance ranges from every 6 to 12 months, depending on activity level and symptom recurrence. Runners, hikers, and patients who stand all day tend to come back closer to 6 months.
A few nuances matter:
- PRP vs cortisone injection: Cortisone calms inflammation quickly but can weaken tissue with repeated use. PRP takes longer to help but supports repair. If you just had a steroid shot, give it 6 to 8 weeks before PRP so the steroid doesn’t blunt platelet signaling. Whole-joint strategy: For knees, adding an adipose or bone marrow cell product is sometimes discussed. If you’re sticking to PRP, consider leucocyte-poor PRP for joints to reduce flares, and avoid nonsteroidal anti-inflammatories for a week before and two weeks after. Expectations: PRP for knee osteoarthritis won’t reverse severe bone-on-bone changes. It can still decrease pain and improve function enough to delay surgery. For structural tears like a meniscus tear, outcomes hinge on tear type and location. A stable, peripheral tear with good blood supply responds better than a complex degenerative tear.
How often to get PRP for shoulders, hips, and ankles follows similar logic. For shoulder pain from rotator cuff tendinopathy or partial tears, plan a loading series of 2 to 3 injections 3 to 4 weeks apart, with guided placement into the tendon. Full-thickness tears over 50 percent thickness rarely respond as well to PRP alone and may need surgical evaluation. For hip pain due to early arthritis or labral fraying, expect 2 to 3 injections 2 to 4 weeks apart. For ankle arthritis or chronic foot pain, again a 2 to 3 injection series with a three-month recheck.
Tendon and ligament injuries: from tennis elbow to plantar fasciitis
Tendons remodel slowly. That is why PRP for tennis elbow, plantar fasciitis, patellar tendinopathy, and partial tears doesn’t need weekly sessions. The goal is to provoke a controlled micro-injury with your platelet therapy, then let biology rebuild higher-quality collagen.
For PRP for tendon injury, I usually recommend one to two injections spaced 4 to 6 weeks apart. Many patients require only a single treatment if the diagnosis is tight and the needle fenestration is thorough. A second treatment is reserved for slower responders or higher-grade degeneration. Then I pair it with eccentric loading exercises, soft tissue work, and progressive return to sport. A return visit at 12 weeks guides the need for another injection.
Ligaments follow a similar philosophy. For a mild ligament injury such as a partial sprain of the medial collateral ligament or a small ankle ligament sprain, one injection may suffice with bracing and rehab. For more substantial partial tears, 2 sessions 4 weeks apart seem to produce steadier improvements. PRP for a shoulder tear of the rotator cuff that is partial thickness can respond with a series, but complete tears need imaging and surgical input.
What about PRP for meniscus tear or cartilage repair? Here the literature is mixed. Carefully selected tears, especially vascular-zone lesions, may benefit as part of a broader plan, but don’t chase monthly injections. A loading plan of two to three sessions with careful follow-up is reasonable. For cartilage, the reality is that PRP is supportive, not a magic patch. It can reduce joint pain and swelling and improve function, which might allow you to train, strengthen, and lose weight, all of which protect cartilage.
Hair restoration schedules: male and female pattern loss
PRP therapy for hair loss lives in a world of cycles. Follicles turn over in months, not weeks, and density changes are subtle before they are obvious. The cadence that consistently works in practice is a front-loaded series, then gradually extending spacing as results stabilize.
For men with male pattern baldness and women with diffuse thinning, I plan a loading phase of 3 to 4 sessions spaced 4 weeks apart. That means once a month for three or four months. If the scalp is sensitive or you swell a lot, we can stretch to every 6 weeks. After loading, consolidation at month 6 to 7 helps anchor gains, then maintenance is typically every 4 to 6 months. Patients under 40 with early loss often hold results on twice-yearly sessions. More advanced loss usually needs three times per year to maintain lift.
Combining PRP with proven medical therapy improves durability. For men, low-dose oral finasteride or topical finasteride plus minoxidil pairs well. For women, oral minoxidil or spironolactone if appropriate, along with iron optimization if ferritin is low, improves outcomes. Microneedling with PRP can be layered in carefully, but don’t traumatize the scalp weekly. Keep sessions spaced enough to recover fully between treatments.
Timeline expectations: shedding slowdowns typically appear by 6 to 8 weeks, texture and caliber improve by month 3, and visible density changes show between months 4 and 6. Photographs in consistent lighting help you see progress that mirrors notice before you do.
Skin rejuvenation and acne scars: face, under eyes, and “vampire” facials
Skin answers quickly to platelet therapy compared with joints, but still needs repetition. For overall skin rejuvenation with a PRP facial or microneedling with PRP, I favor 3 sessions spaced 4 to 6 weeks apart. Younger skin or those with minor texture issues often do well with three treatments. More mature skin with fine lines, wrinkles, and photodamage may prefer four. Maintenance once or twice per year keeps collagen turnover active.
For PRP injection for face, especially for targeted areas like nasolabial fine Go to the website lines or acne scars, spacing can be similar: every 4 to 6 weeks for 3 to 4 sessions. Acne scars benefit from a combination of subcision for tethered scars, microneedling or fractional laser, and PRP to speed healing and amplify collagen. Expect improvement in 20 to 40 percent range per series, with additional series if you want more change.
The delicate under eye region has its own rules. PRP under eyes reduces dark circles that are vascular or thin-skin related and improves crepe texture. Because this tissue swells easily, space sessions every 6 to 8 weeks, typically 2 to 3 treatments in loading. Inject slowly with small volumes. Avoid doing fillers and PRP in the tear trough on the same day. If you already have filler, give it several weeks before PRP to reduce puff risk.
PRP vs filler for cosmetic concerns: they address different needs. PRP helps skin quality and texture by stimulating collagen. Filler replaces volume. If volume loss is the main issue, filler works faster. If tone, pore size, and fine lines bother you, PRP shines. Many patients layer both over time, starting with PRP to improve the canvas.
Sports injuries and muscle strains
Acute muscle injury responds well to platelet therapy when timed correctly. For a hamstring strain, calf tear, or quad injury, a single well-placed PRP injection within the first 7 to 10 days, coupled with structured rehab, often shortens downtime. A second session 2 to 3 weeks later is helpful for higher-grade strains or professional athletes on compressed timelines. For tendon junction injuries, treat like tendinopathy with extended spacing. For shoulder pain from a throwing injury, confirm the target — labrum, rotator cuff, biceps tendon — and match the schedule to the tissue. Don’t stack weekly shots. Let the biology breathe between sessions.
Side effects, safety, and what to avoid around treatments
PRP comes from your own blood, so reaction risk is low. The common side effects are soreness, swelling, and a sense of fullness for a day or two in soft tissues, and sometimes a sharper ache in tendons for a few days as the inflammatory phase starts. Joint flares happen in a small minority, usually resolving with rest and acetaminophen. Infection is rare with good sterile technique.
What to avoid after PRP matters. I ask patients to skip nonsteroidal anti-inflammatories like ibuprofen or naproxen for 48 hours before and 7 to 10 days after. These can blunt platelet signaling. Gentle movement is good. High-intensity exercise is not, at least for the first 48 to 72 hours after a joint or tendon injection. For cosmetic work, avoid saunas, hot yoga, or vigorous facial massage for a couple of days. Alcohol and smoking reduce microcirculation and slow healing.
Is PRP painful? The draw isn’t. The injection can be, depending on the target. Numbing agents and buffered saline reduce sting. For sensitive spots like the scalp or under eyes, topical anesthetic and vibration help. For deep joints, a small amount of local anesthetic around the skin and capsule is fine, but I avoid mixing anesthetic into the PRP itself in tendons to keep platelets as active as possible.
Matching concentration and frequency to the problem
Not all PRP is the same. Platelet concentration, leukocyte content, and activation method change how it behaves. For joints and arthritis, leucocyte-poor PRP often reduces post-injection flares and seems to perform well clinically. For tendons, a slightly higher platelet concentration and controlled leucocyte content can be helpful, especially with needle fenestration to drive the signal into degenerated tissue. For skin, moderate concentration without red cell contamination yields smoother results.
How does this relate to how often you get PRP? Higher concentrations do not mean you can stack sessions faster. In fact, more potent preparations often justify wider spacing, because they provoke a stronger response that needs time to settle into remodeling. A practical example: for knee osteoarthritis with a high-quality leucocyte-poor PRP, three injections 2 to 3 weeks apart is usually plenty for loading. For microneedling with PRP across the face, a standard concentration every 4 to 6 weeks feels right to avoid prolonged redness or swelling and keep collagen synthesis steady.
Budget and expectations: cost, value, and when to pause
The prp injection cost varies by region and complexity. In the United States, cosmetic PRP sessions often range from a few hundred to around a thousand dollars per session. Joint and tendon treatments may be similar or slightly higher, especially if ultrasound guidance and larger volumes are used. Insurance coverage remains limited. That makes scheduling choices meaningful.
A sensible approach is to define a decision point before you start. For example, for PRP for knee osteoarthritis, commit to the loading phase of three injections, then reassess at 8 to 12 weeks after the last session. If you achieve at least 30 to 50 percent symptom improvement and functional gains, plan your consolidation booster at month 6 and a maintenance session every 6 to 12 months as needed. If you see minimal change after a correct diagnosis and proper technique, it is reasonable to stop or to consider complementary strategies. The same logic applies to PRP for hair restoration: evaluate photos and shedding after the third or fourth session. If there is no trend at all, revisit your plan, check thyroid and iron, and consider adding or optimizing medical therapy.
Recovery timelines and return to activity
After a platelet rich plasma injection for joints or tendons, give yourself 48 to 72 hours of relative rest. Gentle range of motion and short walks are fine. Avoid heavy lifting or high-impact exercise for 1 to 2 weeks, then reintroduce progressively based on pain and your therapist’s guidance. For a tendon like Achilles or patellar, expect structured eccentric loading to start around week 2 to 3, with gradual progressions over 8 to 12 weeks. For shoulder tendons, add rotator cuff and scapular control work as pain allows.
For a PRP facial or microneedling with PRP, redness and mild swelling usually fade within 24 to 72 hours. Mineral sunscreen is mandatory, and you can return to makeup after a day if the skin is settled. Under eye treatments may hold a touch of swelling for several days, so plan around events.
How long does PRP last?
Longevity depends on the tissue and your behavior. Cosmetic improvements in skin texture and glow can last 6 to 12 months, longer if you protect your investment with sunscreen, topicals like retinoids, and maintenance sessions twice yearly. For hair, gains hold while the underlying androgenic process continues to push against them. That is why 2 to 3 maintenance sessions per year are common after the initial series. For joints and arthritis, many patients feel better for 6 to 12 months, sometimes longer. Adherence to strengthening, weight management, and activity modification extends results. PRP for chronic pain states like back pain or diffuse joint pain should follow a diagnosis-driven plan rather than a calendar.
When to adjust frequency up or down
The schedule is a starting point, not a law. Several real-world cues guide adjustments:
- If you have a robust flare after injection that lasts more than a few days, consider expanding intervals next time. If benefits fade quickly after the loading phase, add a consolidation session at month 3 rather than month 6, then space maintenance at a shorter interval. If labs show iron deficiency, vitamin D deficiency, or thyroid dysfunction, correct those, because low ferritin can undermine PRP for hair, and poor metabolic health slows repair in tendons and joints. If you use nicotine or vape, be honest: microvascular changes blunt PRP effects, and you may need more sessions to achieve less change.
A patient example helps. A 48-year-old runner with patellar tendinopathy had one PRP injection with aggressive fenestration, then 12 weeks of eccentric loading and gait work. Pain improved 60 percent by week 10. We did not rush a second injection. A six-month check found she was running pain-free. Contrast that with a 62-year-old with knee osteoarthritis and varus alignment who works on her feet. After three injections 3 weeks apart, she reached 50 percent improvement. We scheduled a consolidation at month 4 due to her high demand, then planned maintenance every 6 to 8 months. She maintains function without daily pain medication.
Comparing PRP to other biologic and injection options
PRP vs stem cell therapy is a common question. In musculoskeletal medicine, so-called stem cell treatments often involve bone marrow aspirate concentrate or adipose-derived cell preparations. They are more invasive and costly, with mixed regulatory and evidence landscapes. PRP has a stronger safety profile and a more predictable maintenance schedule. For many patients, especially in early-to-moderate arthritis, PRP offers a better risk-benefit curve. In dermatology, PRP augments microneedling and laser for collagen regeneration without adding foreign material. It is not a filler, and you should not treat it as a direct substitute.
Corticosteroid injections remain a tool for acute flares, but repeated steroid use weakens tendon and cartilage. If you have had more than two steroid injections in a region within a year, shift strategy. Hyaluronic acid injections for knees can pair with PRP in certain protocols, spaced appropriately, but stacking products in a single visit is not universally accepted. If pursued, let your clinician guide sequencing.
The two times not to get PRP
Patients often ask for a calendar. It’s fine to plan ahead, but there are two times I recommend you do not schedule PRP:
- During active systemic illness or fever. You want healthy platelets and stable physiology, not an immune system on high alert. In the immediate wake of a holiday binge of alcohol and poor sleep. Your plasma reflects your current state. Give yourself a week of normal hydration, nutrition, and rest to get the best concentrate.
A compact planning guide
Here is a short, practical reference you can use to set expectations with your clinician.
- Joints and arthritis: 3 injections 2 to 4 weeks apart, consolidation at month 6, maintenance every 6 to 12 months. Tendons and ligaments: 1 to 2 injections 4 to 6 weeks apart, reassess at 12 weeks, add only if progress stalls. Hair restoration: 3 to 4 sessions monthly, consolidation at month 6, maintenance every 4 to 6 months. Skin rejuvenation and acne scars: 3 sessions 4 to 6 weeks apart, maintenance 1 to 2 times per year. Under eyes every 6 to 8 weeks for 2 to 3 sessions.
Final thoughts and how to personalize your schedule
Good platelet therapy is precise in placement and thoughtful in timing. The best results I see come from matching the cadence to the biology of the tissue, using ultrasound guidance for joints and tendons when appropriate, and folding PRP into a broader plan: eccentric rehab for tendons, strength and weight management for joints, medical therapy for hair, and sun discipline for skin. People want hard numbers on how effective PRP is. The honest answer: it ranges. For the right indication with the right schedule, 50 to 80 percent improvement in pain and function for musculoskeletal issues is realistic. For hair, slowed shedding and visible thickening happen in a majority when paired with medical therapy. For skin, texture and glow are reliably better, with wrinkles and fine lines softened over a few months.
How many PRP sessions you need is the wrong first question. Ask instead: what tissue am I treating, what is the goal, and how will I measure progress at 8 to 12 weeks? Set those markers, choose a schedule that respects physiology, and let maintenance be driven by results rather than habit. That is how platelet plasma rejuvenation becomes a sensible, sustainable part of your care rather than a mystery you chase every month.
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