Treatment of androgenetic alopecia with platelet-rich plasma

Androgenetic alopecia, or female pattern baldness (AA) – hair loss caused by genetic and hormonal factors, which is characterized by an androgen-related progressive decrease in scalp hair density. By the age of 60, the disease affects 45% of men and 35% of women. To date, oral oral finasteride and topical minoxidil have been approved by the FDA for the treatment of androgenetic alopecia. However, their limited effectiveness necessitates the search for new treatments for AA. One of them is PRP therapy, which is described in the article estet-portal.com by Drs. J. Stevens and S. Khetarpal.

• Available treatments for androgenetic alopecia
• Mechanism of action of PRP-therapy in the treatment of alopecia
• Proposed protocol for the treatment of androgenetic alopecia with PRP-therapy

Available treatments for androgenetic alopecia

Alopecia reduces the quality of life of patients, causing psychological and emotional discomfort. Effective and safe treatment of this disease can significantly improve the condition of patients.

Available therapies for androgenetic alopecia include:

• minoxidil;
• finasteride;
• spironolactone;
• food additives;
• low intensity light therapy;
• surgical hair transplantation.

While topical minoxidil and oral finasteride are FDA approved for the treatment of androgenetic alopecia, these drugs have shown limited clinical efficacy in some patients.

Benefits of PRP Therapy for the treatment of androgenetic alopecia:

• autologous;
• minimal invasiveness;
• no risk of serious side effects;
• greater availability (compared to transplantation).

Mechanism of action of PRP therapy in the treatment of alopecia 

During wound healing, activated platelets release growth factors and cytokines from alpha granules. These substances are involved in:

• fibroblast activation;
• collagen synthesis;
• extracellular matrix stimulation;
• increased expression of endogenous growth factors.

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Cell proliferation, differentiation, angiogenesis and hemostasis necessary for hair regrowth are contributed to:

• platelet growth factor;
• transforming growth factor beta;
• vascular endothelial growth factor;
• epidermal growth factor;
• insulin-like growth factor-1.

 

 

Photo 1: female, 46 years old, before and 3 months after 2 sessions of PRP-therapy for the treatment of androgenetic alopecia

IGF-1 has been shown to induce and prolong the anagen phase. Platelets also contain dense granules containing bioactive factors that increase membrane permeability and modulate inflammation:

• serotonin;
• histamine;
• dopamine;
• calcium;
• adenosine.

The exact mechanism of action of PRP in alopecia is not fully understood. However, PRP is believed to influence the hair growth cycle by prolonging the anagen phase, preventing apoptosis and the onset of the catagen phase, and accelerating the transition from telogen to anagen.

Many studies demonstrate the effectiveness of PRP in the treatment of androgenetic alopecia.

Angiogenesis and increased follicular vascularization are considered critical for the onset of the anagen phase. Conversely, androgenetic alopecia is characterized by a deterioration in blood circulation and a decrease in oxygen pressure.

The growth factors in PRP act on stem cells in hair follicles to promote neovascularization and folliculogenesis. There is also an increase in the expression of beta-catenin, which enhances the proliferation, survival of cells of the papilla dermis and angiogenesis. Proposed Protocol for Treatment of Androgenetic Alopecia with PRP Therapy 

Based on our own experience, the authors recommend using PRP as an adjunct therapy for AA along with topical and/or oral therapies (eg, minoxidil, spironolactone, finasteride) because PRP does not suppress the hormonal component of androgenetic alopecia.

Read also:

PRP Therapy for Antiaging Hands: The Possibilities of Platelet-Rich Plasma Based on the studies reviewed, the authors recommend preparing PRP by single-turn centrifugation to obtain pure PRP with 3 to 6 times the average platelet concentration in blood and to minimize granulocyte count.

 

Photo 2: female, 31 years old, before and 4 months after 5 sessions of

PRP-therapy for the treatment of androgenetic alopecia Most of the successful studies have added an activator (calcium chloride or calcium gluconate) to PRP, which can promote the release of growth factors.

The authors recommend administering PRP by

subdermal bolus injections

because this technique is less painful and generally more effective. The creation of subdermal depots ensures the diffusion of PRP and reduces the number of injections. Injection points are located in the area of ​​foci of baldness, as a rule, along the hairline, on the crown, crown of the head.

Course of procedures:

During the first 3 months, PRP therapy is carried out every 4 weeks, and then – every 3 months during the first year of treatment (6 sessions during the first year – at 1, 2, 3, 6, 9 and 12 months).

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Plasmolifting – scope and main advantages However, after the first 3 months of therapy, the interval between PRP treatments may be 6 months.

Both men and women have seen positive results in treatment of androgenetic alopecia with PRP therapy:

hair restoration;

• increased hair density;
• Improve the quality of life.
PRP therapy –

promising treatment for androgenetic alopecia

, according to research results. Its main advantages – high safety, minimum side effects and a short rehabilitation period. However, the method of preparation, dosage of platelet-rich plasma, as well as the technique of administration, the number of procedures and the interval between them are not standardized. Therefore, there is a need for further research. Adapted from International Journal of Women’s Dermatology.

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