Platelet-Rich Plasma Across the Spectrum of Alopecias: Where Are We Now?

November 2023 | Volume 22 | Issue 11 | 1134 | Copyright © November 2023


Published online October 30, 2023

Sara Abdel Azim MSa,b, Cleo Whiting BAa, Adam Friedman MD FAADa

aDepartment of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC
bGeorgetown University School of Medicine, Washington, DC

Hair Restoration Surgery 
PRP may be a beneficial adjuvant to HR surgery for AGA. A clinical trial demonstrated that implantation of follicular grafts embedded with plasma growth factors in 20 males with AGA substantially increased follicular unit yield (P<0.001), resulting in a 15.1% increase in follicular density compared to implantation without plasma GFs.17 An RCT demonstrated that intraoperative PRP as a holding solution for harvested follicular grafts significantly improved the mean density of the implanted grafts at 6 months compared to the control solution (P<0.05).18

Conclusion
PRP is a promising regenerative therapy for NCA, demonstrating superior efficacy to traditional treatment modalities in multiple studies. However, routine implementation is limited by steep out-of-pocket costs, lack of a standardized protocol for the intervention, and variable efficacy among patients. Its use in CA remains limited and requires larger, randomized studies to establish efficacy.

Disclosure
The authors declare no conflicts of interest.
 

REFERENCES

  1. Qi J, Garza LA. An overview of alopecias. Cold Spring Harb Perspect Med. Mar 01 2014;4(3)doi:10.1101/cshperspect.a013615
  2. Tejapira K, Yongpisarn T, Sakpuwadol N, et al. Platelet-rich plasma in alopecia areata and primary cicatricial alopecias: A systematic review. Front Med (Lausanne). 2022;9:1058431. doi:10.3389/fmed.2022.1058431 
  3. Abd El-Magid WM, Mohamed RA, Elsharkawy RE. Diphenylcyclopropenone and platelet-rich plasma in the management of severe or recalcitrant alopecia areata. J Cosmet Dermatol. 2023;doi:10.1111/jocd.15805
  4. Wei W, Zhang Y, Long B, et al. Injections of platelet-rich plasma prepared by automatic blood cell separator combined with topical 5% minoxidil in the treatment of male androgenetic alopecia. Skin Res Technol. 2023;29(7):e13315. doi:10.1111/srt.13315 
  5. Balasundaram M, Kumari R, Ramassamy S. Efficacy of autologous platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial. J Dermatolog Treat. 2023;34(1):2182618. doi:10.1080/09546634.2023.2182618
  6. Shah R, Asim M, Ouellette S, et al. A Randomized Control Trial Comparing the Efficacy of Platelet-Rich Plasma and 5% Topical Minoxidil for the Treatment of Androgenetic Alopecia. J Drugs Dermatol. 2023;22(9):905-909.doi:10.36849/JDD.7031
  7. Singh SK, Kumar V, Rai T. Comparison of efficacy of platelet-rich plasma therapy with or without topical 5% minoxidil in male-type baldness: A randomized, double-blind placebo control trial. Indian J Dermatol Venereol Leprol. 2020;86(2):150-157. doi:10.4103/ijdvl.IJDVL_589_18 
  8. Papakonstantinou M, Siotos C, Gasteratos KC, et al. Autologous platelet-rich plasma treatment for androgenic alopecia: a systematic review and meta-analysis of clinical trials. Plast Reconstr Surg. May 01 2023;151(5):739e-747e. doi:10.1097/PRS.0000000000010076
  9. Morkuzu S, McLennan AL, Kanapathy M, et al. Use of Activated Platelet-Rich Plasma (A-PRP) on Alopecia: A Systematic Review and Meta-Analysis. Aesthet Surg J. 2023;43(8):NP631-NP649. doi:10.1093/asj/sjad073
  10. Tawfik C, Tejeda CI, Haughton AM. Case series evaluating the efficacy and safety of platelet-rich plasma for androgenetic alopecia in pediatric patients. JAAD Case Rep. 2023;37:8-12. doi:10.1016/j.jdcr.2023.04.027
  11. El Taieb MA, Ibrahim H, Nada EA, Seif Al-Din M. Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation. Dermatol Ther. 2017;30(1)doi:10.1111/dth.12437
  12. Trink A, Sorbellini E, Bezzola P, et al. A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol. 2013;169(3):690-4. doi:10.1111/bjd.12397
  13. Dina Y, Aguh C. Use of Platelet-Rich Plasma in Cicatricial Alopecia. Dermatol Surg. 2019;45(7):979-981. doi:10.1097/DSS.0000000000001635
  14. Ozcan D, Tuncer Vural A, Ozen O. Platelet-rich plasma for treatment resistant frontal fibrosing alopecia: A case report. Dermatol Ther. 2019;32(5):e13072. doi:10.1111/dth.13072
  15. Jha AK. Platelet-rich plasma as an adjunctive treatment in lichen planopilaris. J Am Acad Dermatol. 2019;80(5):e109-e110. doi:10.1016/j. jaad.2018.09.013
  16. Bolanca Z, Goren A, Getaldic-Svarc B, et al. Platelet-rich plasma as a novel treatment for lichen planopillaris. Dermatol Ther. 2016;29(4):233-5. doi:10.1111/dth.12343
  17. Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006;118(6):1458-1466. doi:10.1097/01.prs.0000239560.29172.33
  18. Pathania V, Sood A, Beniwal N, Baveja S, Shankar P, Patrikar S. Randomized control trial to study the efficacy and safety of platelet-rich plasma as intraoperative holding solution in hair restoration surgery: A pilot study. Med J Armed Forces India. 2023;79(1):46-53. doi:10.1016/j.mjafi.2021.04.015
  19. Winona State University DWKL. Levels of Evidence - Evidence Based Practice Toolkit - Research Hub at Winona State University. https://libguides.winona.edu/ebptoolkit/Levels-Evidence. Accessed September 22, 2023.

AUTHOR CORRESPONDENCE

Adam Friedman MD FAAD ajfriedman@mfa.gwu.edu
Close Menu