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Pozo-Pérez L, Tornero-Esteban P, López-Bran E. Clinical and preclinical approach in AGA treatment: a review of current and new therapies in the regenerative field. Stem Cell Res Ther 2024; 15:260. [PMID: 39148125 PMCID: PMC11328498 DOI: 10.1186/s13287-024-03801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/11/2024] [Indexed: 08/17/2024] Open
Abstract
Androgenetic alopecia (AGA) is the most prevalent type of hair loss. Its morbility is mainly psychological although an increased incidence in melanoma has also been observed in affected subjects. Current drug based therapies and physical treatments are either unsuccessful in the long term or have relevant side effects that limit their application. Therefore, a new therapeutic approach is needed to promote regenerative enhancement alternatives. These treatment options, focused on the cellular niche restoration, could be the solution to the impact of dihydrotestosterone in the hair follicle microenvironment. In this context emerging regenerative therapies such as Platelet-rich plasma or Platelet-rich fibrine as well as hair follicle stem cells and mesenchymal stem cell based therapies and their derivatives (conditioned medium CM or exoxomes) are highlighting in the evolving landscape of hair restoration. Nanotechnology is also leading the way in AGA treatment through the design of bioinks and nanobiomaterials whose structures are being configuring in a huge range of cases by means of 3D bioprinting. Due to the increasing number and the rapid creation of new advanced therapies alternatives in the AGA field, an extended review of the current state of art is needed. In addition this review provides a general insight in current and emerging AGA therapies which is intented to be a guidance for researchers highlighting the cutting edge treatments which are recently gaining ground.
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Affiliation(s)
- Lorena Pozo-Pérez
- Dermatology Department, Clínico San Carlos Hospital, Madrid, Spain.
- Institute for Health Research of Clinico San Carlos Hospital (IdISSC), Madrid, Spain.
| | - Pilar Tornero-Esteban
- Cellular GMP Manufacturing Facility, Institute for Health Research of Clinico San Carlos Hospital (IdISSC), Madrid, Spain
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2
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Donnelly C, Minty I, Dsouza A, Wong YY, Mukhopadhyay I, Nagarajan V, Rupra R, Charles WN, Khajuria A. The role of platelet-rich plasma in androgenetic alopecia: A systematic review. J Cosmet Dermatol 2024; 23:1551-1559. [PMID: 38284294 DOI: 10.1111/jocd.16185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/21/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Androgenetic alopecia (AGA), also referred to as male or female pattern hair loss, is the commonest cause of chronic hair loss and affects up to 80% of men by the age of 70. Despite a high prevalence, there are few approved therapies, which show minimal efficacy. OBJECTIVES This systematic review aims to evaluate the efficacy of platelet-rich plasma (PrP) in the treatment of AGA in male patients. METHODS MEDLINE, EMBASE, Cochrane (CENTRAL), CINAHL, clinicaltrials.gov, Google Scholar and the Science Citation Index database were searched to identify eligible studies. All randomized controlled trials (RCTs) and prospective cohort studies related to PrP use in AGA were included. Primary outcomes included changes in hair density and hair count. Methodological quality was assessed using bias assessment tools. RESULTS Eight RCTs and one cohort study were included in the review with a total of 291 participants. Six studies reported a statistically significant increase in hair density in the PrP group versus the control. Five studies reported a statistically significant increase in hair count with PrP. Seven studies showed moderate risk and two showed low risk of bias. CONCLUSION In a methodologically robust review on the effectiveness of PrP on male AGA, PrP demonstrated some potential to be used therapeutically. However, the low quality of evidence, moderate risk of bias, and high heterogeneity of included studies limit inferences and call for more robust designs to investigate this further.
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Affiliation(s)
- C Donnelly
- Green Templeton College, University of Oxford, Oxford, UK
| | - I Minty
- University College Hospital, London, UK
| | - A Dsouza
- Kasturba Medical College, Manipal, Karnataka, India
| | - Y Y Wong
- University of Glasgow, Glasgow, UK
| | | | - V Nagarajan
- University Hospital Leicester, Leicester, UK
| | - R Rupra
- Norfolk & Norwich University Hospital, Norwich, UK
| | - W N Charles
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Khajuria
- Department of Surgery and Cancer, Imperial College London, London, UK
- Kellogg College, University of Oxford, Oxford, UK
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3
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Panchaprateep R. Medical Treatment for Androgenetic Alopecia. Facial Plast Surg 2024; 40:252-266. [PMID: 37871637 DOI: 10.1055/a-2196-4713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Androgenetic alopecia is a common type of hair loss, which is generally influenced by genetic factors and systemic androgens resulting in follicular miniaturization.1 It can cause cosmetic problems leading to psychological distress among affected men and women. Effective standard medical treatments available are topical minoxidil 2 to 5%, oral finasteride, oral dutasteride, and hair transplantation.1 However, some patients do not achieve favorable results with standard treatments. For these reasons, other novel treatments have been developed, including new medications, regenerative medicines (autologous platelet-rich plasma, adipose-derived stem cells, micrograft generation, and exosome), and low-level laser therapy.
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Affiliation(s)
- Ratchathorn Panchaprateep
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Absolute Hair Clinic, Bangkok Thailand
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4
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Pai SN, Jeyaraman N, Venkatasalam R, Vr R, Ramasubramanian S, Balaji S, Nallakumarasamy A, Sharma S, Patro BP, Jeyaraman M. Standardized Informed Consent Form for Clinicians Administering Platelet-Rich Plasma. Cureus 2024; 16:e57565. [PMID: 38707034 PMCID: PMC11068980 DOI: 10.7759/cureus.57565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction When it comes to medico-legal malpractice suits, lawyers and insurers tend to focus on informed consent documentation. Unfortunately, there is no standard protocol for obtaining informed consent for the use of platelet-rich plasma (PRP) injections, which might cause problems. This study aimed to mitigate this concern through the development of a standardized informed consent document for PRP injections, grounded in evidence-based practices. Materials and methods An examination of databases was conducted to explore the medico-legal ramifications associated with PRP injections, as well as the broader topic of informed consent, with a particular focus on the context of PRP injections. Moreover, interviews were carried out with healthcare providers and individuals who had received PRP injections within the preceding year, utilizing a semi-structured methodology. Results We developed an evidence-based informed consent document tailored for PRP injections. To guarantee its legal validity, the document underwent review by a legal specialist. Subsequently, our institutions implemented the finalized form for PRP injection procedures over one year. Conclusion A legally valid and evidence-based informed consent form for PRP injections would ensure patient's rights, and encourage open communication and transparency between them and the doctor. Moreover, if a lawsuit were to arise, it would serve as a critical document in the doctor's defense and withstand scrutiny from lawyers and the judiciary.
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Affiliation(s)
- Satvik N Pai
- Orthopaedic Surgery, Hospital for Orthopedics, Sports Medicine, Arthritis & Trauma (HOSMAT) Hospital, Bangalore, IND
- Orthopaedic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Naveen Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND
| | | | - Ravi Vr
- Regenerative Medicine, Mothercell Regenerative Centre, Tiruchirappalli, IND
| | | | - Sangeetha Balaji
- Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, IND
| | - Arulkumar Nallakumarasamy
- Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) - Karaikal, Karaikal, IND
| | - Shilpa Sharma
- Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, IND
| | - Bishnu P Patro
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Madhan Jeyaraman
- Clinical Research, Viriginia Tech India, Dr MGR Educational and Research Institute, Chennai, IND
- Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND
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5
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Feng W, Yang L, Li J, Chen Y, Yao B. A bibliometric analysis of trends in the application of platelet-rich plasma in cosmetics research between 2001 and 2022. J Cosmet Dermatol 2024; 23:780-793. [PMID: 37966031 DOI: 10.1111/jocd.16062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Several studies have been conducted on using platelet-rich plasma (PRP) to treat cosmetic issues. Nonetheless, no bibliometric analyses of publications in this field exist. Bibliometrics is an effective tool for methodically assessing the current state of research on a particular topic. This study examines the literature published in this field since 2000 and depicts the resulting network. METHODS The Web of Science Core Collection was searched for any publications mentioning the use of PRP in cosmetic or aesthetic therapy published between 2001 and 2022. The author, region, institution, journal, cited journal, and keywords were extracted, and the bibliometric analysis was carried out using CiteSpace and R studio. RESULTS There were a total of 306 items retrieved. The first publication in this field appeared in 2001, and the number of articles published increased over the next 21 years. Saedi Nazanin is the author with the most publications. The most prolific nations and institutions were the United States and the Fourth Military Medical University, respectively. Similarly, most articles and citations were found in the Journal of Cosmetic Dermatology and Plastic and Reconstructive Surgery. After performing a cluster analysis on the keywords of published publications, we discovered that most of the published literature focused on using PRP in rejuvenation, mechanism, and combination with MSCs. These topics are still at the frontier of future research. CONCLUSION Since the first study in this field was published in 2001, PRP used in cosmetic clinics has been studied. Although early effects have been observed, numerous challenges remain, including a lack of higher-quality clinical studies and explanations of PRP's mechanism. The bibliometric analysis conducted for the purpose of this article provides a summary of academic hotspots and research frontiers, as well as insights and pointers for future productive research.
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Affiliation(s)
- Wei Feng
- Department of Plastic & Reconstructive Surgery, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Lichang Yang
- Department of Breast Oncoplastic Surgery, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jingyu Li
- Department of Plastic & Reconstructive Surgery, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Yan Chen
- Department of Plastic & Reconstructive Surgery, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Bin Yao
- Department of Orthopedics, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
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6
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Li M, Qu K, Lei Q, Chen M, Bian D. Effectiveness of Platelet-Rich Plasma in the Treatment of Androgenic Alopecia: A Meta-Analysis. Aesthetic Plast Surg 2024; 48:977-984. [PMID: 37644190 PMCID: PMC10980625 DOI: 10.1007/s00266-023-03603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a common yet difficult-to-treat condition, which is an important psychosocial problem. Platelet-rich plasma (PRP) therapy has been considered as a promising treatment for AGA. However, the current evidence on the efficacy of PRP for treating AGA is still controversial. This study evaluated the efficacy of PRP monotherapy in the treatment of AGA. METHODS We searched PubMed, Embase, Cochrane Library and Web of Science to collect randomized controlled trials on use of PRP in AGA for a meta-analysis. RESULTS Ten trials with a total 555 treatment units were identified. The hair density in PRP group was significantly higher than control group [MD = 25.09, 95%CI: 9.03-41.15, p = 0.002], but there was no significant difference in hair diameter between two groups [SMD = 0.57, 95%CI: - 0.23 to 1.38, p = 0.16]. Subgroup analyses indicated that hair density was significantly higher among the male-only trials than in the mixed-sex samples (p = 0.02). In addition, neither the split-head design nor the year of publication affected hair density (p = 0.05, p = 0.06). However, hair density was significantly higher in trials with a sample size less than 30 (p = 0.0004). CONCLUSIONS PRP treatment increased hair density in participants with AGA, but not hair diameter. In terms of hair density, PRP elicits stronger effects in male patients. There was a trend toward differed treatment effect by gender with PRP injection, which warrants further investigation. Especially in the case of female. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .
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Affiliation(s)
- Meijia Li
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Kaipan Qu
- Department of Burn and Plastic Surgery, Shandong Provincial Third Hospital, Jinan, China
| | - Qiang Lei
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Mingrui Chen
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China
| | - Donghui Bian
- Department of Burn and Plastic Surgery, The 960th Hospital of the People's Liberation Army, No. 25 Shifan Road, Jinan, 250001, China.
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7
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Shehan JN, Spiegel JH. Hair Restoration Techniques. Facial Plast Surg 2023; 39:512-516. [PMID: 37506740 DOI: 10.1055/s-0043-1771291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Hair restoration is an essential topic in the current management of facial plastic surgery concerns and queries. Advances in hair restoration include oral and topical medications and compounded preparations, injections including platelet-rich plasma, light therapy, and follicular unit extraction methods. This article provides a review of current techniques.
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Affiliation(s)
- Jennifer Nicole Shehan
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Boston University School of Medicine, Boston, Massachusetts
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8
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Sand J, Walen S. Noninvasive Hair Rejuvenation. Clin Plast Surg 2023; 50:509-520. [PMID: 37169416 DOI: 10.1016/j.cps.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Both nonsurgical and surgical modalities for the treatment of hair loss are being used by providers at an increasing rate worldwide. Men and woman are affected by hair loss, but the pathophysiology of the hair loss is thought to be different between sexes; therefore, gender must play a role in treatment decisions. Currently, there are 3 Food and Drug Administration-approved nonsurgical androgenetic alopecia treatments: minoxidil, finasteride, and low-light laser therapy. Platelet-rich plasma injections are showing promise as a single modality and as an adjunct to other nonsurgical and surgical treatments of androgenetic alopecia.
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Affiliation(s)
- Jordan Sand
- Spokane Center for Facial Plastic Surgery, 217 W. Cataldo Avenue, Spokane, WA 99201, USA
| | - Scott Walen
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive H-091, Hershey, PA 17033, USA.
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9
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Levin M, Spiegel JH. Does Platelet-Rich Plasma Have a Therapeutic Role in Hair Restoration? Laryngoscope 2023; 133:719-721. [PMID: 36637194 DOI: 10.1002/lary.30564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 01/14/2023]
Affiliation(s)
- Marc Levin
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey H Spiegel
- Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.,The Spiegel Center, Newton, Massachusetts, USA
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10
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Troha K, Vozel D, Arko M, Bedina Zavec A, Dolinar D, Hočevar M, Jan Z, Kisovec M, Kocjančič B, Pađen L, Pajnič M, Penič S, Romolo A, Repar N, Spasovski V, Steiner N, Šuštar V, Iglič A, Drobne D, Kogej K, Battelino S, Kralj-Iglič V. Autologous Platelet and Extracellular Vesicle-Rich Plasma as Therapeutic Fluid: A Review. Int J Mol Sci 2023; 24:3420. [PMID: 36834843 PMCID: PMC9959846 DOI: 10.3390/ijms24043420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
The preparation of autologous platelet and extracellular vesicle-rich plasma (PVRP) has been explored in many medical fields with the aim to benefit from its healing potential. In parallel, efforts are being invested to understand the function and dynamics of PVRP that is complex in its composition and interactions. Some clinical evidence reveals beneficial effects of PVRP, while some report that there were no effects. To optimize the preparation methods, functions and mechanisms of PVRP, its constituents should be better understood. With the intention to promote further studies of autologous therapeutic PVRP, we performed a review on some topics regarding PVRP composition, harvesting, assessment and preservation, and also on clinical experience following PVRP application in humans and animals. Besides the acknowledged actions of platelets, leukocytes and different molecules, we focus on extracellular vesicles that were found abundant in PVRP.
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Affiliation(s)
- Kaja Troha
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Domen Vozel
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Matevž Arko
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Apolonija Bedina Zavec
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, SI-1000 Ljubjana, Slovenia
| | - Drago Dolinar
- Department of Orthopedic Surgery, University Medical Centre, Zaloška 9, SI-1000 Ljubljana, Slovenia
- MD-RI Institute for Materials Research in Medicine, Bohoričeva 5, SI-1000 Ljubljana, Slovenia
| | - Matej Hočevar
- Department of Physics and Chemistry of Materials, Institute of Metals and Technology, SI-1000 Ljubljana, Slovenia
| | - Zala Jan
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Matic Kisovec
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, SI-1000 Ljubjana, Slovenia
| | - Boštjan Kocjančič
- Department of Orthopedic Surgery, University Medical Centre, Zaloška 9, SI-1000 Ljubljana, Slovenia
| | - Ljubiša Pađen
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Manca Pajnič
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Samo Penič
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
| | - Anna Romolo
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
| | - Neža Repar
- University of Ljubljana, Research Group for Nanobiology and Nanotoxicology, Biotechnical Faculty, SI-1000 Ljubljana, Slovenia
| | - Vesna Spasovski
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia
| | - Nejc Steiner
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Vid Šuštar
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
| | - Aleš Iglič
- University of Ljubljana, Laboratory of Physics, Faculty of Electrical Engineering, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Damjana Drobne
- University of Ljubljana, Research Group for Nanobiology and Nanotoxicology, Biotechnical Faculty, SI-1000 Ljubljana, Slovenia
| | - Ksenija Kogej
- University of Ljubljana, Chair of Physical Chemistry, Faculty of Chemistry and Chemical Technology, SI-1000 Ljubljana, Slovenia
| | - Saba Battelino
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, SI-1000 Ljubljana, Slovenia
| | - Veronika Kralj-Iglič
- University of Ljubljana, Laboratory of Clinical Biophysics, Faculty of Health Sciences, SI-1000 Ljubljana, Slovenia
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11
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Li C, Pan L, Yang L, Kong J, Zhang L. An umbrella review of the use of platelet-rich plasma in the treatment of androgenetic alopecia. J Cosmet Dermatol 2023; 22:1463-1476. [PMID: 36718799 DOI: 10.1111/jocd.15617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the efficacy of platelet-rich plasma (PRP) in the treatment of androgenetic alopecia, as well as establish an effective treatment protocol and optimal PRP preparation procedure. METHODS We searched the PubMed, Scopus, Embase, Cochrane, CNKI, and Wanfang databases from inception to October 29, 2021, using PROSPERO's International Prospective Register of Systematic Reviews (registration ID: CRD42022295921). RESULTS The original literature search revealed 215 reviews; after duplication removal, 89 papers were eliminated, 95 were eliminated after reading the titles and abstracts, and eventually, 28 articles were included after reading the complete text. CONCLUSIONS PRP treatment for androgenetic alopecia is effective, and we recommend the following: (1) a PRP volume of at least 0.05 ml/cm2 , preferably 0.1 ml/cm2 ; (2) at least three consecutive treatments at an interval of 1 month; (3) intensive therapy is beneficial and can be provided from 3 to 6 months after continuous treatment; (4) objective indicators such as hair diameter, hair count; (5) long-term follow-up.
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Affiliation(s)
- Caihong Li
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lingfeng Pan
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Liehao Yang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Jiao Kong
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
| | - Lianbo Zhang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China
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12
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Noninvasive Hair Rejuvenation. Facial Plast Surg Clin North Am 2022; 30:419-431. [DOI: 10.1016/j.fsc.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Lipner SR, Falotico JM. Lessons Learned from Orthopedics: A Call to Action for More Rigorous Platelet-Rich Plasma Hair Loss Clinical Trials. Am J Clin Dermatol 2022; 23:421-424. [PMID: 35397760 DOI: 10.1007/s40257-022-00691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, 1305 York Avenue, New York, NY, 10021, USA.
| | - Julianne M Falotico
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
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14
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Wang L, Lv S, Lin W, Yang D. Autologous Concentrated Growth Factor Used to Treat Linear Scleroderma En Coup de Sabre: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:675-679. [PMID: 35444437 PMCID: PMC9015785 DOI: 10.2147/ccid.s356972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
Abstract
Linear scleroderma en coup de sabre (LSCS) is a variant of localized scleroderma associated with band-like fibrotic lesions in the frontoparietal area. We report a case of LSCS in a woman who presented with progressive mild hyperchromia on the right side of her forehead, with dermal atrophy and hair and eyebrow loss. After the failure of conservative treatments, the patient responded dramatically to injection of autologous localized concentrated growth factor. After three treatments, the atrophy, stiffness, and angiotelectasis on the affected area had improved. No recurrence was detected 24 months after the last treatment. This is the first study describing the use of autologous concentrated growth factor injection to alleviate clinical symptoms of LSCS. This suggests that concentrated growth factor may be a treatment for LSCS in the clinic.
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Affiliation(s)
- Lei Wang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Shuying Lv
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China.,School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Wenjun Lin
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China.,School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Dingquan Yang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
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Effectiveness of Platelet-Rich Plasma Therapy in Androgenic Alopecia—A Meta-Analysis. J Pers Med 2022; 12:jpm12030342. [PMID: 35330343 PMCID: PMC8953144 DOI: 10.3390/jpm12030342] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 01/25/2023] Open
Abstract
Platelet-rich plasma (PRP) represents a novel therapy tested and is used more and more frequently in dermatology and cosmetic surgery for a variety of conditions, including androgenic alopecia (AGA), a common condition with a complex pathogenesis involving genetic factors, hormonal status and inflammation. We performed an extensive literature search which retrieved 15 clinical trials concerning the use in AGA of PRP therapy, alone or in combination, in male, female or mixed patient groups. A quantitative statistical meta-analysis of n = 17 trial groups proved significant increases in hair density from 141.9 ± 108.2 to 177.5 ± 129.7 hairs/cm2 (mean ± SD) following PRP (p = 0.0004). To the best of our knowledge, this is the first meta-analysis that proved a statistically significant correlation between the number of PRP treatments per month and the percentage change in hair density (r = 0.5, p = 0.03), as well as a negative correlation between the mean age of treatment group and the percentage change in hair density (r = −0.56, p = 0.016). Other factors considered for analysis were the PRP preparation method, amount used per treatment, hair diameter, terminal hairs and pull test. We conclude that PRP represents a valuable and effective therapy for AGA in both males and females if patients are rigorously selected.
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16
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Effect and Safety Analysis of PRP and Yifu Combined with Ultrapulsed CO2 Lattice Laser in Patients with Sunken Acne Scar. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6803988. [PMID: 35126939 PMCID: PMC8808142 DOI: 10.1155/2022/6803988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Abstract
Objective To investigate the effect and safety of PRP and Yifu combined with ultrapulsed CO2 lattice laser in patients with sunken acne scar. Methods 700 subjects were selected from the group of patients with sunken acne scar treated in our hospital from November 2010 to December 2020. They were divided into control group (n = 350) and study group (n = 350). The grouping was mainly based on the random number table method. Patients in the control group were treated with ultrapulse CO2 lattice laser, while those in the study group were treated with ultrapulse CO2 lattice laser combined with PRP and Yifu. The clinical effect, scar improvement and quality of life before and after treatment, and adverse events during treatment were compared between the two groups. The clinical effect was categorized into cure after treatment, significant effect, effective, and ineffective. The total effective rate = 1 − ineffective rate. Results After treatment, the total effective rate of the study group (81.43%) was higher than that of the control group (70.00%). After treatment, ECCA, VSS scores, daily activities, symptoms and feelings, work and study, leisure and entertainment, interpersonal relationship, treatment status, and total scores were all lower in both groups than before treatment, and the study group was lower than the control group. During the treatment, the incidence of adverse events in the study group (17.33%) was lower than that in the control group (28.57%), P < 0.05. Conclusion PRP and Yifu combined with ultrapulse CO2 lattice laser in the treatment of sunken acne scar can effectively improve the scar, reduce the incidence of adverse events, and the treatment effect is obvious, which can improve the quality of life of the patients.
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18
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Nepal S, Venkataram A, Mysore V. The Role of Adipose Tissue in Hair Regeneration: A Potential Tool for Management? J Cutan Aesthet Surg 2021; 14:295-304. [PMID: 34908771 PMCID: PMC8611710 DOI: 10.4103/jcas.jcas_47_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Human adipose tissue (AT) is a rich and easily harvestable source of stem cells and various growth factors (GFs). It has been widely used hitherto for facial rejuvenation and volumization. Increasing evidence shows that dermal adipocytes are intricately associated with hair follicles (HFs) and may be necessary to drive follicular stem cell activation. Early published data have shown encouraging preliminary results for the use of adipocytes and their stem cells as a treatment option for hair growth. The aim of this review study is to analyze published literature on the effect of fat on hair growth and to summarize the current evidence.
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Affiliation(s)
- Suman Nepal
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
| | - Aniketh Venkataram
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
| | - Venkataram Mysore
- The Venkat Center for Skin, ENT and Plastic Surgery, Bengaluru, Karnataka, India
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19
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Female Pattern Hair Loss: Why the Follicular Unit Transplantation Surgical Technique Remains a Good Option. Plast Reconstr Surg 2021; 147:839-849. [PMID: 33710162 DOI: 10.1097/prs.0000000000007760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Female pattern hair loss is a common nonscarring alopecia that can present with several patterns of decreased hair density. The condition is very bothersome to affected women, and although there are multiple nonsurgical options, surgical follicular unit transplantation remains one of the most effective options. METHODS A retrospective chart review was performed of the senior author's (C.O.U.) experience and technique of follicular unit transplantation for treatment of female pattern hair loss. RESULTS A total of 751 patients with female pattern hair loss underwent follicular unit transplantation over the past 31 years. Average patient age was 48 years. Patients with small areas of hair loss made up 40 percent of the group (Ludwig stage I), those with medium-sized areas constituted 45 percent (Ludwig stage II), and those with large areas constituted 15 percent (Ludwig stage III). The average operative time was 3 hours 21 minutes. One hundred thirty-five patients (18 percent) underwent a second replacement, at an average period of 4 years after the procedure, because of the progressive nature of female pattern hair loss. Complications included donor-site scar widening in six patients and folliculitis in 17 patients. CONCLUSION Follicular unit transplantation is an excellent option for treatment of female pattern hair loss patients, as there is no need to shave the recipient sites, operative times are shorter than for follicular unit excision techniques, and the incidence of complications is very low. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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20
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Jansen EE, Braun A, Jansen P, Hartmann M. Platelet-Therapeutics to Improve Tissue Regeneration and Wound Healing-Physiological Background and Methods of Preparation. Biomedicines 2021; 9:biomedicines9080869. [PMID: 34440073 PMCID: PMC8389548 DOI: 10.3390/biomedicines9080869] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Besides their function in primary hemostasis, platelets are critically involved in the physiological steps leading to wound healing and tissue repair. For this purpose, platelets have a complex set of receptors allowing the recognition, binding, and manipulation of extracellular structures and the detection of pathogens and tissue damage. Intracellular vesicles contain a huge set of mediators that can be released to the extracellular space to coordinate the action of platelets as other cell types for tissue repair. Therapeutically, the most frequent use of platelets is the intravenous application of platelet concentrates in case of thrombocytopenia or thrombocytopathy. However, there is increasing evidence that the local application of platelet-rich concentrates and platelet-rich fibrin can improve wound healing and tissue repair in various settings in medicine and dentistry. For the therapeutic use of platelets in wound healing, several preparations are available in clinical practice. In the present study we discuss the physiology and the cellular mechanisms of platelets in hemostasis and wound repair, the methods used for the preparation of platelet-rich concentrates and platelet-rich fibrin, and highlight some examples of the therapeutic use in medicine and dentistry.
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Affiliation(s)
- Ellen E. Jansen
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, 52074 Aachen, Germany; (E.E.J.); (A.B.); (P.J.)
| | - Andreas Braun
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, 52074 Aachen, Germany; (E.E.J.); (A.B.); (P.J.)
| | - Patrick Jansen
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, 52074 Aachen, Germany; (E.E.J.); (A.B.); (P.J.)
| | - Matthias Hartmann
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Universität Duisburg-Essen, 45122 Essen, Germany
- Correspondence:
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21
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Mysore V, Kumaresan M, Garg A, Dua A, Venkatram A, Dua K, Singh M, Madura C, Chandran R, Rajput RS, Sattur S, Singh S. Hair Transplant Practice Guidelines. J Cutan Aesthet Surg 2021; 14:265-284. [PMID: 34908769 PMCID: PMC8611706 DOI: 10.4103/jcas.jcas_104_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The field of hair transplant (HT) has grown exponentially in the past decade, especially after the introduction of follicular unit excision (FUE). There is much variation in criteria for case selection, the technique, pre- and post-procedure protocols, by different surgeons. Techniques continue to evolve and evidence in the form of controlled data is not available for all techniques and protocols being used; there is also a debate as to who can do what, what should be the training for staff, role of technicians. This has led to a situation wherein medico legal issues have cropped up as to what is minimum acceptable. An attempt is made to summarize standard protocols with the available evidence. It is emphasized that the objective of these guidelines is to recommend minimum standards for practice of hair transplantation. The principles outlined in these guidelines are of a general nature only, minimal in their level and are not meant to cover all situations. It should be understood that these recommendations are by no means binding and universal, represent minimum standards only and as in all surgical techniques, variations in techniques are possible. It is also further clarified that these are based on current literature, and as science evolves, these guidelines could also change in future. Where published evidence is not available, consensus expert opinion is presented. The task force emphasizes that each patient has to be treated on his/her own merit and that these guidelines do not limit the physician from making an appropriate choice or the necessary innovation for a given patient. The task force recognizes that the treating surgeon is best suited to decide what is needed for a given patient in a given situation. Innovations in medicine need flexibility in approach and these guidelines do not limit the surgeon from undertaking innovative research.
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Affiliation(s)
- Venkatram Mysore
- The Venkat Center for Skin and Plastic Surgery, Bengaluru, Karnataka, India
| | - Muthuvel Kumaresan
- Cutis Skin Clinic & Hair Transplant Center, Coimbatore, Tamil Nadu, India
| | - Anil Garg
- Rejuvenate Hair Transplant Center, Indore, Madhya Pradesh, India
| | - Aman Dua
- AK Clinics & Hair Transplant Center, Delhi, India
| | - Aniketh Venkatram
- Cutis Skin Clinic & Hair Transplant Center, Coimbatore, Tamil Nadu, India
| | - Kapil Dua
- AK Clinics & Hair Transplant Center, Delhi, India
| | | | - C Madura
- Cutis Academy of Cutaneous Sciences, Bangalore, India
| | - Ram Chandran
- Apollo Speciality Center, Chennai, Tamil Nadu, India
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22
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Gupta AK, Renaud HJ, Rapaport JA. Platelet-rich Plasma and Cell Therapy: The New Horizon in Hair Loss Treatment. Dermatol Clin 2021; 39:429-445. [PMID: 34053596 DOI: 10.1016/j.det.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Current medicinal therapies for treating hair loss have shortcomes due to variability and ineffectiveness, noncompliance, and adverse effects. The prevalence of hair loss and its associated negative psychological impact have driven research into regenerative medicine approaches, such as platelet-rich plasma (PRP) and cell-based therapies, in an attempt to find alternative, safe, effective, and reproducible treatments. Current research shows promising results from these therapies; however, more robust trials are needed to confirm the reported efficacies of PRP and cell-based therapies. Moreover, standardization of treatment preparation as well as dose and regimen are needed.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Ontario, Canada; Mediprobe Research Inc., 645 Windermere Road, London, Ontario N5X 2P1, Canada.
| | - Helen J Renaud
- Mediprobe Research Inc., 645 Windermere Road, London, Ontario N5X 2P1, Canada
| | - Jeffrey A Rapaport
- Cosmetic Skin and Surgery Center, 333 Sylvan Avenue, Suite 207, Englewood Cliffs, NJ 07632, USA
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23
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Nazaroff J, Oyadomari S, Brown N, Wang D. Reporting in clinical studies on platelet-rich plasma therapy among all medical specialties: A systematic review of Level I and II studies. PLoS One 2021; 16:e0250007. [PMID: 33891618 PMCID: PMC8064527 DOI: 10.1371/journal.pone.0250007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The clinical practice of platelet-rich plasma (PRP) therapy has grown significantly in recent years in multiple medical specialties. However, comparisons of PRP studies across medical fields remain challenging because of inconsistent reporting of protocols and characterization of the PRP being administered. The purpose of this systematic review was to determine the quantity of level I/II studies within each medical specialty and compare the level of study reporting across medical fields. METHODS The Cochrane Database, PubMed, and EMBASE databases were queried for level I/II clinical studies on PRP injections across all medical specialties. From these studies, data including condition treated, PRP processing and characterization, delivery, control group, and assessed outcomes were collected. RESULTS A total of 132 studies met the inclusion and exclusion criteria and involved 28 different conditions across 8 specialties (cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK), neurology, oral maxillofacial surgery, ophthalmology, and plastic surgery). Studies on PRP for MSK injuries made up the majority of the studies (74%), with knee osteoarthritis and tendinopathy being most commonly studied. Of the 132 studies, only 44 (33%) characterized the composition of PRP used, and only 23 (17%) reported the leukocyte component. MSK studies were more likely to use patient-reported outcome measures to assess outcomes, while studies from other specialties were more likely to use clinician- or imaging-based objective outcomes. Overall, 61% of the studies found PRP to be favorable over control treatment, with no difference in favorable reporting between MSK and other medical specialties. CONCLUSIONS The majority of level I/II clinical studies investigating PRP therapy across all medical specialties have been conducted for MSK injuries with knee osteoarthritis and tendinopathy being the most commonly studied conditions. Inconsistent reporting of PRP composition exists among all studies in medicine. Rigorous reporting in human clinical studies across all medical specialties is crucial for evaluating the effects of PRP and moving towards disease-specific and individualized treatment.
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Affiliation(s)
- Jaron Nazaroff
- University of California Irvine School of Medicine, Irvine, CA, United States of America
| | - Sarah Oyadomari
- University of California Irvine School of Medicine, Irvine, CA, United States of America
| | - Nolan Brown
- University of California Irvine School of Medicine, Irvine, CA, United States of America
| | - Dean Wang
- University of California Irvine School of Medicine, Irvine, CA, United States of America
- Department of Orthopaedic Surgery, University of California Irvine Health, Orange, CA, United States of America
- * E-mail:
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24
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Sawetz I, Lebo PB, Nischwitz SP, Winter R, Schaunig C, Brinskelle P, Kamolz LP, Gualdi A, Lumenta DB. Platelet-rich plasma for striae distensae: What do we know about processed autologous blood contents for treating skin stretchmarks?-A systematic review. Int Wound J 2021; 18:387-395. [PMID: 33738930 PMCID: PMC8244019 DOI: 10.1111/iwj.13541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/13/2020] [Indexed: 11/27/2022] Open
Abstract
Striae distensae, also known as stretch marks, particularly associated with female sex, pregnancy, obesity, and/or hormonal change, are linear bands of benign dermal lesions. Although not posing any health risk, aesthetically unpleasing stretch marks can cause significant psychological distress among those affected. In abundance of therapeutic approaches, some literature sources proclaim platelet‐rich plasma to be a promising treatment modality for striae distensae. We aimed to shed some light on the current literature evidence of platelet‐rich plasma for treating stretch marks and performed an English literature analysis with two independent reviewers in accordance with PRISMA guidelines searching the PubMed and Web of Science databases in June 2019. Of the 12 found studies, 6 matched inclusion criteria. With no control groups in two, just two other reports used intraindividual comparisons, and all but one publication performed histopathological assessments. All studies observed clinical and subjective improvements without using validated scores or patient‐reported outcome measures (PROMs). The main findings were that multiple treatments with platelet‐rich plasma demonstrated increased epidermal thickness, rete ridges formation, and collagen/elastin formation, while decreasing the inflammatory cell infiltrate. The current literature evidence supporting the use of platelet‐rich plasma for striae distensae is poor. We propose in this review an outline for a study protocol with intraindividual control groups, standardised scores, validated PROMs, and participant incentives to enhance the scientific power in future clinical trials.
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Affiliation(s)
- Isabelle Sawetz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Patricia B Lebo
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Sebastian P Nischwitz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,COREMED-Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Raimund Winter
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Caroline Schaunig
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Petra Brinskelle
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Lars P Kamolz
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,COREMED-Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | | | - David B Lumenta
- Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Abstract
Platelets play a crucial role in hemostasis, tissue regeneration and host defense. Based on these settings, platelet-rich plasma (PRP) and its derivatives are therapeutically used to promote wound healing in several scenarios. This review summarizes the biological mechanisms underlying the most traditional as well as innovative applications of PRP in wound healing. These mechanisms involve the combined action of platelet-derived growth factors and cytokines, together with the role of plasma-derived fibrillar, antioxidant and homeostatic factors. In addition, regenerative treatments with PRP consist of personalized and non-standardized methods. Thus, the quality of PRP varies depending on endogenous factors (e.g., age; gender; concomitant medication; disease-associated systemic factors; nutrition) and exogenous factors (anticoagulants and cellular composition). This review also analyses whether these factors affect the biological mechanisms of PRP in wound healing applications.
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Affiliation(s)
- Paula Oneto
- Laboratory of Experimental Thrombosis, Institute of Experimental Medicine-CONICET, National Academy of Medicine, Buenos Aires, Argentina
| | - Julia Etulain
- Laboratory of Experimental Thrombosis, Institute of Experimental Medicine-CONICET, National Academy of Medicine, Buenos Aires, Argentina
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26
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Shapiro J, Ho A, Sukhdeo K, Yin L, Lo Sicco K. Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: A randomized controlled trial. J Am Acad Dermatol 2020; 83:1298-1303. [PMID: 32653577 DOI: 10.1016/j.jaad.2020.07.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) shows promise as an androgenetic alopecia (AGA) treatment. OBJECTIVE To conduct a randomized placebo-controlled split-scalp study to investigate the effects of PRP on hair regrowth and thickness. METHODS Two 7.6-cm × 7.6-cm squares were tattooed on the scalps of 35 study participants with AGA. Areas were randomly assigned to intradermal injection with PRP or saline. Participants received 3 monthly treatment sessions with evaluation 3 months after the final treatment. RESULTS Hair density in the PRP-treated area was significantly increased compared with baseline at all visits. At the final assessment, hair density in PRP-treated areas increased from 151 ± 39.82 hairs/cm2 at baseline to 170.96 ± 37.14 hairs/cm2, a mean increase of approximately 20 hairs/cm2 (P < .05). However, hair density in placebo-treated areas also increased from 151.04 ± 41.99 hairs/cm2 to 166.72 ± 37.13 hairs/cm2 (P < .05). There was no significant difference in hair density change between the 2 groups (P > .05). No serious adverse events were reported. LIMITATIONS Possible PRP diffusion due to split-scalp study design as well as microinjections causing microinjury to both sides. CONCLUSION PRP may have benefit in increasing hair density.
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Affiliation(s)
- Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
| | - Anthony Ho
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | | | - Lu Yin
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
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27
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Neinaa YMEH, Hodeib AAEH, Morquos MM, Elgarhy LH. Platelet-poor plasma gel vs platelet-rich plasma for infraorbital rejuvenation: A clinical and dermoscopic comparative study. Dermatol Ther 2020; 33:e14255. [PMID: 32862476 DOI: 10.1111/dth.14255] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 01/11/2023]
Abstract
Infraorbital dark circles and tear trough deformity are considered common aesthetic problems. Numerous therapeutic modalities have been suggested with variable outcomes. The aim of this study was to compare the efficacy of platelet-poor plasma (PPP) gel vs platelet-rich plasma (PRP) in infraorbital rejuvenation. A total of 68 females presented with dark circles and/or tear trough deformity were recruited and treated by PPP gel injection in the right infraorbital region (Group A) and PRP injection in the left infraorbital region (Group B). They received three treatment sessions at 2-week interval, and followed up monthly for 3 months. They were evaluated clinically and dermoscopically before treatment and at the end of follow-up period. Both groups showed significant clinical improvements proved by significant reduction of degree of hyperpigmentation and tear trough rating scale. Obviously, more significant clinical and dermoscopic improvements were observed in Group A than Group B. Therefore, it could be concluded that both PPP gel and PRP were clinically effective procedures for aesthetic improvement of infraorbital region. Moreover, PPP gel seems to be significantly more effective than PRP as a therapeutic modality.
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Affiliation(s)
| | | | - Mariam Maher Morquos
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Lamia Hamouda Elgarhy
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part II: Clinical Evidence. Dermatol Surg 2020; 46:447-456. [PMID: 31770154 DOI: 10.1097/dss.0000000000002148] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP) is an increasingly popular treatment modality for various dermatologic conditions, but there are limitations in both the published literature and clinician knowledge. OBJECTIVE To create a high-yield, in-depth analysis of PRP in procedural dermatology by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine. MATERIALS AND METHODS A two-part systematic review and expert analysis of publications before October 2018. RESULTS AND CONCLUSION Most studies on PRP report favorable outcomes with the strongest level of evidence existing for androgenetic alopecia followed by postprocedure wound healing, scar revision, striae, rejuvenation, and dermal filling. There is a dearth of large randomized controlled trials, considerable heterogeneity in the variables studied, and lack of specificity in the preparatory protocols, which may influence clinical outcomes. Future investigations should use consistent nomenclature, find ideal solution parameters for each cutaneous indication, determine significant outcome metrics, and follow double-blinded, randomized, controlled methodologies. Addressing these deficiencies will take sound scientific inquiry but ultimately has the potential to benefit the authors' specialty greatly.
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29
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Kaushik A, Kumaran MS. Platelet-Rich Plasma: The Journey so Far ! Indian Dermatol Online J 2020; 11:685-692. [PMID: 33235832 PMCID: PMC7678541 DOI: 10.4103/idoj.idoj_369_19] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/24/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
Platelet-rich plasma (PRP) is an autologous blood product, obtained after blood centrifugation. PRP is rich in growth factors which promote tissue-healing, alter angiogenesis, and possess versatile immunomodulatory effects, in the relative absence of any significant demonstrable adverse effects. Consequently, PRP has found application in multiple specialities in recent years, including dermatology. A literature search was performed on PubMed, Medline database, and Google Scholar, using keywords like platelet-rich plasma (PRP), platelet-concentrated plasma, platelet-rich growth factors, autologous platelet concentrate. Relevant studies were selected, and data was analyzed following extraction. Studies show that PRP has not only been used as an adjunctive modality but has been employed as a stand-alone therapy as well. Multiple authors have reported PRP to be efficacious in disparate dermatological conditions, like alopecia, skin rejuvenation, healing of refractory cutaneous ulcers, and even acne scar management. The strongest evidence so far has been demonstrated in androgenetic alopecia and facial skin rejuvenation. However, routine use in dermatological conditions is hampered by the relative paucity of high-quality evidence and large randomized studies. Furthermore, PRP composition and preparation methods are not yet standardized and even the treatment regimens proposed too vary widely. The present review provides a bird's eye view of the evidence available so far regarding the use of PRP in dermatology. The review focusses more on recent prospective studies, including randomized trials and tries to summarize the evidence in a brief, but comprehensive manner.
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Affiliation(s)
- Akanksha Kaushik
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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30
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Gupta AK, Renaud HJ, Bamimore M. Platelet‐rich plasma for androgenetic alopecia: Efficacy differences between men and women. Dermatol Ther 2020; 33:e14143. [DOI: 10.1111/dth.14143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc. London Canada
- Division of Dermatology, Department of Medicine University of Toronto School of Medicine Toronto Canada
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31
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Commentary on The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part I and The Physician's Guide to Platelet-Rich Plasma in Dermatologic Surgery Part II. Dermatol Surg 2020; 46:457-458. [PMID: 32079869 DOI: 10.1097/dss.0000000000002347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Özcan D, Tunçer Vural A, Özen Ö. Platelet‐rich plasma for treatment resistant frontal fibrosing alopecia: A case report. Dermatol Ther 2019; 32:e13072. [DOI: 10.1111/dth.13072] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/01/2019] [Accepted: 08/20/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Deren Özcan
- Department of DermatologyBaşkent University Faculty of Medicine Ankara Turkey
| | - Ayşe Tunçer Vural
- Department of DermatologyBaşkent University Faculty of Medicine Ankara Turkey
| | - Özlem Özen
- Department of PathologyBaşkent University Faculty of Medicine Ankara Turkey
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