Abstract
Platelet-rich plasma (PRP) represents a novel therapy tested and is used more and more frequently in dermatology and cosmetic surgery for a variety of conditions, including androgenic alopecia (AGA), a common condition with a complex pathogenesis involving genetic factors, hormonal status and inflammation. We performed an extensive literature search which retrieved 15 clinical trials concerning the use in AGA of PRP therapy, alone or in combination, in male, female or mixed patient groups. A quantitative statistical meta-analysis of n = 17 trial groups proved significant increases in hair density from 141.9 ± 108.2 to 177.5 ± 129.7 hairs/cm2 (mean ± SD) following PRP (p = 0.0004). To the best of our knowledge, this is the first meta-analysis that proved a statistically significant correlation between the number of PRP treatments per month and the percentage change in hair density (r = 0.5, p = 0.03), as well as a negative correlation between the mean age of treatment group and the percentage change in hair density (r = −0.56, p = 0.016). Other factors considered for analysis were the PRP preparation method, amount used per treatment, hair diameter, terminal hairs and pull test. We conclude that PRP represents a valuable and effective therapy for AGA in both males and females if patients are rigorously selected.
Highlights
Alopecia is a common condition that affects a large part of the population, Caucasian males, the most common type being androgenic alopecia (AGA), a progressive disorder with significant psychosocial effects that can lead to depression
The literature search performed according to the criteria described within the Methods section resulted in the identification of 15 clinical trials, including studies on the effects of Platelet-rich plasma (PRP) treatment of AGA suitable for inclusion in our meta-analysis
Two studies included separate PRP and negative control groups, while two other studies comprised two groups with different PRP administration protocols, differing in timing or preparation quality; three studies compared effects of PRP alone with those of PRP combined with minoxidil, or different PRP/minoxidil combinations, or other combinations of synthetic growth factors similar to those retrieved in PRP [16]
Summary
Alopecia is a common condition that affects a large part of the population, . The most common type being androgenic alopecia (AGA), a progressive disorder with significant psychosocial effects that can lead to depression. There are several theories trying to explain the complex multifactorial pathogeny of this condition. One of them postulates that chronic perifollicular microinflammation amplifies the expression of pro-inflammatory cytokines, leading to oxidative stress. The oxidative profile acts in combination with high levels of androgens, genetic predisposition and environmental factors such as stress, affecting the corticotropin-releasing hormone pathway and cortisol levels, generating the condition [1]. Gene variants that lead to increased activity of 5α-reductase or increased sensitivity of androgen receptors are deemed to play an important role [2]. Recent studies have evidenced inflammatory infiltrates located in perifollicular/perivascular areas with histiocytes and lymphocytes
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