Local Injection versus Topical Microneedling of Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review.
Johannes Albert Biben,
Ryan Reinhart,
Karina Karina,
Kuswan Ambar Pamungkas,
Krista Ekaputri
et al.
Other
Archives of plastic surgery
2025
PubMed
DOI
CC-BY
PDF
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Study Design
- Тип исследования
- systematic review
- Вмешательство
- Local Injection versus Topical Microneedling of Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review. Autologous platelet-rich plasma (PRP) via syringe injection or topical application with microneedlin
- Препарат сравнения
- Placebo
- Направление эффекта
- Positive
- Риск систематической ошибки
- Unclear
Abstract
Autologous platelet-rich plasma (PRP) has gained popularity for hair restoration due to its effectiveness and safety. PRP could be administered through direct local injections to the scalp or applied topically with the aid of microneedling therapy. This systematic review aims to elaborate on the effectiveness of PRP administered with syringe injection and topical PRP with microneedling combination for the treatment of androgenetic alopecia (AGA). A literature search was employed through PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and Scopus. The database was searched using terms and keywords: "platelet-rich plasma" and "microneedling" and "androgenetic alopecia." Inclusion criteria are human study, patients with AGA, studies that compare PRP with syringe injection and the combination of PRP and microneedling. Exclusion criteria are animal study, review, case reports, or studies on other form of alopecia. A total of 108 articles found in the database. Title and abstract screening yield 12 articles. After full-text reading three articles were included in the review. A combination of PRP and microneedling appears to yield more superior results than direct syringe injection. Topical PRP and microneedling potentially give better results on AGA cases. Further high-quality studies with uniform protocol are needed to confirm these findings. Level of Evidence I.
Full Text
Figures
Fig. 1
PRISMA flow diagram for the systematic review comparing local PRP injection versus topical microneedling-delivered PRP for androgenetic alopecia.
flowchart
Fig. 2
Summary of included study characteristics and risk of bias assessment for the PRP delivery method comparison in hair loss treatment.
chart
Fig. 3
Comparative efficacy outcomes between PRP injection and microneedling-assisted PRP for hair density or growth in androgenetic alopecia patients.
chart
Fig. 4
Patient satisfaction or adverse event comparison between the two PRP administration routes for androgenetic alopecia treatment.
chart
Fig. 5
Summary of evidence quality and clinical recommendations for PRP delivery methods in androgenetic alopecia based on the systematic review findings.
chartTables
Table 1
| Study |
Muhammad
|
Ramadan
|
Ozcan
|
|---|---|---|---|
| Was the study described as randomized? | +1 | +1 | +1 |
| Was the method of randomization appropriate? | +1 | −1 | +1 |
| Was the study described as blinded? | 0 | 0, 5 | 0 |
| Was the method of blinding appropriate? | 0 | +1 | 0 |
| Was there a description of withdrawals and dropouts? | 0 | 0 | 0 |
| Was there a clear description of the inclusion/exclusion criteria? | +1 | +1 | +1 |
| Was the method used to assess adverse effects described? | 0 | +1 | 0 |
| Was the method of statistical analysis described? | +1 | +1 | +1 |
| Total score | 4 | 3, 5 | 4 |
Table 2
| Study | Total subjects | Intervention | PRP protocol | Injection and microneedling protocol |
Additional therapy
| Treatment and follow-up protocol |
|---|---|---|---|---|---|---|
|
Muhammad et al
| Group I | Volume of blood: 20 mL | Device: dermaroller | No data | 3 sessions | |
|
Ramadan et al
| Group I | Volume of blood: 10 mL | Device: dermapen | Female: | 3–6 sessions | |
|
Ozcan et al
| Group I | Volume of blood: 10 mL | Device: dermapen | No additional therapy | 4 sessions |
Table 3
| Study | Hair count/volume/density/diameter | Change of anagen/telogen hair | Hair pull test | Patient assessment | Physician assessment |
|---|---|---|---|---|---|
|
Muhammad et al
| Hair count increase (mean ± SD) | – | Hair pull test conversion (positive to negative) | Conversion of hair loss perception from “severe” to “mild/moderate” | – |
|
Ramadan et al
| 1. Improvement of hair volume/density by clinical evaluation (mean ± SD) | – | Negative in over 95% of all patients | Satisfaction rate: 88% of all patients | – |
|
Ozcan et al
| 1. Improvement of hair count (mean ± SD) | 1. Change of anagen hair (mean ± SD) | 1. Before vs. after in both group I and group II | Group I vs. group II | Group I vs. group II |
Table 4
| Study |
Adverse effect
|
|---|---|
|
Muhammad et al
| The “severe” and “very severe” pain perception level |
|
Ramadan et al
| Group I (23 patients): burning pain, scalp pain, headache |
|
Ozcan et al
| No data |
References
- Advances in hair growth
- Nonsurgical hair restoration treatment Cutis, 2019
- Androgenetic alopecia: therapy update Drugs, 2023
- The inflammatory component of androgenetic alopecia J Am Acad Dermatol, 2022
- Novel drug delivery approaches for the management of hair loss Expert Opin Drug Deliv, 2020
- Physiopathology and current treatments of androgenetic alopecia: going beyond androgens and anti-androgens Dermatol Ther, 2019
- What's new in therapy for male androgenetic alopecia? Am J Clin Dermatol, 2023
- Platelet-rich plasma: evolving role in plastic surgery Plast Reconstr Surg, 2021
- Safety concerns when using novel medications to treat alopecia Expert Opin Drug Saf, 2018
- Platelet-rich plasma for hair restoration Facial Plast Surg Clin North Am, 2020
- Clinical administration of microneedles: skin puncture, pain and sensation Biomed Microdevices, 2009
- Comparison of efficacy of platelet-rich plasma (PRP) with PRP microneedling in androgenetic alopecia Cureus, 2022
- Evaluation of adding platelet-rich plasma to combined medical therapy in androgenetic alopecia J Cosmet Dermatol, 2021
- 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
- Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement Syst Rev, 2015
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews BMJ, 2021
- Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care
- Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996
- Protective effect of surgery against early subtalar arthrodesis in displaced intra-articular calcaneal fractures: a meta-analysis Medicine (Baltimore), 2015
- Micro-needling depth penetration, presence of pigment particles, and fluorescein-stained platelets: clinical usage for aesthetic concerns Aesthet Surg J, 2017
- Platelet-rich plasma with microneedling in androgenetic alopecia: study of efficacy of the treatment and the number of sessions required J Cutan Aesthet Surg, 2021
- Microneedling with platelet-rich plasma versus microneedling with topical 5% minoxidil in patients with androgenetic alopecia- a comparative study J Evol Med Dent Sci, 2017
- A comparative study of microneedling with platelet-rich plasma plus topical minoxidil (5%) and topical minoxidil (5%) alone in androgenetic alopecia Int J Trichology, 2017
- Dermoscopic assessment of microneedling alone versus microneedling with platelet-rich plasma in cases of male pattern alopecia: a split-head comparative study Int J Trichology, 2020
- Efficacy of platelet-rich plasma and concentrated growth factor in treating androgenetic alopecia - a retrospective study Ann Maxillofac Surg, 2020
- Platelet-rich plasma and microneedling improves hair growth in patients of androgenetic alopecia when used as an adjuvant to minoxidil J Cosmet Dermatol, 2018
- Platelet-rich plasma with microneedling in androgenetic alopecia along with dermoscopic pre- and post-treatment evaluation J Cosmet Dermatol, 2018
- A randomized blinded retrospective study: the combined use of micro-needling technique, low-level laser therapy and autologous non-activated platelet-rich plasma improves hair re-growth in patients with androgenic alopecia Expert Opin Biol Ther, 2020
- Use of activated platelet-rich plasma (A-PRP) on alopecia: a systematic review and meta-analysis Aesthet Surg J, 2023
- Platelet-rich plasma as a therapy for androgenic alopecia: a systematic review and meta-analysis J Dermatolog Treat, 2022
- Microneedling and its use in hair loss disorders: a systematic review Dermatol Ther (Heidelb), 2022
- The thickness of human scalp: normal and bald J Invest Dermatol, 1972
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