Platelet-Rich Plasma Effectiveness in Treating Androgenetic Alopecia: A Comprehensive Evaluation.
Rúben Lopes-Silva,
Maria Santos,
Maria Luísa Sequeira,
Andreia Silva,
Tatiana Antunes
et al.
Review
Cureus
2025
4 件の引用
PubMed
DOI
CC-BY
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Study Design
- 研究タイプ
- Review
- サンプルサイズ
- 11
- 介入
- Platelet-Rich Plasma Effectiveness in Treating Androgenetic Alopecia: A Comprehensive Evaluation. None
- 比較対照
- Placebo
- 効果の方向
- Positive
- バイアスリスク
- Moderate
Abstract
Platelet-rich plasma (PRP) has gained recognition in regenerative medicine due to its concentration of growth factors that promote hair follicle activity, making it a potential treatment for androgenetic alopecia (AGA). However, variability in PRP preparation and application has led to inconsistent outcomes across studies. This review evaluates the overall effectiveness of PRP in treating AGA based on the latest available evidence. A systematic search was conducted in PubMed, identifying 156 articles related to PRP and AGA. After applying inclusion and exclusion criteria, 11 studies published between January 2020 and May 2024 were selected. The studies focused on the efficacy of PRP compared to placebo or other treatments and explored different PRP formulations and application methods. The majority of studies demonstrated that PRP is effective in increasing hair density and thickness in patients with AGA. There was a general consensus on the positive effects of PRP, although results varied due to differences in preparation protocols, platelet concentration, and delivery methods. Additionally, combining PRP with other treatments, such as microneedling or topical medications like minoxidil, showed enhanced efficacy in several studies. While some studies reported conflicting outcomes, the overall evidence supports PRP as a promising treatment for AGA. In conclusion, PRP is a viable therapeutic option for AGA, particularly for increasing hair density and thickness. However, the variability in treatment protocols highlights the need for standardized PRP preparation and application methods. Future research should focus on refining these protocols and exploring the potential of combination therapies to maximize treatment effectiveness and consistency.
Full Text
Figures
Tables
Table 1
| Author | Year | n | Study design | Outcome | Results |
| Dicle et al. [ | 2020 | 25 | Two randomized groups receiving either monthly PRP or placebo for three sessions. After a three-month washout period, treatments were switched. Participants had six PRP sessions and were evaluated at baseline, four months, and nine months. | The outcome measured was hair density using trichoscopy. To ensure accuracy, evaluations were conducted by two dermatologists. | A significant increase in hair density was observed in the group who began receiving PRP administrations after the three-month washout period. |
| Gressenberger et al. [ | 2020 | 28 | Two groups. One group received five treatments of 3-4 ml of PRP delivered intracutaneously, while the other group received saline solution. | The main outcome measures were hair density and hair diameter, both measured using the trichoscopy. The secondary objective was the clinical improvement, which was evaluated by an independent reviewer using patient photographs. | The change in hair density was not statistically different between the PRP-treated group and the control group. Hair thickness did not show statistically significant differences between the groups. |
| Ozcan et al. [ | 2022 | 62 | Two groups of 31 participants. One group received four PRP sessions applied via dermapen microneedling at two-week intervals. The other group received PRP injected intraepidermally using a manual point-by-point technique with an insulin needle. | Outcomes: hair count, hair density, anagen hair, telogen hair, average hair length, vellus hair density, vellus hair count, terminal hair count, vellus hair ratio, terminal hair ratio. Hair pull tests and trichoscopy evaluations were conducted before and after treatments. | PRP treatment significantly improved hair pull tests, satisfaction scores, and increased hair count, density, terminal hair density, terminal hair count, and hair length compared to baseline in both treatment groups. |
| Qu et al. [ | 2021 | 52 | Split-head study. In three consecutive sessions at one-month intervals, PRP was injected subdermally into half of the alopecia areas while the other half received saline. Global photographs were taken at baseline, three, and six months. | Outcomes: Hair count, hair density, hair diameter, anagen hairs. Photographic analysis was conducted by five experts. | After three PRP treatments, hair count, density, and diameter significantly improved at three and six months. PRP increased hair density from three months and hair count, diameter, and anagen hair ratio at six months compared to the control side. |
| Shapiro et al. [ | 2020 | 35 | Split-head study. One side of the head received PRP while the other side received the same amount of saline solution. Participants underwent three treatment sessions at one-month intervals, with a final follow-up three months after the last session. | Primary outcome was hair density evaluation in AGA patients treated with non-activated PRP, compared to placebo, using trichoscopy by a blinded investigator. Secondary outcomes included changes in hair diameter, safety, and treatment tolerance. | The increase in hair density and hair diameter was not significantly greater than the increase in the placebo group. Approximately half of the participants noticed some improvement. Pain was the most reported symptom. |
| Singh and Singh [ | 2023 | 80 | Split-head study in two groups. In group one, PRP with an activator was injected into the right half of the scalp and PRP without an activator into the left half. Group two received the opposite. Patients were further categorized by platelet counts in their PRP. | Primary outcomes were hair density and hair thickness. Secondary outcomes were patient self-assessment and changes in the Norwood Hamilton scale. | Hair density and thickness increased with and without activator, with higher platelet counts boosting both. Activator improved density at four months and thickness at six. No significant change in Norwood Hamilton scale. Patients showed moderate to marked improvement. |
Table 2
| Author | Year | n | Study design | Outcome | Results |
| Afzal et al. [ | 2024 | 70 | Two groups of 35 participants. One group received monthly injections of PRP and the other 5% topical minoxidil therapy given as 1 ml, two times daily for six months. Participants of both groups were assessed before treatment and after three and six months. | The efficacy of both groups was evaluated using the patient satisfaction scores, global photography evaluated by a dermatologist, and the hair pull test. | At six months, 77% of PRP patients had a negative hair pull test vs. 40% with minoxidil. Improvement was reported by 91.4% in the PRP group and 74.3% with minoxidil. PRP was effective in 74.5% vs. 43.7% for minoxidil. |
| Balasundaram et al. [ | 2023 | 51 | Two groups. The minoxidil one used 5% topical minoxidil twice daily for six months, while the PRP group received non-activated PRP injections over three monthly sessions, with a final follow-up three months post-treatment. | Primary outcomes evaluated by two blinded dermatologists: hair count, hair density, and anagen proportion Secondary objectives included patient satisfaction score, safety, and tolerance. | No statistical difference was seen between the groups in increasing total hair count, terminal hair count, and density at week 12. The median patient satisfaction score for hair texture at week 24 was better for minoxidil than PRP, but not for hair density. |
| Qu et al. [ | 2022 | 80 | Split-head study in two groups. One group received injection of PRPF in the right side of the head and saline in the other side; the other group received injection of PRPF in the right side of the head and PRP in the other side. The treatment was processed three times, one month apart. | Outcomes: hair count, hair density, terminal/vellus hair amount, mean hair diameter, hair growth rate, telogen hair ratio, and global appearance. Patient satisfaction and side effects was recorded. Evaluations included trichoscopy, global photography, and hair pull tests. | The administration of PRPF showed a statistically significant improvement on hair loss compared to placebo. PRPF seems to be superior to PRP alone on increasing hair count. Satisfaction evaluation scored an average of eight (one to ten scale) and the side effects were minimal. |
| Ramadan et al. [ | 2021 | 126 | Three groups participated: two received PRP via microneedling or injections, while the control group did not. All received 5% topical minoxidil; women also took 100 mg spironolactone, and men took 2.5 mg finasteride, with PRP given over three to six months. | Outcomes focused on enhancing hair density and comparing the changes in AGA grades before and after therapy, assessed by three dermatologists using dermoscopy. Patient satisfaction was evaluated. | PRP treatment significantly improved outcomes compared to control, with microneedling outperforming syringe injections. After six months, 95% of patients had negative pull tests, and hair diameter and density increased more in the microneedling group than in the other group. |
| Wu et al. [ | 2023 | 75 | Three groups. The first group received intradermal PRPF injections. The second group received topical minoxidil 5% twice a day. The third group received a combination of minoxidil and intradermal PRPF injections. Groups one and two received three PRPF treatment sessions at one-month intervals. | Hair count, terminal hair count, vellus hair ratio, hair density, mean thickness, hair growth rate, telogen hair ratio, and global appearance evaluated with trichoscopy and global photographs. Secondary outcomes: patient satisfaction with the treatment and side effects. | A notable increase in hair count, density, and growth rate was noted following PRPF therapy compared to minoxidil treatment. PRPF combined with topical minoxidil yielded greater enhancements in efficacy and patient satisfaction compared to monotherapy. |
Table 3
| Author | Collected blood (ml) | Centrifugation | PRP obtained (ml) | PRP applied (ml/cm2) | Sessions’ number | Sessions’ intervals | Follow-up (months) |
| Alzal et al. [ | 30 | Double Spin | - | 0.1-0.2 | 6 | 1 month | 6 |
| Balasundaram et al. [ | 19 | Double Spin | 2 | 0.1–0.2 | 3 | 1 month | 6 |
| Dicle et al. [ | 30 | Single Spin | 5 | - | 3 | 1 month | 9 |
| Gressenberger et al. [ | 20 | Single Spin | 3-4 | 0.1 | 5 | 4-6 weeks | 6 |
| Qu et al. [ | 40 | Double Spin | 4 | 0.05-0.1 | 3 | 1 month | 6 |
| Ozcan et al. [ | 10 | Single Spin | 4-5 | 0.1 | 4 | 2 weeks* | 6-12** |
| Ramadan et al. [ | 10 | Single Spin | 5 | 0.1 | 3-6 | 1 month | 9 |
| Shapiro et al. [ | 10 | Single Spin | 5 | 0.1-0.2 | 3 | 1 month | 6 |
| Singh and Singh [ | 25 | Double Spin | 2 | 0.1 | 3 | 1 month | 6 |
| Wu et al. [ | - | - | 1 | 0.05-0.1 | 3 | 1 month | 6 |
References
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- Male pattern androgenetic alopecia BMJ, 1998
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- Platelet-rich plasma for androgenetic alopecia treatment: a randomized placebo-controlled pilot study Acta Derm Venereol, 2020
- Platelet rich plasma application by dermapen microneedling and intradermal point-by-point injection methods, and their comparison with clinical findings and trichoscan in patients with androgenetic alopecia Dermatol Ther, 2022
- Platelet-rich plasma for androgenic alopecia: a randomized, placebo-controlled, double-blind study and combined mice model experiment J Cosmet Dermatol, 2021
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- Effect of platelet counts and activator in platelet-rich plasma on the treatment of androgenetic alopecia, split-head comparison: a randomised, double-blind study Indian J Dermatol Venereol Leprol, 2023
- Efficacy of platelet-rich plasma vs. 5% topical monixidil for the treatment of androgenetic alopecia J Coll Physicians Surg Pak, 2024
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- Efficacy of platelet-rich plasma plus basic fibroblast growth factor on the treatment of androgenic alopecia Plast Reconstr Surg, 2023
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