A Split Scalp Study of Single versus Double Spin Platelet-rich plasma Injections in Treatment of Female Pattern Hair Loss: Clinical Effect and Relation to Vascular Endothelial Growth Factor in PRP

Abstract

Abstract Background Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Platelet-rich plasma (PRP) provides an option for patients recalcitrant to the currently approved therapies. As there are many methods for the preparation of PRP, the most suitable for AGA therapy is not yet clear. Aims To compare the efficacy between single and double spin PRP injections in treatment of FPHL and to assess the relationship between the concentrations of vascular endothelial growth factor (VEGF) in the PRP preparation and the treatment results obtained. Patients and Methods 15 female patients with FPHL were enrolled. Each patient was subjected to intradermal injection of PRP (prepared by double-spin method) into the right half of the scalp, in addition to intradermal injection of PRP (prepared by singlespin method) into the left half of the scalp in the form of three treatment sessions three weeks apart. Evaluation of treatment response was done through comparing patients' global photographs, assessment of patients' satisfaction and folliscopic assessment before and after treatment. Results Our results showed clinically significant improvement by comparing patients' photographs in most of the treated patients. In addition, folliscopy revealed significant change of the terminal hair density in the right half of the scalp following treatment sessions.VEGF concentration didn't differ significantly between double-spin and single-spin prepared PRP, also it didn't differ significantly upon calcium activation. Conclusions PRP is an effective treatment modality for FPHL. Double-spin prepared PRP could yield better results in the treatment of FPHL than the single-spin method. However, adding Calcium gluconate prior to PRP injection is of no benefit as it didn't significantly increase the release of VEGF. Yet, further studies discussing different PRP preparation protocols and involving a larger number of cases are needed to minimize statistical errors and to detect the most accurate PRP preparation method with the greatest yield of growth factors.