Evaluation of adding platelet‐rich plasma to combined medical therapy in androgenetic alopecia

Abstract

Androgenetic alopecia (AGA) is a nonscarring alopecia due to hormonal and genetic influences and is characterized by the progressive miniaturization of hair follicles, with the transformation of terminal hair into vellus hair. Female pattern hair loss is a term that is used latently to describe AGA in females. 1 The frequency and severity of AGA increase with the increasing age of the patients. 2 The major pathogenic cause of AGA is a dihydrotestosterone (DHT) imbalance, which might interfere with the progressive miniaturization of scalp hair. Most of the research in this field is aimed at solving this problem by medical therapy that has been used effectively for androgenetic alopecia (AGA). FDA approved two therapies for AGA: topical minoxidil and oral finasteride. 3 Many authors investigated adding some procedures as co-adjuvant therapies for AGA as mesotherapy, platelet-rich plasma (PRP), stem cell therapies, that is, adipose-derived mesenchymal stem cells (AD-MSCs), and human follicle stem cells (HFSCs). 4,5 Platelet-rich plasma is an emerging treatment for AGA. It is an autologous solution drawn from one's blood that has been centrifuged and filtered to contain a high concentration of platelets and their bioactive growth factors. 4,6 The use of PRP is promising adjuvant therapy for AGA. Safety issues, downtime, and side effects seem to be minimal. PRP

Microneedling and Its Use in Hair Loss Disorders: A Systematic Review

“…of MN sessions Treatment duration Endpoints Effectiveness Adverse events Jadad score Ramadan et al. [ 12 ] n = 126 (46 m, 80 f); AGA Combination: PRP, 5% minoxidil, 2.50 mg finasteride (men), 200 mg spironolactone (women) Group 1: medications + PRP injections Group 2: medications + MN + topical PRP Group 3: medications MN automated pen, 2.00 mm needles, session endpoints marked as three passes followed by PRP application 6, once every month 6 months Hair counts, hair diameters, photographic evaluation Yes, in both sexes Hair density increased in group 2 versus group 1; larger effect for groups 1 and 2 versus group 3 No serious events reported Twenty-three subjects reported transient pain after PRP 2 Sohng et al. [ 13 ] n = 29 (24 m, 5 f); AGA Combination: 5% minoxidil Group 1: home-use MN Group 2: home-use MN + 5% minoxidil Group 3: 5% minoxidil MN stamp, 0.25 mm spiral needles, endpoint sessions marked as gentle tapping 20 times in target area 52, twice weekly 6 months Hair counts, self assessments No No serious events reported; mild and transient pruritus noted in one subject 2 Burns et al.…”

Efficacy and safety of combined microneedling therapy for androgenic alopecia: A systematic review and meta‐analysis of randomized clinical trials

“…Thirteen RCTs were finally included [12][13][14][15][16][17][18][19][20][21][22][23][24] (Figure 1).…”

“…Among the 13 RCTs, seven studies [15][16][17][18][19][20]23 reported the efficacy of MN combined with Minoxidil/PRP/Finasteride/Spironolactone versus single Medication, three studies 12,21,24 compared MN combined with PRP/ Dutasteride/Fibroblast growth factors solution with single MN, and three studies 13,14,22 were designed comparing MN combined with Minoxidil, single Minoxidil, and single MN in three groups. In addition, eight studies 13,14,16,[18][19][20][21]24 used electrodynamic microneedles, three studies 12,15,17 used rolling microneedles, one study 22 used a home-use type microneedle with spiral-grooved, and one study 23 used fractional radiofrequency microneedle. Nine studies 13,14,[16][17][18][19][20][21]23 described microneedle depths ranging from 0.25 to 2.50 mm.…”

Treatment of Androgenetic Alopecia Using PRP to Target Dysregulated Mechanisms and Pathways

“…Most recently, a single-blinded, randomized, controlled study by Ramadan et al Sought to evaluate the effect of PRP application technique on hair growth in the treatment of AGA ( 102 ). Additionally, the study incorporated minoxidil and finasteride treatments.…”