INTRODUCTION
Scarring alopecia, also known as cicatricial alopecia, is a hair loss due to the destruction of epithelial stem cells at the hair follicle bulge mediated by inflammation, infection, or other pathologic process.1 This irreversible destruction of stem cells results in fibrous scar tissue and loss of functional hair follicles, leading to permanent hair loss.1 Due to the nature of primary scarring alopecia irreversibly damaging the hair follicles, the treatment of scarring alopecia is very challenging. Early interventions are crucial to manage inflammation and prevent secondary pathological processes.8 Intralesional and topical corticosteroids are considered the first-line therapies to target the inflammation in scarring alopecia.9 Other treatments, including oral immunomodulating agents, antibiotics, and antifungals, are used depending on the type of scarring alopecia as well as other underlying factors.9
Platelet-rich plasma (PRP) therapies recently gained recognition as a potential treatment for hair loss, particularly in nonscarring alopecia.5-7,10 PRP is an autologous serum obtained through venipuncture, which is then centrifuged to extract a high concentration of platelets, growth factors, and cytokines. These growth factors include platelet-derived growth factors (PDGF), vascular endothelial growth factors (VEGF), epidermal growth factor (EGF), transforming growth factor β (TGF-β), and fibroblast growth factor (FGF), all of which play critical roles in cell differentiation, fibroblasts proliferation, tissue angiogenesis, and regeneration.11 Several studies, including a randomized controlled trial, have demonstrated improvements in hair density and growth in androgenic alopecia and alopecia areata when PRP is used as a treatment or as an adjunctive therapy.5,6 The precise mechanisms are not fully understood, but it is believed that the growth factors in PRP modulate the immune response, reduce inflammation, and promote hair follicle growth. However, there is a lack of well-described studies regarding the use of PRP in scarring alopecias. Given the absence of a proven standard treatment for scarring alopecia, exploring PRP as a potential therapeutic option offers the opportunity for a new treatment for scarring alopecia. In this review, we summarized the current literature on the usage of PRP in different types of scarring alopecia.
Platelet-rich plasma (PRP) therapies recently gained recognition as a potential treatment for hair loss, particularly in nonscarring alopecia.5-7,10 PRP is an autologous serum obtained through venipuncture, which is then centrifuged to extract a high concentration of platelets, growth factors, and cytokines. These growth factors include platelet-derived growth factors (PDGF), vascular endothelial growth factors (VEGF), epidermal growth factor (EGF), transforming growth factor β (TGF-β), and fibroblast growth factor (FGF), all of which play critical roles in cell differentiation, fibroblasts proliferation, tissue angiogenesis, and regeneration.11 Several studies, including a randomized controlled trial, have demonstrated improvements in hair density and growth in androgenic alopecia and alopecia areata when PRP is used as a treatment or as an adjunctive therapy.5,6 The precise mechanisms are not fully understood, but it is believed that the growth factors in PRP modulate the immune response, reduce inflammation, and promote hair follicle growth. However, there is a lack of well-described studies regarding the use of PRP in scarring alopecias. Given the absence of a proven standard treatment for scarring alopecia, exploring PRP as a potential therapeutic option offers the opportunity for a new treatment for scarring alopecia. In this review, we summarized the current literature on the usage of PRP in different types of scarring alopecia.
