Platelet-rich plasma injections efficacious for androgenetic alopecia

A monthly schedule of platelet-rich plasma injections was safe and efficacious in patients with androgenetic alopecia and may be preferable to injections administered every three months, according to findings presented by Amelia Hausauer, MD, directory of dermatology at Aesthetx, at the American Society for Dermatologic Surgery Annual Meeting.

Hausauer, formerly of Skin Care and Laser Physicians of Beverly Hills, and colleagues suggested that a growing body of evidence is emerging in support of scalp injections with platelet-rich plasma as a treatment option for androgenetic alopecia. However, guidelines for its use remain limited.

The current analysis was a 6-month, investigator-initiated, single-center, single-blinded prospective randomized trial. Eligible men had Norwood Hamilton stages II to V, while women had Ludwig stage I2 to II1, according to study background.

Clinicians performed one of two regimens of subdermal platelet-rich plasma injections. The first group received three monthly sessions with a fourth booster session 3 months after the initial set. The second group was treated with two sessions every 3 months for a total of two sessions, according to researchers. There were 39 patients total, with the cohort being comprised of 29 men and 10 women.

The researchers evaluated for endpoints including folliscope hair counts, microscopic and global photography at baseline, 3 months and 6 months. Patients also reported their satisfaction via a questionnaire at those time points.

The current presentation included 6-month data.

Compared with baseline, patients in the first treatment group experienced statistically significant increases in hair count (mean change in hairs/cm², +46.7; P < .001). Shaft caliber also improved from baseline in this cohort (+16 mm; P < .001). Further analysis indicated that this was a 29.6% mean increase in hair count and a 31.1% increase in caliber for this treatment arm.

Mean absolute changes among patients in the second group were +13.1 for hair count (P = .009) and +14.8 mm for shaft caliber (P < .001) compared with baseline. The mean percent increase in hair count for this group was 7.2%, with an 26.7% increase in caliber.

Compared with patients in the second treatment group, increases in hair count were statistically significant among those in the first group (mean percent change: group 1, 29.6% vs. group 2, 7.2%; P < .001). Changes in hair count, however, were similar (mean percent change: group 1, +31.1 vs. group 2, +26.7; P = .36).

Questionnaire results showed that patients in the first group were likely to be “very satisfied,” whereas those in the second treatment group were “somewhat satisfied.”

Safety profile information showed a mean rating of two out of a 10-point discomfort scale across study arms. Platelet-rich plasma injections were also found to be safe.

“Subdermal [platelet-rich plasma] injections are an efficacious, tolerable and safe therapy in men and women with [androgenetic alopecia],” Hausauer and colleagues concluded, but noted that the injections may be most effective if administered monthly. “Clinicians should consider these findings when counseling patients and designing optimal treatment plans.” – by Rob Volansky

Reference: Hausauer A, et al. Evaluating the efficacy of different platelet rich plasma (PRP) treatment regimens in the management of androgenetic alopecia: An investigator-initiated, single-center, single-blinded, prospective, randomized clinical trial. Presented at: American Society for Dermatologic Surgery Annual Meeting; Oct. 5-8, 2017; Chicago.

Disclosure: The researchers report that an educational grant was received from Eclipse Aesthetics LLC to fund this investigator-initiated trial.

Editor's Note: This article was updated on October 19 with clarification from the study author.