Investigating the Safety and Efficacy of Platelet-Rich Plasma (PRP) Treatment for Female Androgenetic Alopecia: Review of the Literature

Santo Raffaele Mercuri,Giovanni Paolino,Matteo Riccardo Di Nicola,Laura Vollono

doi:10.3390/medicina57040311

Santo Raffaele Mercuri, Giovanni Paolino + Show 2 more

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https://doi.org/10.3390/medicina57040311

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Abstract

Background: female androgenetic alopecia (FAGA) is a common cause of non-scarring alopecia in women, affecting approximately 40% of women by age 50, bearing a significant psychosocial burden on affected patients. Platelet-rich plasma (PRP) has been widely investigated as a potential effective treatment for several dermatological conditions, including male androgenetic alopecia (MAGA). However, few studies have been conducted focusing on the use of PRP in FAGA. The aim of this review was to identify reports that investigated the use of PRP for the treatment of FAGA. Methods: Electronic databases of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to September 2020 have been searched using different combinations of the following terms: “androgenetic alopecia,” “FAGA,” “female pattern hair loss,” “platelet-rich fibrin,” “platelet-rich plasma,” and “PRP”. Results and conclusions: Eight (n = 8) clinical studies consistent with our research were identified. A total of 197 subjects has been enrolled in the included studies. All of them were adult female patients (mean age: 38.9) affected by female pattern hair loss. PRP is a well-tolerated procedure which showed promising results in males-only and mixed populations of AGA patients. PRP showed to produce high levels of satisfaction and improvement in the quality of life in patients affected by FAGA. In the light of this evidence, PRP may be proposed in patients who did not respond or did not tolerate topical minoxidil, as well as in combination with topical and oral treatments.

Highlights

Androgenetic alopecia (AGA) is an encompassing term for non-scarring hair loss that typically begins in adult life, mediated by the action of androgens on genetically susceptible hair follicles [1]
As many authors consider female androgenetic alopecia (FAGA) a separate entity from male androgenetic alopecia, studies conducted on a mixed population including both sexes were excluded in order to allow correct evaluation of the results
A few studies have focused on the potential use of Platelet-rich plasma (PRP) in women affected by AGA have been conducted to date

Summary

Introduction

Androgenetic alopecia (AGA) is an encompassing term for non-scarring hair loss that typically begins in adult life, mediated by the action of androgens on genetically susceptible hair follicles [1]. The histopathological findings are identical in both sexes, clinical presentation and therapeutic implications differ considerably, the term female androgenetic alopecia (FAGA) advocated by many authors [2,3,4]. Polymorphisms in the androgen receptor gene on the X chromosome, as well as in the genes encoding for the cytochrome p450 alpha-aromatase enzyme, 3β-hydroxysteroid dehydrogenase, and vitamin D receptor have been associated with the development and persistence of FAGA, determining the age of onset, progression, patterning and severity [7,8,9,10,11]

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