Dermoscopic pre‐ and posttreatment evaluation in patients with androgenetic alopecia on platelet‐rich plasma—A prospective study

Abstract

Summary Background Platelet‐rich plasma is rich in growth factors that promote differentiation and growth of dermal papilla cells by various signaling pathways. Dermoscopy is handy, bedside tool that helps to improve diagnostic accuracy in various hair disorders. Objectives To evaluate and study the role of dermoscopy in patients with androgenetic alopecia (AGA) pre‐ and posttreatment with platelet‐rich plasma (PRP). Methods It is a prospective comparative study. Twenty male patients with AGA, aged 18‐45 years with modified Norwood‐Hamilton classification grade II‐VI were included in this study. Patients were given platelet‐rich plasma injections every 3 week for a period of 3 months. Dermoscopy was performed with 10 x magnifications in polarized mode at baseline and at 3 months from the baseline and photographs were taken. Patients were evaluated based on following dermoscopic findings (a) hair count, (b) hair density, (c) hair diameter diversity, perifollicular pigmentation, yellow dots, multi‐hair follicular units, honeycomb pigment pattern and white dots, (d) patient's hair growth assessment score. Results Posttherapy, patients showed significant improvement in hair count (27.4%), hair diversity (84.2%), increase in number of thick, terminals hairs, reduction in yellow dots (60%), perifollicular pigmentation (92.3%) was appreciated. Hair pull test negative after treatment in 10 patients (50%). Patient's hair growth assessment score showed 50%‐75% improvement in 7 (35%) patients. Conclusion Dermoscopy helps to easily evaluate and compare the therapeutic response pre‐ and posttreatment which can be easily documented and visualized at every visit.

Platelet‐rich plasma for androgenetic alopecia: Efficacy differences between men and women

“…There was insufficient data to permit analysis of PRP treatment number or frequency on hair density. Five studies used the single spin method to prepare PRP, 12,13,16,31,32 five used the double spin method, 11,14,15,17,24 and two studies did not report the method 16,41 . Six studies reported the use of a PRP activator, 11‐13,15‐17 three studies reported using non‐activated PRP, 16,31,32 and three did not report whether an activator was used or not 14,24,41 (Table 1).…”

“…Platelet-rich plasma significantly increased hair density in men (MD: 25.83, confidence interval (CI): 15.48-36.17, 12 studies, N = 250, P < .00001, I 2 = 65%; Figure 2). [11][12][13][14][15][16][17]24,31,32,41 Treatment frequency and assessment time of studies ranged from 1 to 8 PRP injections and 3 to 12 months after the first treatment, respectively (Table 1). There was insufficient data to permit analysis of PRP treatment number or frequency on hair density.…”

“…Five studies used the single spin method to prepare PRP, 12,13,16,31,32 five used the double spin method, 11,14,15,17,24 and two studies did not report the method. 16,41 Six studies reported the use of a PRP activator, [11][12][13][15][16][17] three studies reported using non-activated PRP, 16,31,32 and three did not report whether an activator was used or not 14,24,41 (Table 1). studies, N = 88, P = .07, I 2 = 54%) 12,13,16,31,32 (Figure 3).…”

“…Platelet‐Rich Plasma (PRP) is a promising therapy for AGA with accumulating evidence suggesting it is effective, affordable, and has minimal safety issues 5‐9 . However, this evidence is largely based on populations consisting of only or mostly men 10‐17 . Whether PRP is effective for treating AGA in women is less clear, with some studies reporting a beneficial effect, 18‐25 while others report that PRP is not as effective or not effective at all for women 26‐28 .…”

Platelet-rich plasma: The journey so far !

“…In a prospective study on 20 AGA patients, 3-weekly PRP injections given for 3 months showed significant improvement in hair count, hair diversity, increased number of thick terminal hairs, yellow dot reduction, and improved perifollicular pigmentation on dermoscopy. [ 14 ] Significantly better hair growth was reported in patients receiving PRP with microneedling, compared with PRP with 5% minoxidil as well as 5% minoxidil monotherapy. [ 15 ] Another prospective study was done in 30 male AGA patients, where patients receiving monthly interfollicular PRP injections ( n = 16) were compared with patients receiving a topical application of 5% minoxidil twice daily for 4 months ( n = 14).…”