Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature
Abstract
:1. Introduction
1.1. FAGA: Clinical Features, Pathogenesis and Current Therapeutic Options
1.2. Platelet Rich Plasma (PRP)
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Adverse Events | Results | Endpoints | Assessment Methods | Duration of the Study (Weeks) | N° of Sessions | Time Session | PRP Technique | Other Concurrent Treatments | Intervention | Ludwig Stage | Mean Age | N° of Subjects | Type of Study | Year | Author | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Transient edema and tenderness (=4), mild itching (N = 2) | Improvement in both hair count and hair diameter in both groups; greater improvement in hair thickness than hair count in Group A compared to Group B. | Hair count; hair diameter | Phototrichograms using Follioscope PT® software at BL and w14 | 14 | 1 | Single session | 60 mL of peripheral blood in g 8 mL of 4% sodium citrate solution centrifuged with the SmartPReP® platelet concentrate system; 4 mL injected in the scalp (intra/perifollicular areas) | No (naïve or 6 months wash-out) | NA-L-PRP followed by 12 weeks of weekly polydeoxirybonucleotide (PDRN) (Group A) vs. 12 weeks of weekly PDRN only (Group B) | NR | 33.9 (20–60) | 40 | Randomized, controlled comparative trial | 2015 | Lee, S. | ||||||
NR | No significant difference in the main hair count or hair mass between Group A and B; higher perceived improvement in hair loss in Group A compared to Group B (13.3% vs. 0%); higher perceived hair mass in Group A compared to Group B (26.7% vs. 18.2%) | Hair count; hair mass index; patient satisfaction | Global photography; Cohen hair | check system; patient survey | 27 | 1 | Single session | 60 mL of peripheral blood centrifuged in Angel PRP system (Cytomedix®); produced PRP diluted with platelet-poor plasma; 10 mL of low-concentration, leukocyte- and | erythrocyte-free PRP for injection | No (naïve or 2 months wash-out) | NA-P-PRP (Group A) vs. saline injections (Group B) | II | NR | 26 | Randomized, double-blind, placebo-controlled trial | 2016 | Puig, C. | ||||
Swollen forehead/face (29%); sore/painful scalp over 3 days (26%) | 58% patients claiming to be satisfied with the treatment, with 65% of them reporting either “marked” or “exceptional” improvement. | Patient satisfaction | Custom survey | 1 to 3 | Every 8–12 weeks | NR | NR; patients who underwent treatment with supplements, topical minoxidil and oral finasteride | u-PRP | NR | 51 | 41 | Patient survey | 2017 | Laird, M. | |||||||
Temporary pain and pinpoint bleeding at the injection sites | Significant increase in hair density and hair thickness, improvement in hair-pull test in the PRP-treated areas compared with placebo areas; higher overall patient’s satisfaction for PRP areas compared to placebo areas. | Hair density (number of | hairs/cm2); hair diameter; hair volume; patient’s satisfaction | Global photography; hair pull test; patient’s satisfaction scale; phototrichograms | 28 | 1 to 4 | Every other week | 10 mL of peripheral blood in 1.5 mL of sodium citrate solution centrifuged at 1200 rpm for 15 min; buffy coat collected and centrifuged at 2000 rpm for 10 min; lower layer collected | No | AA-L-PRP (Group A) vs. saline injections (Group B) | I-II-III | 29.3 (20–45) | 30 | Randomized, intrapatient split-side, placebo-controlled trial | 2018 | Tawfik, A. | |||||
NR | Significant increase in hair count, hair density and hair diameter; reduction in the vellus hair number | hair count; hair density (frontal-central-vertex); hair diameter; vellus hair count (frontal-central-vertex) | Global photography; hair pull test; phototrichograms using Trichoscan® software | 24 | 4 | Every 2 weeks | 10 mL of peripheral blood in acid-citrate-dextrose solution in MyCells® system centrifuged at 2500 rpm for 10 min; 5 mL of pure and concentrated autologous platelet-rich plasma injected in the scalp (perifollicular areas) | NR; patients not responding to treatment with | topical minoxidil and/or oral finasteride lasting for at least 1 year | NA-L-PRP | I; I-II; II; II-III | 47.1 (33–64) | 10 | Open-label, not randomized single-group clinical study | 2019 | Starace, M. | |||||
Pain/discomfort/bruising (N = 4) | Greater degree of improvement in hair count in Group B compared to Group A; mild improvement in hair density and cumulative thickness in Group A compared to improvement in Group B. Similar degree of improvement in vellus hair density in both groups; significantly greater improvement in QOL responses in Group A compared to Group B | Hair count; terminal hair density; vellus hair density; total thickness; patient’s quality of life | Phototrichograms using Trichoscan® software; 16-item qualityof | life | (QOL) questionnaire; 7-item questionnaire | 48 | 3 | Every 4 weeks; washout among treatment regimens: 8 weeks | 60 mL of peripheral blood in 8 mL of citrate dextrose solution centrifuged at 1500 rpm for 10 min followed by 10 further mins at 3500 rpm after removal of the red cell layer; 5 mL of platelet-poor plasma injected in the scalp | No (naïve or 3 months wash-out) | NA-PRP followed by topical minoxidil 1/day for 12 weeks (Group A) vs. topical minoxidil 1/day for 12 weeks then PRP (Group B) | I-II | NR | 20 | Randomized, controlled, comparative trial | 2020 | Bruce, AJ | ||||
Scalp tightness (N = 10); swelling, redness, post-injection bleeding, tingling (Group A and B) | Significant improvement in hair density in Group A compared to no improvement in Group B; significant improvement in mean hair diameter and global clinical appearance in Group A compared to Group B | Hair density; hair diameter; global clinical appearance | Global photography; magnified photography | 24 | 3 | Every 4 weeks | 22 mL of peripheral blood in Eclipse® PRP system centrifuged at 3500 rpm for 10 min; removal of the uppermost platelet-poor plasma suprenatant; remaining 4.0 mL platelet-rich plasma injected in the scalp | No (naïve or 12 months wash-out) | NA-L-PRP (Group A) vs. saline injections (Group B) | I-II-III | 50 (27–85) | 30 | Randomized, controlled trial | 2020 | Dubin, D | ||||||
/ | / | Severity of alopecia; hair count; hair density; hair diameter; anagen to telogen ratio; vellus to terminal ratio; patient’s | quality of life | Severity of Alopecia Tool (SALT) score; phototrichogram using Trichoscan® software; Dermatology Life Quality Index (DLQI) | 64 (ensimated) | / | / | / | No (naïve or 2 weeks washout) | / | / | / | 16 (enstimated) | Randomized, double blind, intrapatient, split-side, placebo control trial | 2021 (enstimated) | ClinicalTrials.gov identifier: NCT03474718 |
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Mercuri, S.R.; Paolino, G.; Di Nicola, M.R.; Vollono, L. Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature. Medicina 2021, 57, 311. https://doi.org/10.3390/medicina57040311
Mercuri SR, Paolino G, Di Nicola MR, Vollono L. Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature. Medicina. 2021; 57(4):311. https://doi.org/10.3390/medicina57040311
Chicago/Turabian StyleMercuri, Santo Raffaele, Giovanni Paolino, Matteo Riccardo Di Nicola, and Laura Vollono. 2021. "Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature" Medicina 57, no. 4: 311. https://doi.org/10.3390/medicina57040311