Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol.

J Stevens,S Khetarpal

doi:10.1016/j.ijwd.2018.08.004

Abstract

Androgenetic alopecia (AGA) is a common hair loss disorder caused by genetic and hormonal factors that are characterized by androgen-related progressive thinning of scalp hair in a defined pattern. By the age of 60 years, 45% of men and 35% of women develop AGA. Currently, U.S. Food and Drug Administration-approved treatments for AGA include oral finasteride and topical minoxidil. Due to the limited number of effective therapies for AGA, platelet-rich plasma (PRP) has become an effective alternative treatment. PRP is an autologous concentration of platelets in plasma with numerous growth factors that contribute to hair regeneration. The growth factors contained within the alpha granules of platelets act on stem cells in the bulge area of the hair follicles and stimulate the development of new follicles along with neovascularization. PRP has become a promising treatment modality for AGA. Although there have been several studies previously reported, a standard practice for PRP preparation and administration as well as a method to evaluate results have not been established. This literature review was conducted to evaluate the effectiveness of PRP for AGA and discuss the various treatment protocols that have been proposed.

Highlights

Androgenetic alopecia (AGA), known as female pattern hair loss, is the most common cause of hair loss, affects up to 50% of women over the course of their lifetime, and is known to advance with age and menopause (Rogers and Avram, 2008)
Advocates of platelet-rich plasma (PRP) high in leukocyte concentration believe the presence of leukocytes provide protection from infection, increase growth factor release, and contribute to angiogenesis, matrix production, and hypercellularity (Dohan Ehrenfest et al, 2009, 2012)
A microscopic evaluation and immunohistochemistry were performed 2 weeks after completion of the PRP treatment and showed an increase in Ki67+ epidermal basal keratinocytes, small blood vessels around hair follicles, and hair follicular bulge cells in PRP-treated hair skin (p b .05). These results suggest that PRP may increase keratinocyte proliferation and perifollicular angiogenesis (Gentile et al, 2015)

Summary

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Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol☆,☆☆. MD b a Northeast Ohio Medical University, Rootstown, Ohio b Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio article info. Article history: Received 15 May 2018 Received in revised form 10 August 2018 Accepted 10 August 2018

Introduction

Discussion

Calcium chloride

No weeks

Findings

Proposed treatment protocol

Conclusion