Platelet-rich plasma in androgenetic alopecia

Abstract

The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich plasma (PRP) and its use in androgenetic alopecia (AGA). The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on PRP. A comprehensive literature search was done in the English language on the PRP across multiple databases. The grade of evidence and strength of recommendation were evaluated on the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) framework. A draft of clinical recommendations was developed on the best available evidence, which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, the final consensus statement was prepared. A total of 30 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], and case series) were critically evaluated, and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of manual double-spin method for the preparation of PRP for AGA. Minimum three to five sessions of PRP are recommended for AGA with a gap of 1 month between the two sessions. Patients with Grade II to V Norwood Hamilton classification of AGA are the ideal subset for PRP. A total of 5 to 7 mL of PRP and 0.05 to 0.1 mL/cm 2 is the recommended dose of PRP for AGA. Activation of PRP is not required when it is used for AGA. About 1 to 1.5 million platelets/μL of platelets in PRP is the recommended platelet concentration in PRP for the treatment of AGA. I-PRF (injectable platelet-rich fibrin) has also been found to be useful in AGA, although further studies are required to establish its role. PRP can also have an adjunctive role in hair transplantation procedures.

Evaluation of the effects of adding an adipose tissue‐derived stromal vascular fraction to platelet‐rich plasma injection in the treatment of androgenetic alopecia: A randomized clinical trial

“…study, 9 mL of blood was collected, single‐spin centrifugation was performed with commercial kits, and no activator was added. Consequently, similar to the findings of the studies above, it may be postulated that the manual method and double‐spin centrifugation is the preferred technique for PRP preparation 19,21 …”

“…Consequently, similar to the findings of the studies above, it may be postulated that the manual method and double-spin centrifugation is the preferred technique for PRP preparation. 19,21 In a study conducted by Kadry et al, 60 patients were divided into two groups of 30; one group received three sessions of SVF injections at a 1-month interval, while the other group received PRP under the same conditions. The hair count and diameter were evaluated 3 months after the last session.…”

“…Based on substantial evidence, Sharma et al 19 . concluded that the manual method with double‐spin is the preferred method for preparing PRP and did not consider using an activator necessary.…”

A split scalp study to evaluate the effects of platelet rich plasma prepared by two different methods in androgenetic alopecia

“…They further proposed that activator is not required for PRP preparation. 9 Various market devices are also available for the preparation of PRP which include Angel®, Cascade®, Selphyl®, C-Punt®, i-Stem® Preparation System and MAG-18®. 6 We used double spin PRP with activation through calcium as it is a more conventional method of PRP preparation and helps to achieve the therapeutic concentration of platelets 5 However, single spin PRP preparation at 100 g has been found to preserve integrity of platelets and provides platelet recovery.…”

“…In a recommendation for the use of PRP in AGA by Sharma et al, they also recommended the use of manual DS PRP. They further proposed that activator is not required for PRP preparation 9 . Various market devices are also available for the preparation of PRP which include Angel®, Cascade®, Selphyl®, C‐Punt®, i‐Stem® Preparation System and MAG‐18® 6 …”