Platelet-Rich Plasma in Female Androgenetic Alopecia: A Comprehensive Systematic Review and Meta-Analysis

In this work, Zhou et al.3 summarize different treatment regimes in female androgenetic alopecia (AGA), and quantitively analyze the efficacy of PRP in this disease.

They evaluated 636 studies and 12 trials from six databases (MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, LILACS, and CNKI ). Meta-analysis was conducted with enrolled observational studies and randomized controlled trials separately.

A total of 42 studies (including 6 studies using Regen Lab technology4-9) including 776 female participants, covering 16 randomized controlled trials and 26 observational trials, were included for these systematic review and meta-analysis . PRP showed positive efficacy in treating female AGA in hair density compared to the control groups with odds ratio (OR) 1.61 [95% CI 0.52–2.70] and compared to baseline with OR 1.11 [95% CI 0.86–1.37].

This work demonstrated an effective response and safety for the application of PRP in the treatment of female AGA. Especially for those patients with negative response to the topical use of minoxidil, PRP offers an alternative treatment option.

The authors only used hair density as an endpoint to perform meta-analysis for the diversitity of endpoint settings among the enrolled studies, while hair density is the most used one. This result is in accordance with previous systemic review.
Taken together, these results confirm the efficacy of PRP in the treatment of female AGA.

Bruno BOEZENNEC, MD, Managing Editor

References :

1.Torabi P, Behrangi E, Goodarzi A, Rohaninasab M. A systematic review of the effect of platelet-rich plasma on androgenetic alopecia of women. Dermatol Ther. 2020 Nov;33(6):e13835. doi: 10.1111/dth.13835. Epub 2020 Jul 31. PMID: 32588941.

2.Evans AG, Mwangi JM, Pope RW, Ivanic MG, Botros MA, Glassman GE, Pearce FB Jr, Kassis S. Platelet-rich plasma as a therapy for androgenic alopecia: a systematic review and meta-analysis. J Dermatolog Treat. 2022 Feb;33(1):498-511. doi: 10.1080/09546634.2020.1770171. Epub 2020 May 26. PMID: 32410524.

3.Zhou S, Qi F, Gong Y, Zhang C, Zhao S, Yang X, He Y. Platelet-Rich Plasma in Female Androgenic Alopecia: A Comprehensive Systematic Review and Meta-Analysis. Front Pharmacol. 2021 May 6;12:642980.

4.Gentile P, Garcovich S. Autologous activated platelet-rich plasma (AA-PRP) and non-activated (A-PRP) in hair growth: a retrospective, blinded, randomized evaluation in androgenetic alopecia. Expert Opin Biol Ther. 2020 Mar;20(3):327-337.

5.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. 2014 Oct-Dec;7(4):213-9.

6.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 Nov;83(5):1298-1303.

7.Juhasz MLW, Sukhdeo K, Lo Sicco K, Shapiro J. Stratifying clinical response to adjuvant platelet-rich plasma in patients with androgenetic alopecia. Br J Dermatol. 2020 Sep;183(3):580-582.

8.Rossano F, Di Martino S, Iodice L, Di Paolo M, Misso S, Tomeo R, Marini AM, Brugnone R, Marlino S, Santorelli A, Di Francia R. Correlation between individual inflammation genetic profile and platelet rich plasma efficacy in hair follicle regeneration: a pilot study reveals prognostic value of IL-1a polymorphism. Eur Rev Med Pharmacol Sci. 2017 Nov;21(22):5247-5257.

9.Ho A, Sukhdeo K, Lo Sicco K, Shapiro J. Trichologic response of platelet-rich plasma in androgenetic alopecia is maintained during combination therapy. J Am Acad Dermatol. 2020 Feb;82(2):478-479.