Platelet-rich plasma for androgenic alopecia treatment: A comprehensive review

Girijala, Raghavendra L; Riahi, Ryan R; Cohen, Philip R.

doi:10.5070/d3247040910

Cited by 23 publications

(24 citation statements)

References 88 publications

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“…After Uebel and colleagues reported cosmetic improvement of AGA with PRP in 2006, 19 numerous trials have been conducted to investigate the efficacy of this agent on AGA and the results across these trials produced incongruent conclusions. [8][9][10][11][12][13][14][15][16][17][18] Evidence to support the existence of a "design effect" -in terms of split-scalp or whole-head administration of PRP monotherapy in AGA trials -have never been reported before. The design effect could partly explain why the whole-head study by Yaseer et al 33 showed a significant increase in total hair density at 6 months, while split-scalp trial by Zhou et al 30 did not.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Since the publication of Carlos Uebel's work in 2006, 5 the AGA literature has been flooded with studies on PRP's efficacy. [8][9][10][11][12][13][14][15][16][17][18] Uebel et al 19 were the first to demonstrate that AGA can be cosmetically improved with growth factors derived from platelets. 5,19 Platelet-rich plasma, as its name suggests, is essentially a concentrate of platelets, anucleate cells that contain anagen-promoting growth factors 8,20 ; the concentration is, on average, three-to sevenfold higher than that of whole blood.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15][16][17][18] Uebel et al 19 were the first to demonstrate that AGA can be cosmetically improved with growth factors derived from platelets. 5,19 Platelet-rich plasma, as its name suggests, is essentially a concentrate of platelets, anucleate cells that contain anagen-promoting growth factors 8,20 ; the concentration is, on average, three-to sevenfold higher than that of whole blood. The therapeutic effect of PRP is believed to be related to the these factors.…”

Section: Introductionmentioning

confidence: 99%

“…The therapeutic effect of PRP is believed to be related to the these factors. 5,8,11 Relative to other treatments, persons with AGA exhibit higher compliance, and report fewer adverse effects with PRP. 5,21 In trial studies, PRP is administered in a whole-head or split-scalp manner.…”

Section: Introductionmentioning

confidence: 99%

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The effect of placebo in split‐scalp and whole‐head platelet‐rich plasma trials for androgenetic alopecia differs: Findings from a systematic review with quantitative evidence syntheses

Gupta

Bamimore

2022

J of Cosmetic Dermatology

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Background: Some studies have shown that platelet-rich plasma (PRP) improves androgenetic alopecia (AGA), while others do not. We determined whether the placebo effect significantly varies between split-scalp and whole-head trials on PRP monotherapy for AGA. Our rationale was based on the plausibility of PRP diffusing to the control (i.e., "placebo") side of split-scalp trials. This is not possible in whole-head studies. Methods:We systematically searched the literature for available data. Our choice of analyses and outcomes were determined by the available data.Results: Our endpoint was change in total hair density 6 months after baseline. Our regression showed that total hair density after 6 months was significantly (p < 0.05) higher in the placebo arm of split-scalp trials, compared to whole-head studies, by 37 hairs/cm 2 . Our one-arm meta-analyses showed that the pooled change in total hair density between the PRP side and placebo side in split-scalp studies was −3 hairs/ cm 2 (p = 0.37), that is, a slight decrease in hair density in the placebo side of the scalp.For whole-head studies, the corresponding difference in total hair density between patients receiving PRP and those on placebo was −30 hairs/cm 2 (p = 0.000017), that is, a much larger decrease in hair density. Patients in the placebo group in whole-head trials lost significantly more hair than in the placebo side of the split-head trials where hair loss was comparatively reduced -presumably because of PRP diffusing from the treatment side of the scalp. Conclusions:The association between design (i.e., split-scalp vs. whole-head) and outcome, in placebo arms of AGA trials on PRP monotherapy, had never been reported. This "design effect" could partly reconcile the incongruent conclusions across the PRP literature for AGA; furthermore, clinical guidelines can consider "design effect" when selecting evidence to base care practices on. K E Y W O R D S pattern baldness, placebo effect, platelet-rich plasma, regression analysis, split scalp | 1455 GUPTA And BAMIMORE How to cite this article: Gupta AK, Bamimore MA. The effect of placebo in split-scalp and whole-head rich plasma trials for androgenetic alopecia differs: Findings from a systematic review with quantitative evidence syntheses. J

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of placebo in split‐scalp and whole‐head platelet‐rich plasma trials for androgenetic alopecia differs: Findings from a systematic review with quantitative evidence syntheses

Gupta

Bamimore

2022

J of Cosmetic Dermatology

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“…The platelet‐rich plasma, containing numerous growth factors, is then injected into the deep dermis or subcutaneous tissue at a volume of 4–8 mL per session. Mild side effects include scalp pain, headache, and burning sensation, but these effects usually subside in 10–15 min post‐injection and do not warrant use of topical anesthesia or pain medications 109 …”

Section: Injectablesmentioning

confidence: 99%