Platelet-rich plasma in alopecia areata: intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling

Ragab, Sally Esam Marouf; Nassar, Samia; Morad, Heba Ahmed; Hegab, Doaa Salah

doi:10.15570/actaapa.2020.35

Cited by 16 publications

(22 citation statements)

References 24 publications

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“…[ 28 ] n = 80 (50 m, 30 f); alopecia areata (AA) Comparison: cryotherapy versus MN Group 1: cryotherapy Group 2: MN MN automated pen, 1.00–2.00 mm needles, session endpoints marked as 4–5 passes longitudinally, vertically, and diagonally 6, once every 2 weeks 12 weeks Hair counts, hair density, Severity of Alopecia Tool (SALT) scores, photographic evaluation, self assessments Yes Hair counts, hair density, SALT scores, photographic evaluation, and self assessments improved in groups 1 and 2; higher changes to SALT scores in group 2 versus 1 No adverse events in group 2 3 Ragab et al. [ 29 ] n = 60 (48 m, 12 f); AA Combination: PRP solution Group 1: PRP injections Group 2: fractional CO 2 laser + PRP topical Group 3: MN + PRP topical MN roller, 1.50 mm needles, session endpoints marked as 4–5 passes longitudinally, vertically, and obliquely until mild erythema noted 3, once monthly 3 months SALT Yes SALT scores improved in groups 1, 2, and 3; no difference in SALT scores across groups No serious events reported; pain higher in group 1 versus group 3 3 Abdallah et al. [ 30 ] n = 20 (19 m, 1 f); AA Intrapatient comparison: triamcinolone acetonide injections, minoxidil 5% injections Patch 1: triamcinolone acetonide injections Patch 2: 5% minoxidil injections Patch 3: triamcinolone acetonide injections + 5% minoxidil injections Patch 4: MN Patch 5: control MN roller, session endpoints marked as 4–5 passes longitudinally, vertically, and diagonally 4, once every 4 weeks 16 weeks SALT, Lesional Area & Density (LAD) scores Yes SALT and LAD scores decreased in patches 1, 2, 3, and 4; largest differences seen in patches 1 and 3 versus patch 5 No serious events reported 2 Giorgio et al.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, Ragab et al. demonstrated that, over a 3-month period, MN alongside topical PRP improves SALT scores similarly to fractional CO 2 laser therapy alongside topical PRP (Table 3 ) [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Ragab et al. found that MN alongside topical PRP improved hair parameters similarly to PRP injections, and suggested that MN may also enhance transdermal delivery for AA [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…No serious events reported 1 A table summarizing all included studies assessing the use of MN on AA and AT subjects. Each study summary features parameters regarding author, year of publication, total subjects, gender, study type, treatment regimen, MN procedure, number of MN sessions, treatment duration, assessment endpoints, effectiveness, adverse events, and Jadad score CO 2 laser therapy alongside topical PRP (Table 3) [29].…”

Section: Nomentioning

confidence: 99%

“…As an adjunct therapy, Giorgio et al suggested that the release of growth factors from MN may induce immunosuppressive actions that amplify the effects of substances such as 5-aminolevulinic acid [31]. Ragab et al found that MN alongside topical PRP improved hair parameters similarly to PRP injections, and suggested that MN may also enhance transdermal delivery for AA [29].…”

Section: Aa and Atmentioning

confidence: 99%

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

English¹,

Ruiz²,

DoAmaral³

2021

Dermatol Ther (Heidelb)

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Introduction: Microneedling (MN) is a minimally invasive procedure involving the induction of percutaneous wounds with medicalgrade needles. In this literature review, we investigate clinical data on MN for the treatment of hair loss disorders. Methods: A literature search was conducted through PubMed up to November 2021 to identify original articles evaluating the use of MN on hair loss disorders. The database was searched using the following keywords: ''microneedling,'' ''micro needling,'' ''micro needle,'' ''microneedle,'' ''needle,'' ''dermaroller'' and ''alopecia,'' ''hair loss,'' ''alopecia,'' ''areata,'' ''cicatricial,'' or ''effluvium,'' Results: A total of 22 clinical studies featuring 1127 subjects met our criteria for inclusion. Jadad scores ranged from 1 to 3, with a mean of 2. As an adjunct therapy, MN improved hair parameters across genders and a range of hair loss types, severities, needling devices, needling depths of 0.50-2.50 mm, and session frequencies from once weekly to monthly. Across 17

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Ragab et al. found that MN alongside topical PRP improved hair parameters similarly to PRP injections, and suggested that MN may also enhance transdermal delivery for AA [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Nomentioning

confidence: 99%

Section: Aa and Atmentioning

confidence: 99%

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

English¹,

Ruiz²,

DoAmaral³

2021

Dermatol Ther (Heidelb)

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Single‐cell transcriptome analysis of fractional CO₂ laser efficiency in treating a mouse model of alopecia

Hasegawa

Fujimoto²,

Mita

et al. 2022

Lasers Surg Med

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Objectives Hair loss, including alopecia, is a common dermatological issue worldwide. At present, the application of fractional carbon dioxide (CO2) laser in the treatment of alopecia has been documented; however, the results vary between reports. These varying results may be due to the limited knowledge of cellular action in laser‐irradiated skin. The objective of this study was to investigate the molecular and cellular mechanisms of laser treatment under effective conditions for hair cycle initiation. Methods A fractional CO2 laser was applied and optimized to initiate the hair cycle in a mouse model of alopecia. Several cellular markers were analyzed in the irradiated skin using immunofluorescence staining. Cellular populations and their comprehensive gene expression were analyzed using single‐cell RNA sequencing and bioinformatics. Results The effective irradiation condition for initiating the hair cycle was found to be 15 mJ energy/spot, which generates approximately 500 μm depth columns, but does not penetrate the dermis, only reaching approximately 1 spot/mm2. The proportion of macrophage clusters significantly increased upon irradiation, whereas the proportion of fibroblast clusters decreased. The macrophages strongly expressed C–C chemokine receptor type 2 (Ccr2), which is known to be a key signal for injury‐induced hair growth. Conclusions We found that fractional CO2 laser irradiation recruited Ccr2 positive macrophages, and induced hair regrowth in a mouse alopecia model. These findings may contribute to the development of stable and effective fractional laser irradiation conditions for human alopecia treatment.

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Fractional carbon dioxide laser alone and as an assisted drug delivery for treatment of alopecia areata: a clinical, dermoscopic and immunohistochemical study

et al. 2023

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Alopecia areata (AA) is a common cause of hair loss with no available universally successful treatment. Thus, new innovative treatments are urgently needed. This research aimed to evaluate the effectiveness of fractional carbon dioxide laser (FCL) alone or combined with triamcinolone acetonide (TA) solution, platelet-rich plasma (PRP), or vitamin D3 solution in treating AA. Sixty-four AA patients with 185 lesions were recruited and divided into four treatment groups. All patients received FCL either alone (group A, n = 19) or followed by topical TA (group B, n = 16) or PRP (group C, n = 15), or vitamin D3 solution (group D, n = 14). The response was assessed using Alopecia Areata Severity Index (AASI), MacDonald Hull and Norris grading, and trichoscopy. Histopathological features and immunohistochemical decorin expression were studied. All groups showed significant improvement in AASI compared to the baseline, with insignificant differences between them. Post-treatment, trichoscopic features of disease activity significantly decreased in all groups. Compared to control biopsies, both anagen follicles and decorin expression were significantly decreased in all pretreatment specimens. After treatment, all groups showed significantly increased anagen follicles and decorin expression compared to the baseline. Accordingly, FCL is an effective treatment for AA alone or combined with TA, PRP, or vitamin D3 solution. In AA, Decorin expression was downregulated, while enhanced expression following successful treatment occurred. This suggests the role of decorin in AA pathogenesis. However, further research is still recommended to clarify the exact role of decorin in AA pathogenesis and to investigate the therapeutic benefits of decorin-based therapy.

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Platelet-rich plasma in alopecia areata: intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling

Cited by 16 publications

References 24 publications

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

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

Single‐cell transcriptome analysis of fractional CO₂ laser efficiency in treating a mouse model of alopecia

Fractional carbon dioxide laser alone and as an assisted drug delivery for treatment of alopecia areata: a clinical, dermoscopic and immunohistochemical study

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Platelet-rich plasma in alopecia areata: intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling

Cited by 16 publications

References 24 publications

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

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

Single‐cell transcriptome analysis of fractional CO2 laser efficiency in treating a mouse model of alopecia

Fractional carbon dioxide laser alone and as an assisted drug delivery for treatment of alopecia areata: a clinical, dermoscopic and immunohistochemical study

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Single‐cell transcriptome analysis of fractional CO₂ laser efficiency in treating a mouse model of alopecia