Intralesional Platelet-Rich Plasma Injection in Patients with Recalcitrant Alopecia Areata.

OBJECTIVES: Alopecia areata (AA) is a common, chronic autoimmune disease that causes non-cicatricial hair loss. Its relapsing and remitting nature leads to the search for new, effective treatment options. The study aimed to evaluate the therapeutic efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroid (ILS) injections in patients with AA. METHODS: A retrospective chart review was carried out from 2020-2021. A total of 75 patients with AA were included in the study. Thirty-six patients were treated with intralesional PRP, and 39 patients were treated with ILS injections for three sessions. The patients were evaluated with a hair pull test and SALT scores at months 0, 3, and 6. RESULTS: Of 75 patients, the mean age of the PRP group was 34.33±10.61, and the mean age of the ILS group was 33.82±13.31 years. After three PRP or ILS therapy sessions, at 3. and 6. months, SALT 3 and SALT 6 scores were statistically significantly lower in the PRP group than in the ILS group (p=0.038, p<0.001, respectively). When the treatment response was evaluated at the end of the 6th month in the PRP group, there was no response in 2 (5.5%) patients, partial response in 1 (2.7%) patient, good response in 3 (8.4%) patients, and very good response in 30 (83.4%) patients. Only 2 (5.9%) patients had a clinical relapse in a 6-month period. Side effects were seen in 16 (44.4%) patients in the PRP group and 8 (20.5%) patients in the ILS group, and the frequency of side effects in the PRP group was statistically significantly higher than in the ILS group (p=0.026). However, the side effects of both groups were minor, such as itching, pain, burning, ecchymosis, and folliculitis. CONCLUSION: PRP seems to be an effective and safe treatment option for limited patchy alopecia areata, but its superiority over ILS has not been fully demonstrated, making ILS still the first-line treatment.