Effects of Platelet Rich Plasma in Treatment of Androgenetic Alopecia (AGA): An Interventional Study
Abstract
Androgenetic alopecia (AGA) is a common condition having severe psychosocial implications. Numerous modalities of treatment are there but none is satisfactory both to the patient and the treating physician. This present study was carried out on 50 patients of AGA aged between 20 to 50 years to find out the effect of PRP with micro needling on AGA. These selected cases were treated by activation of the procedure site (scalp) by micro needling technique and application of platelet rich plasma on the activated site. A total of 6 such sittings were given to each patient at interval of 30 days each, over a total period of 6 months. Macro photographs were taken at baseline and after 6 months by 2 independent observers who rated those using of standardized seven-point rating scale of clinical change. In this study, 24% patients perceived stoppage of hair fall, 68% patients noticed reduction in hair fall, 6% of the patients perceived no change in hair fall and remaining 2% patients perceived increased hair fall after last visit with minimal or no side effects. So over all 92% patients had noticed some clinical improvement in their condition. So it was concluded that PRP with micro needling is an effective combination in treating AGA. This may be because micro needling has its own action and it would also help in promoting penetration of PRP but the level of evidence of this fact as available published data is low. This demands further studies to gain more evidence before it is used more extensively.
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Introduction
Androgenetic alopecia (AGA) is a non scarring alopecia that affects both males and females.1 It's prevalence increases with age and affects 50% of men and women by 50 years of age.2 By the age of 20, over 90% of males demonstrate some degree of hair loss which is usually progressive and patterned.3 In contrast, in females the alopecia presents as diffuse loss of hair largely affecting the frontal and vertex areas.
Androgenetic alopecia involves the action of androgens which are needed for regulation of hair growth in both sexes.4 The hormone specifically involved is the Dihydrotestosterone (DHT) which leads to change in local metabolism leading to conversion of susceptible terminal hairs into vellus hairs.1 Additionally, Transforming Growth Factor–Beta (TGF-B) an inhibitory factor secreted by hair follicles, micro-needling proliferation and cellular differentiation.
Treatment modalities proposed for promoting hair growth in AGA include topical Minoxidil, topical Amenexil, oral and topical 5-alpha reductase inhibitors (finasteride and dutasteride), Oral biotin, botulinum toxins injections, hair transplant surgery etc. Platelet rich plasma (PRP) is an autologous preparation of platelets in concentrated plasma5 and is an exciting non surgical therapeutic option for hair growth and stimulation. 6
Conclusion
PRP with micro needling is an effective combination because micro needling has its own action and it would also help in promoting penetration of PRP but the level of evidence as of now , from the available published data is low , this demands further studies to gain more evidence before it is used more extensively.