Autologous Adipose Derived Stem Cell versus Platelet Rich Plasma Injection in the Treatment of Androgentic Alopecia: Efficacy, Side Effects and Safety

Abstract

Background: Platelet Rich Plasma (PRP) is based on the release of growth factors stimulating the initiation/ extension of anagen phase as well as promoting vascularization, Adipose Derived Stem Cell (AT-ADSCs) treatment were recently introduced as an alternative potential therapeutic application for hair growth. Objective: The aim of this study was to assess the efficacy side effects and safety of AT-ASCs and PRP in the treatment of androgentic alopecia. Patients and methods: Sixty randomized patients were treated by PRP, and AT-ASCs. Each patient was evaluated, and each lesion was treated by those modalities, patients received three sessions with one month interval for 3 months, follow up after 3 months. Results: A highly significant improvement <0.001 in terminal hair count of AT-ASCs group evaluated by videodermoscopy assessment of AGA. That were confirmed by highly significant improvement in intermediate hair count and mean caliber (<0.001) associated with high incidence of side effects especially headache and erythema. In contrast, PRP group showed significant improvement 0.037 in terminal hair count and non-significant improvement in intermediate hair count and of mean caliber with minimum side effects. AT-ASCs showed a significant improvement in terminal hair count than PRP, Highly significant improvement in Intermediate hair count and hair caliber. Also, side effects of AT-ASCs showed highly significant pain, headache and erythema but no serious adverse events. Conclusion: Our study suggests that the There was significant improvement in AGA after PRP and highly significant after AT-ASCs therapy with significant difference of ADSC in terminal hair count and highly significant in caliber. Both modalities could effectively and safely be used to treat AGA.

Minoxidil, Platelet-Rich Plasma (PRP), or Combined Minoxidil and PRP for Androgenetic Alopecia in Men: A Cost-Effectiveness Markov Decision Analysis of Prospective Studies

“…Probabilities were extrapolated from randomized controlled trials (RCTs) that evaluated the efficacy and safety of minoxidil monotherapy, minoxidil+PRP, or PRP monotherapy for men with AGA Hamilton-Norwood stages I-V [9][10][11][12][13][14][15]20,21]. Treatment response probabilities between health states were determined using physician assessments based on prospective clinical studies at six-month cycles.…”

“…Hair pull tests, dermoscopic evaluations, and photographs were used to determine treatment responses [1]. During the first cycle, 55% of patients improved with minoxidil+PRP [12], 53% of patients improved with PRP monotherapy [9], and 51% of patients improved with minoxidil monotherapy [10,14]. Following the first six-month cycle for those who improved, 99% of patients continued minoxidil+PRP [11], 97% of patients continued PRP monotherapy [15,20], and 91% of patients continued minoxidil monotherapy [11,13,14,20,21].…”

“…Following the first six-month cycle for those who improved, 99% of patients continued minoxidil+PRP [11], 97% of patients continued PRP monotherapy [15,20], and 91% of patients continued minoxidil monotherapy [11,13,14,20,21]. Over subsequent cycles, 98% of men who improved continued treatment, while 50% of men who did not improve continued treatment (Table 1) [1,[9][10][11][12][13][14][15]20,21].…”

“…Minoxidil adverse effects included pruritus of the scalp, seborrheic dermatitis, and erythema [11,13,14,20,21]. PRP adverse effects included injection site pain [9][10][11][12][13]15].…”

“…For hair restoration, PRP increases proliferation rates of human dermal papilla cells that regulate hair follicle growth [8]. Growth factors bind and interact with both dermal papilla cells and primitive stem cells, resulting in the activation of the proliferative phase of the hair cycle [6][7][8][9]. Promoting and maintaining the anagen phase of the hair cycle delays the catagen phase and increases hair density [6][7][8][9].…”