Successful Management of Treatment-Resistant Alopecia Areata with Platelet Rich Plasma: A Case Series

Abstract

Introduction. Alopecia areata (AA) is an autoimmune disease-causing non-scarring alopecia. It is usually treated with immunosuppressive agents, to which some patients fail to respond adequately. Material and Methods. Three patients with AA refractory to standard therapy were treated with intra-dermal injection of autologous platelet rich plasma (PRP) every four weeks. Results. All three patients showed remarkable improvement after multiple sessions of PRP treatment. Conclusion. Autologous PRP is safe and effective in treatment-resistant forms of AA demonstrated in many case reports; therefore it deserves further study with randomized, placebo-controlled trials.

Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study

“…In literature there are few clinical trials discussing treatment of AA with PRP [9], [16], [17], [18], [19], [20], [21], [22], [23], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35] and most of them agree with our results. On the other hand, D'Ovidio and Roberto in 2014 showed restricted usefulness of PRP in long standing cases (more than 2 years) and proposed that PRP effect may be held in reserve for mild cases [44].…”

“…These GFs are believed to stimulate stem cells sited in HF at the bulge areas leading to growth of fresh follicles and enhancing angiogenesis [13], [15]. Despite of its promising results in AA, a paucity of randomized controlled clinical trials had been published to assess the efficiency of PRP in management of AA [9], [13], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], 29], [30], [31], [32], [33], [34], [35]. Photobiomodulation (PBM), or low-level laser (or) light therapy (LLLT) is using red light (600-700 nm) or near infrared (700 nm-1000+nm) which is obtained from 5 to 500 mW light-emitting diode (LED) source [36], [37].…”

Platelet-rich plasma in alopecia areata and primary cicatricial alopecias: A systematic review

“…The PRP preparation protocols of included studies are demonstrated in Tables 3 , 4 . Regarding the centrifugation method, there were 13 studies using single spin method ( 33 , 34 , 36 , 39 , 43 , 47 , 49 , 52 , 53 , 58 , 60 , 63 , 64 ), 10 using double spin method ( 35 , 37 , 38 , 40 – 42 , 45 , 46 , 51 , 56 ), and eight provided no information ( 44 , 48 , 54 , 55 , 57 , 59 , 61 , 62 ). Several types of PRP activators were used; seven studies used calcium chloride ( 37 , 38 , 41 , 45 , 46 , 49 , 60 ), four used calcium gluconate ( 33 , 34 , 36 , 42 ), one used calcium carbonate ( 52 ), two did not use any activators ( 48 , 53 ), and 17 provided no information ( 35 , 39 , 40 , 43 , 44 , 47 , 51 , 54 – 59 , 61 – 64 ).…”

“…Regarding treatment protocol, most studies used three or four treatment sessions, with 15 using three sessions ( 33 , 34 , 38 , 40 – 42 , 45 , 47 , 50 , 53 , 54 , 56 , 60 , 63 , 64 ), six using four sessions ( 35 , 36 , 39 , 49 , 57 , 59 ), two treated until a satisfactory response was obtained ( 51 , 61 ), and the remaining studies used different number of sessions. Our included studies selected different treatment intervals, with the most common interval being 4 weeks, selected by 17 studies ( 33 , 34 , 36 , 38 , 40 – 42 , 44 , 45 , 47 , 51 , 55 , 56 , 58 , 60 , 62 , 64 ); five studies selected 3 weeks ( 35 , 39 , 50 , 57 , 59 ), four selected 2 weeks ( 37 , 46 , 49 , 52 ), one selected 1 week ( 43 ), and four selected interval of ≥ 6 weeks ( 53 , 54 , 62 , 63 ).…”

“…Mubki reported an increased hair diameter in combined PRP and TA injected scalp side compared to a decline in the contralateral side in a 22-year-old female with chronic diffuse AA for 5 years ( 49 ). Two case reports published in 2019 reported some efficacy of PRP as adjuvant therapy on hair regrowth in AT patients ( 51 , 52 ). Of the two studies, one study initiated PRP as adjuvant therapy after a 7-month course of Janus kinase inhibitor (JAKi) treatment in an 11-year-old patient with AT ( 52 ), and another study added PRP as an adjuvant to topical corticosteroids and minoxidil ( 51 ).…”