Follicular Unit Extraction (FUE) Hair Transplantation in Combination with Platelet Rich Plasma for the Treatment of Scarring Alopecia: A Case Series

Abstract

Objective: To study the effect of addition of platelet rich plasma (PRP) to the hair transplantation for scarring alopecia.Methods: An evaluation of the patients with detailed history, clinical examination and laboratory investigations was done. Routine baseline investigations and skin biopsy were done in order to rule out any activity of the underlying disease process. Freshly prepared Platelet rich plasma (PRP) using YCELL BIO kit was injected in freshly done slits over recipient area.Results: A total of 4 cases were studied-A 26 years old male with cleft lip surgical scar with absent hair growth on the middle third of the upper lip, a 22 year old male with a 5 year old post traumatic depressed scar over the junction of medial and lateral third of the right eyebrow, a 17 year old boy with a post burn scar over his left upper lip and adjoining lower cheek area and a 55 years old post menopausal female, an already diagnosed and treated case of frontal fibrosing alopecia (FFA). Hair transplantation was performed with follicular unit extraction (FUE). Freshly prepared PRP was injected intradermally after creating the slits. In all the cases, there was a good survival rate of the healthy hair follicles, accompanied by improvement in the texture of the surrounding skin.Conclusions: Platelet rich plasma, being a cocktail of growth factors, can bring vitality to the tissue and improve its vascularity, thus making it more receptive to the transplant. Additionally, with the improved vascularity of the recipient bed and activated fibroblasts, there is accelerated hair growth and better cosmetic outcomes of the scar.

Adjuvant measures and genetic evaluations to improve results of hair transplantation

“…Growth factors in PRP promote hair regrowth by binding to their respective receptors expressed by stem cells of the hair follicle bulge region and associated tissues. Upon ligand binding, stem cells induce the proliferative phase of the hair follicle, producing the anagen follicular unit and facilitating hair regrowth (1,36). Hair transplantation is a relatively safe surgery and is associated with very few complications, however, it can seriously impact the cosmetic and psychological outcome for the patients (24).…”

“…Alopecia may result in considerable psychological disturbances and low self-esteem (1). Androgenic alopecia (AGA) is characterized by progressive visible thinning of scalp hair in genetically susceptible men and some women (2).…”

Platelet-rich plasma in interventional dermatology and trichology: How far have we come?

“…Garg et al have successfully documented significant improvement in sensation in post-traumatic and post-burn scars following PRP therapy and this neuronal regenerative potential remains to explored. [3,103] Recent research also points toward the efficacy of three weekly intramatricial PRP injections in refractory nail disorders such nail lichen striatus and idiopathic trachyonychia, with improvement noted in 3-6 weeks. [104] Current data indicates that human hair follicles contain multipotent stem cells (MSCs) other than epithelial and melanocytic stem cells.…”

Regeneration through platelet rich plasma – A cell therapy with a path full of milestones, controversies and cautions!

“…It is picking up the pace for difficult to treat conditions including non-healing ulcers, scarring alopecia, and post-burn scars. [ 1 2 3 ] With encouraging results being reported from the scientific community globally, PRP and its new generations have generated great interest amongst dermatologists, plastic surgeons, orthopedicians, orodental surgeons, faciomaxillary surgeons alike.…”

“…[ 4 ] PRP requires a conducive environment with balanced nutrition and correction of the underlying deficiencies to work to its full potential. [ 2 3 ]…”