FPIN's Help Desk Answers

Platelet-Rich Plasma for Androgenic Alopecia

 

Am Fam Physician. 2022 Jan ;105(1):84-85.

Clinical Question

Are intradermal injections of autologous platelet-rich plasma an effective treatment for androgenic pattern hair loss?

Evidence-Based Answer

Platelet-rich plasma injections more effectively increase hair density vs. usual treatment in men with androgenic alopecia. (Strength of Recommendation [SOR]: A, three meta-analyses of randomized controlled trials [RCTs] and cohort studies.) Platelet-rich plasma injections in men are also more effective than minoxidil, 5-alpha reductase inhibitors, and bimatoprost, but not low-level laser therapy. (SOR: A, network meta-analysis of RCTs.) Platelet-rich plasma injections pose little risk of serious adverse events. (SOR: A, meta-analysis of RCTs and cohort studies.) Platelet-rich plasma would be considered an off-label use because it does not have approval from the U.S. Food and Drug Administration for the treatment of androgenic alopecia.

Evidence Summary

A 2020 systematic review and meta-analysis of 13 RCTs (N = 343) examined the effectiveness of platelet-rich plasma injections for androgenic alopecia.1 Seven studies (n = 171; participants were 18 to 65 years of age and 58% were men) examined hair density changes from baseline. One study randomized people to platelet-rich plasma vs. placebo injections in an unblinded fashion. In the other six trials, patients blinded to treatment assignment randomly received injections of platelet-rich plasma on one-half of their head and a placebo on the other. In one study, minoxidil or finasteride (Propecia) was added to both the placebo and platelet-rich plasma injection groups. Patients had two to five platelet-rich plasma injections over the course of two months, with follow-up of three to six months. At follow-up, hair density per cm2 was compared with baseline. Pooled data favored the platelet-rich plasma group with a mean difference of 30.4 (95% CI, 1.8 to 58.9). Normal hair density is approximately 160 to 250 hairs per cm2. Considerable heterogeneity was noted (I2 = 100%). Va

Address correspondence to Timothy Mott, MD, at tfmott@yahoo.com. Reprints are not available from the authors.

Author disclosure: No relevant financial relationships.


Copyright © Family Physicians Inquiries Network. Used with permission.

References

1. Dervishi G, Liu H, Peternel S, et al. Autologous platelet-rich plasma therapy for pattern hair loss: a systematic review. J Cosmet Dermatol. 2020;19(4):827–835.

2. Evans AG, Mwangi JM, Pope RW, et al. Platelet-rich plasma as a therapy for androgenic alopecia: a systematic review and meta-analysis. J Dermatolog Treat. 2020 [published online ahead of print].

3. Gupta AK, Bamimore MA, Foley KA. Efficacy of non-surgical treatments for androgenetic alopecia in men and women: a systematic review with network meta-analyses, and an assessment of evidence quality. J Dermatolog Treat. 2020 [published online ahead of print].

Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (https://www.cebm.net).

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to http://www.fpin.org or email: questions@fpin.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of FPIN's Help Desk Answers published in AFP is available at https://www.aafp.org/afp/hda.

 

 

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