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Strazzulla LC, Avila L, Lo Sicco K, Shapiro J. An Overview of the Biology of Platelet-Rich Plasma and Microneedling as Potential Treatments for Alopecia Areata. J Invest Dermatol 2017:S0022-202X(17)32751-3. [PMID: 29103820 DOI: 10.1016/j.jid.2017.07.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/21/2017] [Indexed: 10/18/2022]
Abstract
Platelet-rich plasma and microneedling have been investigated recently as potential therapeutic options for the treatment of hair disorders. Evidence from laboratory studies indicates that these treatments enhance growth factor production that in turn facilitates hair follicle development and cycling. Several small studies and case reports have presented encouraging findings regarding the use of these treatments for alopecia areata. Future investigations will be needed to validate these therapeutic techniques for patients with alopecia areata and further refine which subtypes of the disease these methods are best indicated for.
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Affiliation(s)
- Lauren C Strazzulla
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Lorena Avila
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.
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102
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Navarro RM, Pino A, Martinez-Andres A, Molina C, Martinez AM, Martinez N, Orive G, Anitua E. The effect of plasma rich in growth factors combined with follicular unit extraction surgery for the treatment of hair loss: A pilot study. J Cosmet Dermatol 2017; 17:862-873. [DOI: 10.1111/jocd.12446] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/19/2022]
Affiliation(s)
| | - Ander Pino
- BTI Biotechnology Institute; Vitoria (Álava) Spain
| | | | | | | | | | - Gorka Orive
- BTI Biotechnology Institute; Vitoria (Álava) Spain
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103
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Cheng H, Zhang J, Li J, Jia M, Wang Y, Shen H. Platelet-rich plasma stimulates angiogenesis in mice which may promote hair growth. Eur J Med Res 2017; 22:39. [PMID: 29020977 PMCID: PMC5637248 DOI: 10.1186/s40001-017-0278-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) is an autologous concentration of human platelets in plasma. In this paper, we aimed to investigate the effect of PRP on hair growth. METHODS Platelet-rich plasma and platelet-poor plasma were prepared by sterile centrifugation and injected into shaved dorsal skin of mice (n = 10). Saline injection was used in the control group. The length of randomly plucked hairs was measured at 8, 13, 18 days after PRP injection. Histological examination was preformed to observe the histologic changes of skins. The immunohistochemistry analysis of CD31 was performed to detect the changes of hair length and formation of new vessels. RESULTS At 13 and 18 days after the last injection, the hair length of mice in PRP group (4.24 ± 0.60 and 8.29 ± 0.48 mm, respectively) was significantly longer compared with the control group (3.70 ± 0.52 and 7.21 ± 0.64 mm, p < 0.05). No significant difference in the hair length was found between the PPP group and the control (p > 0.05). In addition, the number of CD31-positive vessel in the PRP group (9.90 ± 0.60) was more than that in the control group (8.60 ± 2.34, p < 0.05). CONCLUSION Platelet-rich plasma might promote hair length growth and increase the number of hair follicles by inducing angiogenesis.
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Affiliation(s)
- Hanxiao Cheng
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China
| | - Jufang Zhang
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China.
| | - Jinsheng Li
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China
| | - Ming Jia
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China
| | - Yuyan Wang
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China
| | - Haiyan Shen
- Department of Plastic Surgery, Hangzhou First People's Hospital, Nanjing Medical University, No. 261 Huansha Road, Hangzhou, 310006, China
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104
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Picard F, Hersant B, Niddam J, Meningaud JP. Injections of platelet-rich plasma for androgenic alopecia: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:291-297. [DOI: 10.1016/j.jormas.2017.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/25/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
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105
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Garg S, Manchanda S. Platelet-rich plasma-an 'Elixir' for treatment of alopecia: personal experience on 117 patients with review of literature. Stem Cell Investig 2017; 4:64. [PMID: 28815175 DOI: 10.21037/sci.2017.06.07] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/26/2017] [Indexed: 11/06/2022]
Abstract
Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery and dermatology. PRP is a simple, cost-effective and feasible treatment option with high patient satisfaction for hair loss and can be regarded as a valuable adjuvant treatment modality for androgenic alopecia and other types of non-scarring alopecias. Authors have proposed a hair model termed "Golden anchorage with 'molecular locking' of ectodermal and mesenchymal components for survival and integrity of hair follicle (HF)" in this article. Golden anchorage comprises of bulge stem cells, ectodermal basement membrane and bulge portion of APM. PRP with its autologous supply of millions of growth factors works on 'Golden anchorage' along with keratinocytes (PDGF), dermal papilla (IGF and fibroblast growth factor), vasculature (VEGF and PDGF) and neural cells (Nerve Growth Factor) in a multipronged manner serving as an 'elixir' for hair growth and improving overall environment.
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Affiliation(s)
- Suruchi Garg
- Department of Dermatology and Aesthetic Surgery, Aura Skin Institute, Chandigarh, India
| | - Shweta Manchanda
- Department of Dermatology and Aesthetic Surgery, Aura Skin Institute, Chandigarh, India
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106
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Guo H, Gao WV, Endo H, McElwee KJ. Experimental and early investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs 2017; 26:917-932. [DOI: 10.1080/13543784.2017.1353598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Hongwei Guo
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wendi Victor Gao
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
| | - Hiromi Endo
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
- Department of Dermatology, Ohashi Hospital, Toho University, Tokyo, Japan
| | - Kevin John McElwee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health Research Institute, Vancouver, Canada
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107
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Alves R, Grimalt R. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disord 2017; 4:18-24. [PMID: 29457008 DOI: 10.1159/000477353] [Citation(s) in RCA: 300] [Impact Index Per Article: 42.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 05/05/2017] [Indexed: 12/16/2022] Open
Abstract
Platelet-rich plasma (PRP) is currently used in different medical fields. The interest in the application of PRP in dermatology has recently increased. It is being used in several different applications as in tissue regeneration, wound healing, scar revision, skin rejuvenating effects, and alopecia. PRP is a biological product defined as a portion of the plasma fraction of autologous blood with a platelet concentration above the baseline. It is obtained from the blood of patients collected before centrifugation. The knowledge of the biology, mechanism of action, and classification of the PRP should help clinicians better understand this new therapy and to easily sort and interpret the data available in the literature regarding PRP. In this review, we try to provide useful information for a better understanding of what should and should not be treated with PRP.
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Affiliation(s)
- Rubina Alves
- Department of Dermatology, Universitat International Catalunya, Barcelona, Spain
| | - Ramon Grimalt
- Department of Dermatology, Universitat International Catalunya, Barcelona, Spain
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108
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Tawfik AA, Osman MAR. The effect of autologous activated platelet-rich plasma injection on female pattern hair loss: A randomized placebo-controlled study. J Cosmet Dermatol 2017; 17:47-53. [DOI: 10.1111/jocd.12357] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Abeer Attia Tawfik
- Dermatology and Laser at Dermatology Unit; Medical Laser Applications; National Institute Of Laser Enhanced Sciences (NIlES); Cairo University; Cairo Egypt
| | - Mai Abdel Raouf Osman
- Dermatology and Laser at Dermatology Unit; Medical Laser Applications; National Institute Of Laser Enhanced Sciences (NIlES); Cairo University; Cairo Egypt
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109
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110
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Ferneini EM, Beauvais D, Castiglione C, Ferneini MV. Platelet-Rich Plasma in Androgenic Alopecia: Indications, Technique, and Potential Benefits. J Oral Maxillofac Surg 2017; 75:788-795. [DOI: 10.1016/j.joms.2016.10.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 10/25/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
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111
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Abstract
Androgenetic alopecia (AGA) is characterized by a non-scarring progressive miniaturization of the hair follicle in predisposed men and women with a pattern distribution. Although AGA is a very prevalent condition, approved therapeutic options are limited. This article discusses the current treatment alternatives including their efficacy, safety profile, and quality of evidence. Finasteride and minoxidil for male androgenetic alopecia and minoxidil for female androgenetic alopecia still are the therapeutic options with the highest level evidence. The role of antiandrogens for female patients, the importance of adjuvant therapies, as well as new drugs and procedures are also addressed.
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Affiliation(s)
- Yanna Kelly
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil. .,Department of Dermatology, Hospital do Servidor Publico Municipal de São Paulo, São Paulo, SP, Brazil. .,, 1364, Oscar Freire Street, São Paulo, SP, 05409-010, Brazil.
| | - Aline Blanco
- Department of Dermatology, Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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112
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Giordano S, Romeo M, Lankinen P. Platelet-rich plasma for androgenetic alopecia: Does it work? Evidence from meta analysis. J Cosmet Dermatol 2017; 16:374-381. [PMID: 28296142 DOI: 10.1111/jocd.12331] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The use of platelet-rich plasma (PRP) has increased among different surgical specialities for the treatment of various conditions. Androgenetic alopecia is a common condition, with severe attendant psychosocial implications. PRP injections for hair restoration have become a popular practice among plastic surgeons. We performed a meta-analysis comparing local injection of platelet-rich plasma versus control to evaluate this issue in order to investigate the effectiveness of PRP local injections for androgenetic alopecia. METHODS A systematic literature search was performed. Primary outcome was the increase in number of hairs. Secondary outcomes were the increase in hair thickness and the percentage increase in hair number and thickness. We performed random-effect analysis. RESULTS Six studies involving 177 patients were retrieved and included in the present analysis. A significantly locally increased hair number per cm2 was observed after PRP injections versus control (mean difference (MD) 17.90, 95%CI 5.84-29.95, P=.004). Similarly, a significantly increased hair thickness cross section per 10-4 mm2 (MD 0.22, 95%CI 0.07-0.38, P=.005) favoring PRP group. The pooled results did not show statistically significant differences in percentage increase in hair number (MD 24.12%, 95%CI -12.76-60.99, P=.20) and hair thickness (MD 32.63%, 95%CI -16.23-81.48, P=0.19) among patients treated with PRP. CONCLUSIONS Local injection of PRP for androgenic alopecia might be associated with an increased number of hairs and some hair thickness improvement in the treated areas with minimal morbidity. The results of this meta-analysis should be interpreted with caution as it consists of pooling many small studies. Larger randomized studies can verify this perception.
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Affiliation(s)
- Salvatore Giordano
- Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.,Department of Surgery, Welfare District of Forssa, Forssa, Finland
| | - Marco Romeo
- Department of Plastic Surgery, Jiménez Diaz Foundation and the Autonomous University of Madrid, Madrid, Spain
| | - Petteri Lankinen
- Department of Orthopaedics and Traumatology, Turku University Hospital and the University of Turku, Turku, Finland
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113
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Frautschi RS, Hashem AM, Halasa B, Cakmakoglu C, Zins JE. Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review. Aesthet Surg J 2017; 37:353-362. [PMID: 28207031 DOI: 10.1093/asj/sjw178] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Platelet rich plasma (PRP) has attracted attention in a number of surgical fields due to a wide variety of potential clinical benefits. Yet PRP has not gained wide popularity in aesthetic surgery as a result of uncertainty surrounding objective clinical evidence. Objectives We aim to describe the current applications, define preparation and activation, explore effectiveness, and propose a classification system to facilitate comparisons across studies. Methods A comprehensive review of the literature regarding the use of platelet rich plasma in aesthetic surgery was performed. Data gathered included: PRP application, study type, subject number, centrifugation, anticoagulation, activation, PRP composition, and outcomes. Results Thirty-eight reports were identified. Applications included injection into aging skin (29%), scalp alopecia (26%), lipofilling (21%), fractional laser (13%), and facial surgery (11%). The majority of studies (53%) were case series without controls. Leucocytes were sparsely defined (32%). The concentration of injected and/or baseline platelets was rarely clarified (18%). The mechanism of activation was described in 27 studies (71%), while anticoagulation was uncommonly elucidated (47%). While most studies (95%) claim effectiveness, objective measures were only utilized in 17 studies (47%). Conclusions Current studies produce context-dependent results with a lack of consistent reporting of PRP preparation, composition, and activation in aesthetic applications, making meaningful meta-analysis unrealistic. Thus the method of PRP preparation warrants increased attention. We recommend a set of descriptors, FIT PAAW (described below), to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective. Level of Evidence 4
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Affiliation(s)
| | - Ahmed M Hashem
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
| | - Brianna Halasa
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH
| | | | - James E Zins
- Facial Surgery Section Editor for Aesthetic Surgery Journal
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114
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Karnaukhov VK, Lukyanova AA, Lukashina MI, Vorobeva ES, Afanasov IM. Тіе Modern treatment of androgenetic alopecia. VESTNIK DERMATOLOGII I VENEROLOGII 2017. [DOI: 10.25208/0042-4609-2017-93-1-21-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Androgenetic alopecia (AGA) is the most common reason for hair loss. Its frequency in Caucasian population is up to 80% in men and 42% in women. Current gold standard for AGA treatment includes minoxidil and/or finasteride. Both drugs have moderate treatment efficacy and can cause significant side effects. Minoxidil is the only option for treatment of AGA in women since finasteride has no efficacy. This review considers actual concepts of molecular mechanisms of pathogenesis and current treatment options of AGA with their limitations and shortcomings. Current state and perspectives of novel approaches to AGA treatment, potentially more effective and safe than minoxidil and finasteride, are described. The review discusses growth factors and cytokines, topical 5-alpha-reductase inhibitors, androgen receptor antagonists, prostaglandin analogs and antagonists, Wnt signaling activators and platelet-rich plasma injections.
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115
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Gentile P, Cole JP, Cole MA, Garcovich S, Bielli A, Scioli MG, Orlandi A, Insalaco C, Cervelli V. Evaluation of Not-Activated and Activated PRP in Hair Loss Treatment: Role of Growth Factor and Cytokine Concentrations Obtained by Different Collection Systems. Int J Mol Sci 2017; 18:ijms18020408. [PMID: 28216604 PMCID: PMC5343942 DOI: 10.3390/ijms18020408] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 11/25/2022] Open
Abstract
Platelet rich plasma (PRP) was tested as a potential therapy for androgenetic alopecia (AGA) through two different clinical protocols in which one population (18 participants) received half-head treatment with autologous non-activated PRP (A-PRP) produced by CPunT Preparation System (Biomed Device, Modena, Italy) and the other half-head with placebo, and a second separated population in which all participants (n = 6, 3 participants per group) received treatment with calcium-activated PRP (AA-PRP) produced from one of two different PRP collection devices (Regen Blood Cell Therapy or Arthrex Angel System). For the A-PRP study, three treatments were administered over 30-day intervals. Trichoscan analysis of patients, three months post-treatment, showed a clinical improvement in the number of hairs in the target area (36 ± 3 hairs) and in total hair density (65 ± 5 hair cm2), whereas negligible improvements in hair count (1.1 ± 1.4 hairs) and density (1.9 ± 10.2 hair cm2) were seen in the region of the scalp that received placebo. Microscopic evaluation conducted two weeks after treatment showed also an increase in epidermal thickness, Ki67+ keratinocytes, and in the number of follicles. The AA-PRP treatment groups received a singular set of injections, and six months after the treatments were administered, notable differences in clinical outcomes were obtained from the two PRP collection devices (+90 ± 6 hair cm2 versus −73 ± 30 hair cm2 hair densities, Regen versus Arthrex). Growth factor concentrations in AA-PRP prepared from the two collection devices did not differ significantly upon calcium activation.
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Affiliation(s)
- Pietro Gentile
- Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata, Via Courmayeur, No. 102, 00135 Rome, Italy.
- Plastic and Reconstructive Surgery Department, Catholic University, 1005 Tiranna, Albania.
| | - John P Cole
- Cole Hair Transplant Group, Alpharetta, 30004 GA, USA.
| | - Megan A Cole
- Cole Hair Transplant Group, Alpharetta, 30004 GA, USA.
| | - Simone Garcovich
- Institute of Dermatology, Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Alessandra Bielli
- Institute of Anatomic Pathology, University of Rome Tor Vergata, 00133 Rome, Italy.
| | | | - Augusto Orlandi
- Institute of Anatomic Pathology, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Chiara Insalaco
- Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata, Via Courmayeur, No. 102, 00135 Rome, Italy.
- Cole Hair Transplant Group, Alpharetta, 30004 GA, USA.
| | - Valerio Cervelli
- Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata, Via Courmayeur, No. 102, 00135 Rome, Italy.
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116
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Ayatollahi A, Hosseini H, Shahdi M, AhmadNasrollahi S, NassiriKashani M, Yadangi S, Firooz FH, Firooz A. Platelet-rich Plasma by Single Spin Process in Male Pattern Androgenetic Alopecia: Is it an Effective Treatment? Indian Dermatol Online J 2017; 8:460-464. [PMID: 29204389 PMCID: PMC5707838 DOI: 10.4103/idoj.idoj_11_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction and Objective: Platelet-rich plasma (PRP) is an autologous preparation of platelets in concentrated plasma. The platelet is a natural source of different growth factors and cytokines. These growth factors act on stem cells in the bulge area of the follicles and stimulate the development of new follicles, and promote neovascularization. The aim of this study was to investigate the efficacy and safety of PRP injections in androgenetic alopecia (AGA) in men. Patients and Methods: Fifteen male patients (mean age: 39 ± 9.7 years) with AGA grades III–VI were enrolled in the study. Five injections of 2–4 ml PRP (Regenlab PRP Kit-RegenACR®, Le Mont-sur-Lausanne Switzerland) by single spin process were administered every 2 weeks. Standard photographs, trichogram, and measurement of hair density and diameter in an area marked with a tattoo (with digital photographic hair analyzer) were done at baseline and 3 months after the last injection. In addition, patients completed a patient satisfaction questionnaire at each visit on a −2 to +2 score (−2: much worse, −1: slightly worse, 0: without change, +1: slightly better, +2: much better). Results: Thirteen patients completed the study. The number of hairs increased slightly from 149.62 ± 49.56 to 168.46 ± 43.703/cm2, however, this increase was not statistically significant (P = 0.24). On the other hand, the thickness of hairs decreased from 0.051 ± 0.105 to 0.045 ± 0.011 mm, which was also not significant (P = 0.37). There was a significant decrease in anagen hairs and increase in telogen hairs, and anagen/telogen ratio decreased significantly from 6.38 ± 4.57 to 2.67 ± 1.87 (P = 0.003). Conclusion: Our study could not show any benefit from PRP injections in the treatment of male AGA. There is a strong need for well-designed, randomized controlled trials with large sample size, proper control group, standard treatment protocols (concerning the amount, number and interval of PRP injections, method of preparation and activation, etc.), and long follow-up periods to evaluate the safety and efficacy of PRP in the treatment of male AGA.
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Affiliation(s)
- Azin Ayatollahi
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
| | - Hamed Hosseini
- Clinical Trial Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Saman AhmadNasrollahi
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
| | - Mansour NassiriKashani
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
| | - Somaye Yadangi
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
| | - Farid H Firooz
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
| | - Alireza Firooz
- Tehran University of Medical Science, Center for Research and Training in Skin diseases and Leprosy, Tehran, Iran
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117
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Abstract
Follicular unit extraction (FUE) is becoming an increasingly popular method for hair restoration. As FUE leaves behind no linear scars, it is more suitable to harvest from various body areas including beard, chest, and extremities in hirsute individuals. Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. Body hair transplantation can be successfully used either alone or in combination with scalp hair in advanced grades of baldness, for improving the cosmetic appearance of hairlines and in scarring alopecia when there is paucity of donor scalp hair. Harvesting of body hairs opens up a new viable donor source for hair restoration surgeons, especially in cases of advanced Norwood grades five and above of androgenetic alopecia.
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Affiliation(s)
- Kuldeep Saxena
- Cosmazone Hair Restoration Clinics, Mumbai-Gwalior-Delhi, India
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118
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119
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Double-Blind, Placebo-Controlled Pilot Study on the Use of Platelet-Rich Plasma in Women With Female Androgenetic Alopecia. Dermatol Surg 2016; 42:1243-1247. [DOI: 10.1097/dss.0000000000000883] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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120
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Dastan M, Najafzadeh N, Abedelahi A, Sarvi M, Niapour A. Human platelet lysate versus minoxidil stimulates hair growth by activating anagen promoting signaling pathways. Biomed Pharmacother 2016; 84:979-986. [PMID: 27764761 DOI: 10.1016/j.biopha.2016.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/21/2016] [Accepted: 10/07/2016] [Indexed: 12/30/2022] Open
Abstract
Minoxidil and human platelet lysate (HPL) are commonly used to treat patients with hair loss. However, the roles of HPL versus minoxidil in hair follicle biology largely remain unknown. Here, we hypothesized that bulge and dermal papilla (DP) cells may express specific genes, including Kras, Erk, Akt, Shh and β-catenin after exposure to minoxidil or HPL. The mouse hair follicles were isolated on day 10 after depilation and bulge or DP regions were dissected. The bulge and DP cells were cultured for 14days in DMEM/F12 medium. Then, the cells were treated with 100μM minoxidil and 10% HPL for 10 days. Nuclear morphology was identified using DAPi staining. Reverse transcriptase and real-time polymerase chain reaction (PCR) analysis were also performed to examine the expression of Kras, Erk, Akt, Shh and β-catenin mRNA levels in the treated bulge and DP regions after organ culture. Here, we found that minoxidil influences bulge and DP cell survival (P<0.05). Apoptosis in DP cells was also meaningfully decreased by HPL treatment (P=0.014). In addition, Kras, Akt, Erk, Shh and β-catenin mRNA levels were changed in response to minoxidil treatment in both bulge and DP cells. HPL mediated Erk upregulation in both bulge and DP cells (P<0.05), but Kras and Akt mRNA levels were not considerably different in the HPL-treated cells. β-catenin mRNA level was also significantly increased in the bulge region by HPL. We also found that Shh mRNA level was considerably higher in HPL-treated bulge cells than in minoxidil-treated bulge cells. In contrast, the expression of β-cateinin and Shh in the DP cells was not meaningfully increased after treatment with HPL. Our results suggest that minoxidil and HPL can promote hair growth by activating the main anagen inducing signaling pathways.
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Affiliation(s)
- Maryam Dastan
- Department of Biology, Urmia University, Urmia, Iran; Research Laboratory for Embryology and Stem Cells, Department of Anatomy and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Nowruz Najafzadeh
- Research Laboratory for Embryology and Stem Cells, Department of Anatomy and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Ali Abedelahi
- Department of Anatomy, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadreza Sarvi
- Department of Medical Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Niapour
- Research Laboratory for Embryology and Stem Cells, Department of Anatomy and Pathology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Commentary on a Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia. Dermatol Surg 2016; 42:498-9. [PMID: 26967461 DOI: 10.1097/dss.0000000000000656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
Platelet-rich plasma (PRP) is a solution derived from whole blood that is enriched in the platelet fraction. Platelets serve as a reservoir of growth factors and cytokines. When platelets are activated in vivo, signaling molecules are released into the immediate microenvironment and activate receptors for various pathways. Historically, PRP has been applied to wound beds to promote healing of complex wounds. Over the last decade, it has served as a valuable therapeutic tool in various specialties such as maxillofacial surgery, plastic surgery, orthopedics and sports medicine. Only recently has PRP been utilized for dermatologic purposes, more specifically, for the treatment of male and female pattern hair loss. In this review, we discuss molecular and cellular pathways upregulated by PRP important in hair folliculogenesis, and examine clinical evidence from all previously published studies involving the use of PRP for pattern hair loss.
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Rossi A, Anzalone A, Fortuna MC, Caro G, Garelli V, Pranteda G, Carlesimo M. Multi-therapies in androgenetic alopecia: review and clinical experiences. Dermatol Ther 2016; 29:424-432. [PMID: 27424565 DOI: 10.1111/dth.12390] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Androgenetic alopecia (AGA) is a genetically determined progressive hair-loss condition which represents the most common cause of hair loss in men. The use of the medical term androgenetic alopecia reflects current knowledge about the important role of androgens and genetic factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should be started early and continued indefinitely, since the benefit will not be maintained upon ceasing therapy. To date, only two therapeutic agents have been approved by the Food and Drug Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment options are available: topical and systemic drugs may be used and the choice depends on various factors including grading of AGA, patients' pathological conditions, practicability, costs and risks. So, the treatment for AGA should be based on personalized therapy and targeted at the different pathophysiological aspects of AGA.
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Affiliation(s)
- Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
| | - Alessia Anzalone
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
| | - Maria Caterina Fortuna
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
| | - Valentina Garelli
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
| | - Giulia Pranteda
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Italy
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125
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Gupta AK, Carviel JL. Meta-analysis of efficacy of platelet-rich plasma therapy for androgenetic alopecia. J DERMATOL TREAT 2016; 28:55-58. [DOI: 10.1080/09546634.2016.1179712] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. K. Gupta
- Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada
- Mediprobe Research Inc, London, Ontario, Canada
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126
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Collagen and Fractionated Platelet-Rich Plasma Scaffold for Dermal Regeneration. Plast Reconstr Surg 2016; 137:1498-1506. [DOI: 10.1097/prs.0000000000002094] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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127
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Saxena K, Saxena DK, Savant SS. Successful Hair Transplant Outcome in Cicatricial Lichen Planus of the Scalp by Combining Scalp and Beard Hair Along With Platelet Rich Plasma. J Cutan Aesthet Surg 2016; 9:51-5. [PMID: 27081255 PMCID: PMC4812894 DOI: 10.4103/0974-2077.178562] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Kuldeep Saxena
- Cosmazone Hair Restoration Clinics, Mumbai, Maharahtra, India
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128
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Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia. Dermatol Surg 2016; 42:491-7. [DOI: 10.1097/dss.0000000000000665] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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129
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Bolanča Ž, Goren A, Getaldić-Švarc B, Vučić M, Šitum M. Platelet-rich plasma as a novel treatment for lichen planopillaris. Dermatol Ther 2016; 29:233-5. [DOI: 10.1111/dth.12343] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Željana Bolanča
- Department of Dermatovenereology; University Hospital Center Sestre milosrdnice; Zagreb Croatia
| | - Andy Goren
- University of Rome (“G. Marconi”); Rome Italy
| | - Biserka Getaldić-Švarc
- Clinical Unit for Laboratory Hematology and Coagulation; Clinical Institute of Chemistry, University Hospital Center Sestre milosrdnice; Zagreb Croatia
| | - Majda Vučić
- Department of Pathology; University Hospital Center Sestre milosrdnice; Zagreb Croatia
| | - Mirna Šitum
- Department of Dermatovenereology; University Hospital Center Sestre milosrdnice; Zagreb Croatia
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130
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Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol 2016; 15:434-443. [DOI: 10.1111/jocd.12207] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Mohd Asif
- Department of Dermatology, Venereology, and Leprosy; National Institute of Medical Sciences; Jaipur Rajasthan India
| | - Sanjay Kanodia
- Department of Dermatology, Venereology, and Leprosy; National Institute of Medical Sciences; Jaipur Rajasthan India
| | - Kishor Singh
- Department of Dermatology, Venereology, and Leprosy; National Institute of Medical Sciences; Jaipur Rajasthan India
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131
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Management of androgenetic alopecia: a comparative clinical study between plasma rich in growth factors and topical minoxidil. EUROPEAN JOURNAL OF PLASTIC SURGERY 2016. [DOI: 10.1007/s00238-015-1175-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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132
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Mubki T. Platelet-rich plasma combined with intralesional triamcinolone acetonide for the treatment of alopecia areata: A case report. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2016. [DOI: 10.1016/j.jdds.2015.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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133
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Platelet-rich plasma microneedling versus 5% topical minoxidil in the treatment of patterned hair loss. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2016. [DOI: 10.1097/01.ewx.0000472824.29209.a8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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134
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Garg S. Outcome of Intra-operative Injected Platelet-rich Plasma Therapy During Follicular Unit Extraction Hair Transplant: A Prospective Randomised Study in Forty Patients. J Cutan Aesthet Surg 2016; 9:157-164. [PMID: 27761085 PMCID: PMC5064679 DOI: 10.4103/0974-2077.191657] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Context: Platelet-rich plasma (PRP) therapy is finding importance in aesthetic medicine. Aim: The objective of this study was to study efficacy of PRP therapy in follicular unit extraction (FUE) hair transplant. Materials and Methods: It is a single-blind, prospective randomised study on 40 FUE hair transplant subjects, allocated in two groups (PRP and non-PRP) alternately. PRP was injected intra-operatively immediately after creating slits over the recipient area in PRP group; and normal saline in non-PRP group. Two groups were evaluated at 2, 4 and 8 weeks, 3 and 6 months of the procedure. Statistical Analysis: It was done using Chi-square test and test of significance was set as P < 0.05. Results: In PRP group, all subjects had >75% hair regrowth at 6 months, density of >75% grafts was noticed in 12 patients at 4 weeks meaning reduced fall of transplanted hair during catagen phase. New hair growth started at 8 weeks in 16 patients and redness over recipient area completely disappeared in 19 patients at 3 months of surgery and activity in dormant follicles as fine thread like hair was noticed besides the thick transplanted hair in all subjects. In non-PRP group, four patients had >75% hair regrowth at 6 months; none showed >75% graft density at 4 weeks, and 13 subjects showed dormant follicle activity at 4 months. The number of patients having lengthier hairs was significantly more in PRP group. Conclusion: Intra-operative PRP therapy is beneficial in giving faster density, reducing the catagen loss of transplanted hair, recovering the skin faster and activating dormant follicles in FUE transplant subjects.
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Affiliation(s)
- Suruchi Garg
- Department of Dermatology and Aesthetic Surgery, Aura Skin Institute, Chandigarh, India
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135
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PERIPHERAL NERVE REGENERATION: CELL THERAPY AND NEUROTROPHIC FACTORS. Rev Bras Ortop 2015; 46:643-9. [PMID: 27027067 PMCID: PMC4799329 DOI: 10.1016/s2255-4971(15)30319-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 06/16/2011] [Indexed: 12/25/2022] Open
Abstract
Peripheral nerve trauma results in functional loss in the innervated organ, and recovery without surgical intervention is rare. Many surgical techniques can be used for nerve repair. Among these, the tubulization technique can be highlighted: this allows regenerative factors to be introduced into the chamber. Cell therapy and tissue engineering have arisen as an alternative for stimulating and aiding peripheral nerve regeneration. Therefore, the aim of this review was to provide a survey and analysis on the results from experimental and clinical studies that used cell therapy and tissue engineering as tools for optimizing the regeneration process. The articles used came from the LILACS, Medline and SciELO scientific databases. Articles on the use of stem cells, Schwann cells, growth factors, collagen, laminin and platelet-rich plasma for peripheral nerve repair were summarized over the course of the review. Based on these studies, it could be concluded that the use of stem cells derived from different sources presents promising results relating to nerve regeneration, because these cells have a capacity for neuronal differentiation, thus demonstrating effective functional results. The use of tubes containing bioactive elements with controlled release also optimizes the nerve repair, thus promoting greater myelination and axonal growth of peripheral nerves. Another promising treatment is the use of platelet-rich plasma, which not only releases growth factors that are important in nerve repair, but also serves as a carrier for exogenous factors, thereby stimulating the proliferation of specific cells for peripheral nerve repair.
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136
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Platelet-Rich Plasma with Basic Fibroblast Growth Factor for Treatment of Wrinkles and Depressed Areas of the Skin. Plast Reconstr Surg 2015; 136:931-939. [DOI: 10.1097/prs.0000000000001705] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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137
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Lynch MD, Bashir S. Applications of platelet-rich plasma in dermatology: A critical appraisal of the literature. J DERMATOL TREAT 2015; 27:285-9. [DOI: 10.3109/09546634.2015.1094178] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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138
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Singhal P, Agarwal S, Dhot PS, Sayal SK. Efficacy of platelet-rich plasma in treatment of androgenic alopecia. Asian J Transfus Sci 2015; 9:159-62. [PMID: 26420936 PMCID: PMC4562137 DOI: 10.4103/0973-6247.162713] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) has shown remarkable beneficial effects without any major adverse reactions in the treatment of androgenic alopecia. The growth factors in activated autologous PRP induce the proliferation of dermal papilla cells. OBJECTIVES The objective was to investigate the clinical efficacy of PRP in treatment of androgenic alopecia. MATERIALS AND METHODS Ten patients were given autologous PRP injections on the affected area of alopecia over a period of 3 months at interval of 2-3 weeks and results were assessed. RESULTS Three months after the treatment, the patients presented clinical improvement in the hair counts, hair thickness, hair root strength, and overall alopecia. CONCLUSION PRP appears to be a cheap, effective, and promising therapy for androgenic alopecia with no major adverse effects.
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Affiliation(s)
- Parul Singhal
- Department of Pathology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Sachin Agarwal
- Department of Dermatology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Paramjeet Singh Dhot
- Department of Pathology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Satish K Sayal
- Department of Dermatology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
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139
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Gentile P, Garcovich S, Bielli A, Scioli MG, Orlandi A, Cervelli V. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial. Stem Cells Transl Med 2015; 4:1317-23. [PMID: 26400925 DOI: 10.5966/sctm.2015-0107] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 07/13/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery, and preliminary evidence suggests that it might have a beneficial role in hair regrowth. Here, we report the results of a randomized, evaluator-blinded, placebo-controlled, half-head group study to compare, with the aid of computerized trichograms, hair regrowth with PRP versus placebo. The safety and clinical efficacy of autologous PRP injections for pattern hair loss were investigated. PRP, prepared from a small volume of blood, was injected on half of the selected patients' scalps with pattern hair loss. The other half was treated with placebo. Three treatments were administered to each patient at 30-day intervals. The endpoints were hair regrowth, hair dystrophy as measured by dermoscopy, burning or itching sensation, and cell proliferation as measured by Ki67 evaluation. Patients were followed for 2 years. Of the 23 patients enrolled, 3 were excluded. At the end of the 3 treatment cycles, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 33.6 hairs in the target area, and a mean increase in total hair density of 45.9 hairs per cm² compared with baseline values. No side effects were noted during treatment. Microscopic evaluation showed the increase of epidermis thickness and of the number of hair follicles 2 weeks after the last PRP treatment compared with baseline value (p < .05). We also observed an increase of Ki67(+) keratinocytes in the epidermis and of hair follicular bulge cells, and a slight increase of small blood vessels around hair follicles in the treated skin compared with baseline (p < .05). Relapse of androgenic alopecia was not evaluated in all patients until 12 months after the last treatment. After 12 months, 4 patients reported progressive hair loss; this was more evident 16 months after the last treatment. Those four patients were re-treated. Our data clearly highlight the positive effects of PRP injections on male pattern hair loss and absence of major side effects. PRP may serve as a safe and effective treatment option against hair loss; more extensive controlled studies are needed. SIGNIFICANCE Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery, and preliminary evidence suggests that it might have a beneficial role in hair regrowth. Here, the results of a randomized, placebo-controlled, half-head group study to compare the hair regrowth with PRP versus placebo are reported. Hair regrowth was quantified by a blinded evaluator using computerized trichograms. The safety and clinical efficacy of autologous PRP injections for pattern hair loss were investigated. Of the 23 patients enrolled, 3 were excluded. At the end of the 3 treatment cycles, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 33.6 hairs in the target area and a mean increase in total hair density of 45.9 hairs per cm² compared with baseline values. No side effects were noted during treatment. The data clearly highlight the positive effects of PRP injections on male pattern hair loss and absence of major side effects. PRP may serve as a safe and effective treatment option against hair loss; more extensive controlled studies are needed.
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Affiliation(s)
- Pietro Gentile
- Plastic and Reconstructive Surgery Department, University of Rome "Tor Vergata," Rome, Italy Plastic and Reconstructive Surgery Department, Catholic University, Tirana, Albania
| | - Simone Garcovich
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Alessandra Bielli
- Institute of Anatomic Pathology, University of Rome "Tor Vergata," Rome, Italy
| | | | - Augusto Orlandi
- Institute of Anatomic Pathology, University of Rome "Tor Vergata," Rome, Italy
| | - Valerio Cervelli
- Plastic and Reconstructive Surgery Department, University of Rome "Tor Vergata," Rome, Italy
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141
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Maria-Angeliki G, Alexandros-Efstratios K, Dimitris R, Konstantinos K. Platelet-rich Plasma as a Potential Treatment for Noncicatricial Alopecias. Int J Trichology 2015; 7:54-63. [PMID: 26180449 PMCID: PMC4502475 DOI: 10.4103/0974-7753.160098] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Androgenetic alopecia (AGA) and alopecia areata (AA) are common hair loss disorders affecting both men and women. Despite available therapeutic options, search for new, more effective treatment is constant. Platelet-rich plasma (PRP) could be effective in promoting hair growth: (1) To present PRP and its mechanism of action in promoting hair growth and (2) to evaluate its preparation methods and its therapeutic potential in noncicatrial alopecias in a systematic review. An international bibliography search, through five databases, was conducted to find articles regarding PRP's action on hair loss. Growth factors in platelets’ granules of PRP bind in the bulge area of hair follicle, promoting hair growth. In our systematic review, 14 articles matched our criteria, including 12 articles for AGA and two for AA. PRP is a potential useful therapeutic tool for alopecias, without major adverse effects. Nevertheless, due to the small number of conducted trials, further studies are required to investigate its efficacy.
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Affiliation(s)
- Gkini Maria-Angeliki
- Department of Dermatology and Venereology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Rigopoulos Dimitris
- Department of Dermatology and Venereology, Attikon Hospital, Medical School, University of Athens, Athens, Greece
| | - Kouskoukis Konstantinos
- Department of Dermatology and Venereology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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142
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Mareyeva AN, Kondrakhina IN, Abuladze MG. Using platelet-enriched autologous plasma for treatment of non-scarring alopecias (androgenetic and circumscribed alopecia). VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-3-62-66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The article presents literature data on the efficacy of using platelet-enriched autologous plasma for treatment of non-scarring alopecias (androgenetic and circumscribed alopecia).
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143
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Bae JM, Jung HM, Goo B, Park YM. Hair regrowth through wound healing process after ablative fractional laser treatment in a murine model. Lasers Surg Med 2015; 47:433-40. [PMID: 25945952 DOI: 10.1002/lsm.22358] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE Alopecia is one of the most common dermatological problems in the elderly; however, current therapies for it are limited by low efficacy and undesirable side effects. Although clinical reports on fractional laser treatment for various alopecia types are increasing, the exact mechanism remains to be clarified. The purposes of this study were to demonstrate the effect of ablative fractional laser treatment on hair follicle regrowth in vivo and investigate the molecular mechanism after laser treatment. MATERIALS AND METHODS Ablative CO2 fractional laser was applied to the shaved dorsal skin of 7-week-old C57BL/6 mice whose hair was in the telogen stage. After 12 mice were treated at various energy (10-40 mJ/spot) and density (100-400 spots/cm(2) ) settings to determine the proper dosage for maximal effect. Six mice were then treated at the decided dosage and skin specimens were sequentially obtained by excision biopsy from the dorsal aspect of each mouse. Tissue samples were used for the immunohistochemistry and reverse transcription polymerase chain reaction assays to examine hair follicle status and their related molecules. RESULTS The most effective dosage was the 10 mJ/spot and 300 spots/cm(2) setting. The anagen conversion of hair was observed in the histopathological examination, while Wnt/β-catenin expression was associated with hair regrowth in the immunohistochemistry and molecular studies. CONCLUSIONS Ablative fractional lasers appear to be effective for inducing hair regrowth via activation of the Wnt/β-catenin pathway in vivo. Our findings indicate that fractional laser treatment can potentially be developed as new treatment options for stimulating hair regrowth.
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Affiliation(s)
- Jung Min Bae
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Han Mi Jung
- Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | | | - Young Min Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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144
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Gupta AK, Lyons DCA, Daigle D. Progression of surgical hair restoration techniques. J Cutan Med Surg 2015; 19:17-21. [PMID: 25775658 DOI: 10.2310/7750.2014.13212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Early surgical hair restoration (SHR) techniques were fraught with limitations. Major advancements and refinements have taken place yielding minimally invasive, relatively scar-free, and natural-looking hair transplantations. OBJECTIVE Our aim was to review the origins and advancements of SHR and to discuss future directions for the field. METHODS Searches were performed using: Pubmed, Scopus, and the International Society of Hair Restoration Surgery's Hair Transplant Forum International for articles related to SHR. Reference sections of articles obtained were reviewed. Relevant textbooks obtained were reviewed. RESULTS AND CONCLUSION SHR techniques originated as macro-level graft transplantations and excision of scalp tissue. They progressed toward micro-level graft transplantations performed with extreme caution and precision. However, all SHR techniques are limited by their reliance on existing donor hair to fill balding areas. Further advancements in hair follicle cell cloning and regeneration of growth may offer a solution to this overarching limitation.
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Affiliation(s)
- Aditya K Gupta
- Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON
| | - Danika C A Lyons
- Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON
| | - Deanne Daigle
- Department of Medicine, University of Toronto, Toronto, ON, and Mediprobe Research Inc., London, ON
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145
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Conde Montero E, Fernández Santos M, Suárez Fernández R. Platelet-Rich Plasma: Applications in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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146
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Gkini MA, Kouskoukis AE, Tripsianis G, Rigopoulos D, Kouskoukis K. Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period. J Cutan Aesthet Surg 2015; 7:213-9. [PMID: 25722600 PMCID: PMC4338465 DOI: 10.4103/0974-2077.150743] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) is defined as an autologous concentration of plasma with a greater count of platelets than that of whole blood. Its action depends on the released growth factors from platelets. It has been investigated and used in numerous fields of medicine. Recently, PRP has received growing attention as a potential therapeutic tool for hair loss. AIMS To evaluate the efficacy and safety of PRP injections in the scalp of patients with androgenetic alopecia. SETTINGS AND DESIGN Prospective cohort study. MATERIALS AND METHODS 20 patients, 18 males and 2 females, with androgenetic alopecia were enrolled in the study. PRP was prepared using a single spin method (Regenlab SA). Upon activation, it was injected in the androgen-related areas of scalp. Three treatment sessions were performed with an interval of 21 days and a booster session at 6 months following the onset of therapy. STATISTICAL ANALYSIS Statistical analysis of the data was performed using the Statistical Package for the Social Sciences (SPSS), version 19.0 (IBM, NY, USA). RESULTS Hair loss reduced and at 3 months it reached normal levels. Hair density reached a peak at 3 months (170.70 ± 37.81, P < 0.001). At 6 months and at 1 year, it was significantly increased, 156.25 ± 37.75 (P < 0.001) and 153.70 ± 39.92 (P < 0.001) respectively, comparing to baseline. Patients were satisfied with a mean result rating of 7.1 on a scale of 1-10. No remarkable adverse effects were noted. CONCLUSIONS Our data suggest that PRP injections may have a positive therapeutic effect on male and female pattern hair loss without remarkable major side effects. Further studies are needed to confirm its efficacy.
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Affiliation(s)
- Maria-Angeliki Gkini
- Department of Dermatology and Venereology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Gregory Tripsianis
- Laboratory of Medical Statistics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitris Rigopoulos
- Department of Dermatology and Venereology, Medical School, Attikon Hospital, University of Athens, Athens, Greece
| | - Konstantinos Kouskoukis
- Department of Dermatology and Venereology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Lee SH, Zheng Z, Kang JS, Kim DY, Oh SH, Cho SB. Therapeutic efficacy of autologous platelet-rich plasma and polydeoxyribonucleotide on female pattern hair loss. Wound Repair Regen 2015; 23:30-6. [PMID: 25524027 DOI: 10.1111/wrr.12250] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 12/08/2014] [Indexed: 12/17/2022]
Abstract
Autologous platelet-rich plasma (PRP) exerts positive therapeutic effects on hair thickness and density in patients with pattern hair loss. The aim of our study was to evaluate the efficacy of intra-perifollicular autologous PRP and polydeoxyribonucleotide (PDRN) injections in treating female pattern hair loss (FPHL). Twenty FPHL patients were treated with a single session of PRP injection, followed by 12 sessions of PDRN intra-perifollicular injection, along the scalp at weekly intervals. Additionally, another 20 FPHL patients were treated with 12 sessions of PDRN injection only. Meanwhile, one half of the backs of two rabbits was injected with the PRP preparation, while the other half was injected with phosphate buffered saline as a control. Tissue samples from the rabbits were analyzed by real-time polymerase chain reaction and Western blotting. Compared with baseline values, patients treated with PRP and PDRN injections exhibited clinical improvement in mean hair counts (23.2 ± 15.5%; p < 0.001) and mean hair thickness (16.8 ± 10.8%; p < 0.001). In addition, patients treated with the 12 sessions of intra-perifollicular PDRN injection alone also showed clinical improvement in mean hair counts (17.9 ± 13.2%; p < 0.001) and mean hair thickness (13.5 ± 10.7%; p < 0.001). Comparison analyses between the two groups revealed that combined therapy with PRP and PDRN induces greater improvement in hair thickness than treatment with PDRN therapy alone (p = 0.031), but not in hair counts (p > 0.05). The pilot animal study revealed significant up-regulation of WNT, platelet-derived growth factor, and fibroblast growth factor expression in rabbit skin treated with the PRP preparation, compared with control skin. In conclusion, intra-perifollicular injections of autologous PRP and/or PDRN generate improvements in hair thickness and density in FPHL patients.
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Affiliation(s)
- Si-Hyung Lee
- Laboratory of Disease Functional Genomics, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
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148
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Abstract
INTRODUCTION Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules. AREAS COVERED We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia. EXPERT OPINION Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.
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Affiliation(s)
- Leyre Falto-Aizpurua
- University of Miami, Miller School of Medicine, Department of Dermatology and Cutaneous Surgery , 1475 NW 12th Avenue, Suite 2175, Miami, FL 33136 , USA
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150
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Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N. Platelet-rich plasma in androgenic alopecia: myth or an effective tool. J Cutan Aesthet Surg 2014; 7:107-10. [PMID: 25136212 PMCID: PMC4134641 DOI: 10.4103/0974-2077.138352] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Platelet-rich plasma (PRP) has become a newer method for the treatment of various types of alopecia. In this prospective study, safety, efficacy and feasibility of PRP injections in treating androgenic alopecia were assessed. Eleven patients suffering from hair loss due to androgenic alopecia and not responding to 6 months treatment with minoxidil and finasteride were included in this study. The hair pull test was performed before every treatment session. A total volume of 2-3 cc PRP was injected in the scalp by using an insulin syringe. The treatment was repeated every two weeks, for a total of four times. The outcome was assessed after 3 months by clinical examination, macroscopic photos, hair pull test and patient's overall satisfaction.
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Affiliation(s)
- Swapna S Khatu
- Department of Dermatology, Venereology and Leprosy, Smt Kashibai Navale Medical College, Pune, Maharashtra, India
| | - Yuvraj E More
- Department of Dermatology, Venereology and Leprosy, Smt Kashibai Navale Medical College, Pune, Maharashtra, India
| | - Neeta R Gokhale
- Department of Dermatology, Venereology and Leprosy, Smt Kashibai Navale Medical College, Pune, Maharashtra, India
| | - Dipali C Chavhan
- Department of Dermatology, Venereology and Leprosy, Smt Kashibai Navale Medical College, Pune, Maharashtra, India
| | - Nitin Bendsure
- Department of Dermatology, Venereology and Leprosy, Smt Kashibai Navale Medical College, Pune, Maharashtra, India
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