Platelet-rich fibrin: A review of its role as a new treatment in androgenetic alopecia.

Abstract

Androgenetic alopecia (AGA) is a major cause of hair loss resulting from a complex interplay between various genes and hormones with the result being follicular miniaturization and altered hair cycle dynamics. Platelet-rich plasma (PRP) has a well-established role as adjunctive therapy in AGA but there are many limitations of it. In an attempt to overcome the shortcomings of PRP, liquid platelet-rich fibrin (PRF) was developed. This article critically reviews the protocol for the preparation and clinical outcomes of PRF. The articles published so far in the English language regarding the preparation and clinical outcomes of PRF were reviewed. Among five studies analyzing various centrifugation speeds and centrifugation times, three of the studies favored low-speed centrifugation, whereas two studies did not support this methodology. A horizontal centrifuge may be preferred over a fixed-angle centrifuge for PRF. Five clinical studies on the use of PRF showed a significant effect on AGA. At present, there is no consensus regarding the preparation of PRF. Most studies used fixed-angle centrifugation favored low centrifuge speed and less centrifugation time. Larger studies are needed to determine the optimal centrifugation force and time. A horizontal centrifuge may be preferred over a fixed-angle centrifuge due to the higher yield of platelets, and lesser shear trauma to the cells. In addition, larger, well-designed studies are needed to confirm the benefits of PRF over PRP.