Autologous platelet‐rich plasma therapy for pattern hair loss: A systematic review

Abstract

Background Androgenetic alopecia (male pattern and female pattern hair loss) is characterized by thinning of the scalp hair. Intradermal injection of autologous platelet‐rich plasma (PRP) might have an effect on hair regrowth. Aims The aim was to evaluate efficacy and safety of platelet‐rich plasma compared to placebo or no treatment in people with pattern hair loss. Patients/Methods We searched the databases CENTRAL and MEDLINE on December 24, 2018 and included randomized controlled trials (RCTs). Primary outcomes were mean change of hair density from baseline and serious treatment‐related adverse events. Secondary outcome was mean change of hair thickness from baseline. Time point of outcome assessment was 6 months after start of treatment. Results We identified 13 relevant randomized controlled trials with 356 randomized (343 analyzed) people or half‐head areas who received PRP in a simple parallel or half‐head design. The pooled data of seven studies (171 analyzed people or half‐head areas) were favorable in the PRP group on hair density. We estimated a mean difference from baseline of 30.35 associated with a wide 95% confidence interval (1.77‐58.93), a considerable heterogeneity (I2 = 100%), and unclear risk of bias in most of the studies. Regarding hair thickness, data were also favorable in the PRP group, but these data were limited to a single study. We did not identify serious treatment‐related adverse events. Conclusion The results of seven RCTs indicated that autologous platelet‐rich plasma was associated with an increase of hair density when compared to placebo.

Quality issues identified in systematic reviews on platelet‐rich plasma therapy for pattern hair loss—A method study

“…Fifteen references matched the inclusion criteria and were included in the present method study 1–15. In five systematic reviews,4,6,8,13 we identified various overt methodological inconsistencies.…”

“…This result would indicate an astounding absence of heterogeneity, which does not appear to make much sense considering the inclusion of various types of study designs and comparisons. For example, Mao et al12 reported an I 2 value of 63% in a meta‐analysis of four RCTs, and Dervishi et al1 reported an I 2 value of 100% in a meta‐analysis of seven RCTs.…”

“…The original search strategy is shown in Dervishi et al1 We updated the search in the database MEDLINE via PubMed on October 17, 2019, applying the text words ((“Platelet‐Rich Plasma”) AND “Alopecia”). We included systematic reviews and/or meta‐analyses on platelet‐rich plasma therapy for pattern hair loss.…”

“…During the preparation of a systematic review on platelet‐rich plasma therapy for pattern hair loss,1 we systematically searched for other systematic reviews on the same topic.…”

Female pattern hair loss: A comprehensive review

“…Both techniques cause microtrauma that induces neovascularization, collagen formation, and stimulation of growth factors to increase hair growth and thickness (Figure 3). 6,[40][41][42] Adipose tissue, which is a source of mesenchymal stem cells, can be injected into the scalp as a treatment option for FPHL. This therapy allows for the release of growth factors and angiogenesis to induce hair growth.…”