Androgenetic Alopecia Treatment with Platelet Rich Plasma (PRP)

Androgenetic alopecia is an often hereditary condition with thinning of the hair into vellus hairs which occurs in males and females according to a male pattern (Hamilton classification) or a female pattern (ludwig classification)

It is psychologically devastating and treatments include topical (minoxidil), oral (finasteride) treatments sometimes so ineffective that the only solution is wearing a wig.

Mesotherapy has been used for over 40 years and consists of local injections but little evidence to this day exists that it would be effective. More recently* platelet rich plasma (PRP) injections have been used for this indication (it was previously used mainly in joint conditions)

Even with a relatively short time* it has  been used, evidence (although not enough yet) shows that it might show some effectiveness.

Study 1: Platelet-rich plasma for androgenetic alopecia: a pilot study.

Schiavone G, Raskovic D, Greco J, Abeni D.

Dermatol Surg. 2014 Sep;40(9):1010-9. doi: 10.1097/01.DSS.0000452629.76339.2b.

• 64 patients
• Two injections of a leukocyte platelet-rich plasma with the addition of concentrated plasmatic proteins were administered at baseline and after 3 months (single spin at baseline and double-spin centrifugation at 3 months). Photographs were taken at baseline and after 6 months, and 2 independent evaluators rated them.
• Results show that some improvement was observed in almost all patients and the proportion of patients improving importantly clinical was 40.6% for one evaluator and 54.7% for the other.

Study 2: Platelet-rich plasma in androgenic alopecia: myth or an effective tool.

Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N.

J Cutan Aesthet Surg. 2014 Apr;7(2):107-10. doi: 10.4103/0974-2077.138352.

• 11 patients suffering from hair loss due to androgenic alopecia and not responding to 6 months treatment with minoxidil and finasteride were included in this study. The hair pull test was performed before every treatment session.
• A volume of 2-3 cc PRP was injected in the scalp. The treatment was repeated every two weeks, for a total of four times. The outcome was assessed after 3 months by clinical examination, macroscopic photos, hair pull test and patient’s overall satisfaction.
• Results after 3 weeks show:
  • a significant reduction in hair loss was observed between first and fourth injection.
  • Hair count increased from average number of 71 hair follicular units to 93 hair follicular units. -Therefore, average mean gain is 22.09 follicular units per cm(2.)
• After the fourth session, the pull test was negative in 9 patients.

Conclusion: These two studies suggest that PRP might be effective in the treatment of androgenetic (androgenic) alopecia. Although study 2 is stronger evidence-based medicine than study 1, further studies, such as randomized-control ones are warranted to further investigate this method.

*At the time of publication

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland

Source of information: the 2 aforementioned studies