Patient, protocol factors influence platelet-rich plasma efficacy in androgenetic alopecia

Six patient and protocol factors were found to affect the efficacy of platelet-rich plasma treatment on patients with androgenetic alopecia, according to a multivariate network analysis.

Platelet-rich plasma (PRP) is often used as a therapeutic treatment for androgenetic alopecia (AGA). However, due to the lack of protocols for its administration, evidence for its efficiency is sparse.

“Many individuals worldwide are negatively affected by androgenetic alopecia,” Aditya K. Gupta, MD, PhD, FAAD, FRCPC, professor of dermatology at the University of Toronto, and colleagues wrote. “There is a general technique for administering PRP to persons with AGA. ... This technique is currently not standardized.”

By systematically reviewing 25 peer-reviewed studies with 10 unique PRP regimens, researchers conducted a multivariable meta-regression and network meta-analyses to identify the patient- and protocol-related factors associated with the efficacy of PRP monotherapy.

First, researchers analyzed the patient factors that may impact PRP treatment according to a mean 6-month change in hair density from baseline. Results showed that treatment at a younger vs. older age yielded better results (P < .05). Improvement in hair density was also greater in women than men by 241 hairs/cm² (P < .05).

Second, the study analyzed the efficacy of protocol factors. Results revealed that more frequent PRP sessions with decreased time between treatments correlated with higher hair density compared with less frequent sessions with increased time between treatments (P < .05). Chemically activated PRP also performed significantly better by 16.47 hairs/cm² compared with inactivated PRP (P < .05). The change in hair density was more positive by 145.39 hairs/cm² with double centrifugation rather than single spin (P < .05). Lastly, whole-head administration proved better by 60.16 hairs/cm² compared with split-scalp administration (P < .05).

“The data presented here demonstrate that there are many factors than can influence PRP’s efficacy in AGA. ... There is a need for a more homogenized protocol in PRP for AGA, and more work is needed to ensure patients are provided with optimal PRP therapy,” Gupta and colleagues wrote.