International Journal of Trichology

LETTER TO EDITOR
Year
: 2012  |  Volume : 4  |  Issue : 4  |  Page : 291--292

Role of Platelet-rich Plasma in the Management of Androgenetic Alopecia


Nitin D Chaudhari, Yugal K Sharma, Kedar Dash, Palak Deshmukh 
 Department of Dermatology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, India

Correspondence Address:
Nitin D Chaudhari
43 Yashshree Society, Near MIT College, Paud Road, Pune - 411 038
India




How to cite this article:
Chaudhari ND, Sharma YK, Dash K, Deshmukh P. Role of Platelet-rich Plasma in the Management of Androgenetic Alopecia.Int J Trichol 2012;4:291-292


How to cite this URL:
Chaudhari ND, Sharma YK, Dash K, Deshmukh P. Role of Platelet-rich Plasma in the Management of Androgenetic Alopecia. Int J Trichol [serial online] 2012 [cited 2022 May 18 ];4:291-292
Available from: https://www.ijtrichology.com/text.asp?2012/4/4/291/111222


Full Text

Sir,

Androgenetic alopecia (AGA), a hereditary and androgen-dependent progressive thinning of the scalp hair in a defined pattern, is a common dermatological disorder affecting more in men and occasionally in women, with significant negative impact on their social and psychological well being. It commonly begins by 20 years of age and affects nearly 50% of men by the age of 50 years. [1] Its etiopathogenesis is mainly androgen-dependent and modulated via the testosterone metabolite dihydrotestosterone, the expression of hair follicle-related androgen receptor; and genetic factors also have been implicated. [2]

Hair follicle has a very complex biologic structure and growth of the hair process is regulated by specific growth cycles. The mature follicle undergoes successive transformation from anagen (active hair shaft production) to catagen (apoptosis-driven regression) to telogen (resting phase with the involution of hair follicle). [3] Role of apoptosis (by the pathway of caspases cascade) in determining the passage from anagen to catagen is well known. Many growth factors play a fundamental role in the life-long cyclic transformation of the hair follicle functioning as biologic switches that are turned on and off during the different phases, controlling the active phase and promoting apoptosis to induce catagen and telogen. [4] The main growth factors involved in the establishment of hair follicle are vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), insulin 1-like growth factor, and fibroblast growth factor (FGF). Platelets release large amounts of platelet-derived growth factor (PDGFaa, PDGFbb, and PDGFab), transforming growth factor beta (TGFβ1 and β2), EGF, and VEGF. [5]

Concerns about the efficacy and safety during the requisite long-term treatment of AGA with the FDA-approved oral finasteride and topical minoxidil therapy prompted the use of a newer modality of platelet-rich plasma (PRP) which has shown beneficial effect. PRP has been used in the past to prevent infection and speed up the wound healing process by reducing bleeding/swelling after surgery by the plastic-, dental-, general-, neuro-, and orthopedic surgeons. PRP, an autologous concentration of human platelets in a small volume of plasma has a higher platelet concentration (4-7 times) above the baseline. It is obtained from the patient's own blood after processing in an automated centrifuge and it is injected subcutaneously into the area of alopecia. [6] Ubel in 2005 studied 23 patients of hair transplant after enriching the hair root grafts with PRP and without PRP. Two areas (2.5 cm 2 ) each were marked on the scalp and planted with 20 grafts/cm 2 . After 1 year, the area implanted with the PRP-enriched grafts demonstrated a yield of 18.7 FU/cm 2 versus 16.4 FU/cm 2 of that without PRP, an increase in follicular density of 15.7%. [7] Li et al. [7] performed an in vivo study, where mice received subcutaneous injections of PRP, and their results were compared with control mice. Activated PRP increased the proliferation of dermal papilla (DP) cells and stimulated extracellular signal regulated kinase and Akt signaling. Fibroblast growth factors 7 (FGF-7) and beta-catenin, both potent stimuli of hair growth, where upregulated in the DP cells. The injection of mice with PRP induced faster telogen-to-anagen transition than that was seen in control mice. [8]

The beneficial effects of PRP in AGA can thus be attributed to various platelet-derived growth factors causing improvement in the function of hair follicle and promotion of hair growth. It is safe, cheap, and non-allergic and it appears to be a useful adjuvant in the management of AGA.

References

1Ellis JA, Sinclair R, Harrap SB. Androgenetic alopecia: Pathogenesis and potential for therapy. Expert Rev Mol Med 2002;4:1-11.
2Trüeb RM. Molecular mechanisms of androgenetic alopecia. Exp Gerontol 2002;37:981-90.
3Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride male pattern hair loss study group. J Am Acad Dermatol 1998;39:578-89.
4Price VH. Treatment of hair loss. N Engl J Med 1999;341:964-73.
5Parsley WM, Perez-Meza D. Review of factors affecting the growth and survival of follicular grafts. J Cutan Aesthet Surg 2010;3:69-75.
6Marx RE. Platelet-rich plasma (PRP): What is PRP and what is not PRP? Implant Dent 2001;10:225-8.
7Uebel C. A new advance in baldness surgery using platelet-derived growth factor. Hair Transplant Forum Int'l 2005;15:77-84.
8Li ZJ, Choi HI, Choi DK, Sohn KC, Im M, Seo YJ, et al. Autologous platelet-rich plasma: A potential therapeutic tool for promoting hair growth. Dermatol Surg 2012;38:1040-6.