Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Net Letter
2017:83:3;412-412
doi: 10.4103/0378-6323.191128
PMID: 27679404

A study of the efficacy of platelet-rich plasma in the treatment of androgenetic alopecia in males

Shruti Gupta, TN Revathi, S Sacchidanand, HV Nataraj
 Department of Dermatology, Venereology and Leprosy, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Correspondence Address:
Shruti Gupta
Nivedita Niwas, 32-UB, Jawahar Nagar, New Delhi - 110 007
India
How to cite this article:
Gupta S, Revathi T N, Sacchidanand S, Nataraj H V. A study of the efficacy of platelet-rich plasma in the treatment of androgenetic alopecia in males. Indian J Dermatol Venereol Leprol 2017;83:412
Copyright: (C)2017 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Androgenetic alopecia is a type of progressive patterned hair loss, where there is androgen-mediated conversion of susceptible terminal hairs into vellus hairs in genetically predisposed individuals.[1] It is known that transforming growth factor-β, an inhibitory factor secreted by hair follicles, plays an important role in the pathogenesis of androgenic alopecia.[1],[2] The potential of platelet-rich plasma in promoting hair growth is known since 1993.[3] This study was conducted to determine the effect of platelet-rich plasma in the management of androgenetic alopecia, mainly in terms of improvement in hair density and diameter and assess the variation in response among the different grades of androgenetic alopecia.

This was an open-labeled pilot study conducted in the department of dermatology, venereology and leprosy, Bangalore Medical College and Research Institute, Bengaluru. Approval of the Institute Ethics Committee was obtained. A convenience sample of 30 men in the age group of 20–50 years, with androgenetic alopecia Grade III-VII (Hamilton–Norwood classification) were included in the study. Patients with alopecia other than androgenetic alopecia, those on any other treatment modalities for androgenetic alopecia, history of bleeding disorders and active infection at the local site were excluded from the study. After obtaining written informed consent, a detailed history was elicited from each patient and a clinical examination was performed. Hair density and diameter were measured using a CapilliCARE hair and scalp analysis system (trichoscan).[4] Blood investigations were performed to rule out metabolic causes of alopecia.

Platelet-rich plasma was prepared by the double spin method.[5],[6] The scalp was activated by microneedling following which platelet-rich plasma was massaged on the scalp. A total of six sittings were administered in each patient at an interval of 15 days. Hair density and diameter were measured over an area near the vertex, 10 cm from the glabella. Digital photographs were taken before starting the treatment and periodically thereafter. Results were assessed at the end of 6 months on the basis of change in the density and diameter of hair as measured by trichoscan, by an independent observer evaluation of global photographs and patient's self-satisfaction, as evaluated by a questionnaire. Data analysis was done with the help of Epidemiological Information Package (2010) developed by the Centre for Disease Control, Atlanta.

The age of participants ranged from 25 to 35 years with a mean age of 28.3 ± 3.1 years. The number of patients belonging to androgenetic alopecia grades 6, 5A, 5, 4A, 4, 3V and 3 were 11, 7, 3, 2, 2, 3 and 2, respectively. The age at onset of androgenetic alopecia ranged between 20 and 28 years with the mean age being 23.2 ± 2.3 years. The duration of hair loss varied from 1 to 11 years with the mean duration being 5.5 ± 2.6 years. A positive family history was present in 26 (86.7%) of thirty patients.

On the basis of trichoscan evaluation, the percentage increase in hair diameter was 39.8 ± 17.2 [Table - 1] and the percentage increase in hair density was 39.7 ± 16.5 [Table - 2]. On the basis of independent observers' evaluation of global photographs, the average improvement was 30.2 ± 12.2%. Ten (33.3%) patients had <25% improvement, 17 (56.7%) had 25–49.9% improvement and 3 (10%) had 50–74.9% improvement [Figure - 1] and [Figure - 2]. On the basis of self-assessment by the patient, the mean percentage improvement was 30 ± 13.1, the range being 10–70. Twenty eight (93.3%) patients reported complete cessation of hair fall as early as at the end of 2 months of treatment. Twenty (66.7%) patients reported an increase in hair growth. Eleven (36.7%) patients also noticed an improvement in hair quality in terms of hair texture. Patients with a lower grade of alopecia responded better to the therapy [Table - 3]. The response to platelet-rich plasma was found to be inversely proportional to the duration of alopecia [Table - 4]. The response also varied significantly with family history [Table - 5]. No adverse effects were noted.

Table 1: Change in the diameter of hair as measured by trichoscan
Table 2: Change in the density of hair as measured by trichoscan
Table 3: Efficacy of platelet-rich plasma with respect to grade of androgenetic alopecia
Table 4: Efficacy of platelet-rich plasma with respect to duration of alopecia
Table 5: Efficacy of platelet-rich plasma with respect to family history
Figure 1: Pre- and post-treatment (at 6 months) photograph of patient 1
Figure 2: Pre- and post-treatment (at 6 months) photograph of patient 2

Androgenetic alopecia is the most common cause of hair loss. Platelet-rich plasma contains a large array of growth factors such as platelet-derived growth factors, vascular endothelial growth factors, epidermal growth factors, fibroblast growth factor-2 and insulin-like growth factors which promote hair growth by inducing the follicular stem cells to shift from a dormant to an active state. Vascular endothelial growth factor-8 and platelet-derived growth factor-4 also facilitate angiogenesis around the hair follicle.[7] Rinaldi et al. found that growth factors from platelet-rich plasma could prevent dermal papilla apoptosis, prolong anagen phase and delay catagen and telogen phase.[8] There is histopathological evidence supporting these findings.[9]

The findings from our study also support the beneficial role of platelet rich plasma in androgenetic alopecia; the improvement in length and density of hair was objectively measured and confirmed [Figure - 3]. Complete cessation of hair fall was seen as early as following 3–4 sittings. Another interesting fact noticed was that the response to platelet-rich plasma depended significantly on the grade of androgenetic alopecia, duration of hair loss and the presence of family history of androgenetic alopecia.

Figure 3: Trichoscan findings showing change in diameter and density of hair

The major limitation of this study is small sample size. Other limitations are lack of a control group and short follow up period. Controlled, prospective clinical trials are needed to assess the role of this modality in the treatment of androgenetic alopecia.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References
1.
Sinclair RD. Disorders of hair. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. UK: Blackwell Publishing Ltd.; 2010. p. 66.1-66.100.
[Google Scholar]
2.
Paus R, Oslen EA, Messenger AG. Hair growth disorders. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's Dermatology in General Medicine. 7th ed. USA: The McGraw-Hill Companies, Inc.; 2008. p. 766-9.
[Google Scholar]
3.
Knighton DR, inventor; Curative Technologies, Inc., assignee. Method for Promoting Hair Growth. United States patent 5178883. 1993 Jan 12.
[Google Scholar]
4.
Sarangi K. Androgenic alopecia. In: Savant SS, editor. Textbook of Dermatosurgery and Cosmetology. 2nd ed. India: Association of Scientific Cosmetologists and Dermatosurgeons; 2008. p. 576-8.
[Google Scholar]
5.
Marx RE. Platelet-rich plasma (PRP): What is PRP and what is not PRP? Implant Dent 2001;10:225-8.
[Google Scholar]
6.
Sánchez AR, Sheridan PJ, Kupp LI. Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Implants 2003;18:93-103.
[Google Scholar]
7.
Reese RJ. Autologous platelet rich plasma: What do we know? Important concepts relevant to hair restoration surgery. Hair Transplant Forum Int 2010;20:14-7.
[Google Scholar]
8.
Rinaldi F, Sorbellini E, Coscera T. The role of platelet rich plasma to control anagen phase: Evaluation in vitro and in vivo in hair transplant and hair treatment. Int J Trichol. 2011;3:S14-5.
[Google Scholar]
9.
Takikawa M, Nakamura S, Nakamura S, Ishirara M, Kishimoto S, Sasaki K, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg 2011;37:1721-9.
[Google Scholar]

Fulltext Views
169

PDF downloads
90
Show Sections