Systematic Review of Platelet-Rich Plasma Use in Androgenetic Alopecia Compared with Minoxidil®, Finasteride®, and Adult Stem Cell-Based Therapy

Abstract

The number of articles evaluating platelet-rich plasma (PRP) efficacy in androgenic alopecia (AGA) have exponentially increased during the last decade. A systematic review on this field was performed by assessing in the selected studies the local injections of PRP compared to any control for AGA. The protocol was developed in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases was performed to identify studies on hair loss treatment with platelet-rich plasma. Of the 163 articles initially identified, 123 articles focusing on AGA were selected and, consequently, only 12 clinical trials were analyzed. The studies included had to match predetermined criteria according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach. In total, 84% of the studies reported a positive effect of PRP for AGA treatment. Among them, 50% of the studies demonstrated a statistically significant improvement using objective measures and 34% of the studies showed hair density and hair thickness improvement, although no p values or statistical analysis was described. In total, 17% of the studies reported greater improvement in lower-grade AGA, while 8% noted increased improvement in higher-grade AGA. Only 17% of the studies reported that PRP was not effective in treating AGA. The information analyzed highlights the positive effects of PRP on AGA, without major side effects and thus it be may considered as a safe and effective alternative procedure to treat hair loss compared with Minoxidil® and Finasteride®.

Targeting Wnt/β-Catenin Pathway for Developing Therapies for Hair Loss

“…A randomized clinical trial demonstrated that the microinjection of adipose-derived mesenchymal stem cells (AD-MSCs) and stromal vascular fraction cells (SVFs) can stimulate the scalp epidermal stem cells and hair growth in androgenic alopecia patients. However, in many of these patients, frequent microinjection is required to sustain the hair growth [ 10 ]. Thus, novel therapies for hair loss treatment has long been sought.…”

Systematic Review—The Potential Implications of Different Platelet-Rich Plasma (PRP) Concentrations in Regenerative Medicine for Tissue Repair

“…One of the problems most frequently raised by the scientific international audience is the level of consolidated evidence-based medicine (EBM) offered by PRP in the in vivo treatment of soft/bone tissue defects [ 10 , 11 , 45 , 48 , 50 ], aesthetic defects [ 55 ], wound healing [ 46 , 47 , 56 , 57 ] and hair loss [ 5 , 6 , 7 , 58 , 59 , 60 , 61 ] compared versus FDA-approved and/or EMA/CAT and/or other institutions. The rationale of this problem is borne by the fact that many institutional guidelines of several nations are based on the EBM impact of a drug/procedure.…”

Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

“…In all enrolled studies, calcium gluconate at a 10:1 ratio and sodium citrate were mostly added as activators and anticoagulants, respectively. Moreover, platelet concentrations differed from 1.5 to 7 times as much as the whole blood, according to PRP preparation protocols [52,58].…”

“…Alternatively, the use of autologous platelet-derived growth factors, contained in PRP, may represent a valid regenerative strategy for their capacity to promote cell proliferation, differentiation, and neo-angiogenesis, favoring, in vivo, the WH process [52], and hair regrowth (HR) has been reported recently [53][54][55][56][57][58].…”