A 46-year-old woman with androgenetic alopecia, before and 3 months after 3 platelet-rich plasma treatment sessions.

A 46-year-old woman with androgenetic alopecia, before and 3 months after 3 platelet-rich plasma treatment sessions.

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Androgenetic alopecia (AGA) is a common hair loss disorder caused by genetic and hormonal factors that are characterized by androgen-related progressive thinning of scalp hair in a defined pattern. By the age of 60 years, 45% of men and 35% of women develop AGA. Currently, U.S. Food and Drug Administration-approved treatments for AGA include oral f...

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... three monthly sessions followed by sessions at 6-month intervals have also been effective. Overall, male and female patients have had positive results from PRP injections in AGA in terms of regrowth, in- creased hair density, and improved quality of life ( Figs. 1 and 2). ...

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... No notable disparities in participant attributes, such as age and sex, the period from the injury to surgery were observed. Furthermore, the PRP utilized in this study exhibited a significantly higher platelet concentration, surpassing standard blood platelet levels, thereby affirming the efficacy of PRP preparation [31]. ...
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Purpose Double‐blind, randomized, placebo‐controlled trials evaluating the efficacy and safety of Platelet‐rich plasma (PRP) in the treatment of Achilles tendon rupture (ATR) have been scant. This study examines the therapeutic impact of PRP injection 3 weeks after surgery in middle‐aged males. Methods This double‐blind, randomized, placebo‐controlled trial included consecutive ATR patients who satisfied the inclusion criteria and was conducted from 5 September 2018 to 24 June 2021. Three weeks after surgery using the side‐locking loop technique, PRP or saline was injected at the suture site under ultrasound guidance. Evaluations were conducted at predetermined intervals (6, 10, 12, 16 and 24 weeks and 1 and 2 years) after surgery. The primary outcome was the period needed to perform a bilateral heel raise, and the important secondary outcomes were the periods needed to perform a single heel raise and 20 unilateral heel raises, respectively. Results There were seven participants in the PRP group and seven in the saline group. Demographically, both groups exhibited comparable characteristics. No complications were reported. At 6 weeks after surgery, all participants achieved bilateral heel raise. The PRP and saline groups averaged 12.3 ± 2.7 and 15.7 ± 5.9 weeks to achieve a single heel raise and 14.3 ± 2.7 and 17.7 ± 4.5 weeks to achieve 20 unilateral heel raises, respectively, with no significant differences between both groups. Moreover, no substantial disparities in clinical scores, period of jogging initiation and magnetic resonance imaging tendon assessments were noted. Conclusions PRP did not offer a distinct advantage over saline in terms of recovery from ATR in middle‐aged males. This finding underscores the need to reassess the post‐operative significance of PRP and highlights the importance of further research to determine its potential advantages and risks. Level of Evidence Level I.
... Growth factors, such as insulin-like growth factor (IGF-1), platelet-derived growth factor (PDGF), and fibroblast growth factor (FGF), are essential in HF morphogenesis by acting on stem cells in the bulge area of HFs (23,24). Although growth factors have positive effects on HF regeneration, their high cost limits their use in clinical applications (25). Using stem cells and growth factors in cell-based therapies is an accepted therapeutic strategy for damaged-tissue repair because of their direct cellular effects (26). ...
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Purpose: Human amniotic fluid stem cells (hAFSCs) have shown significant regenerative potential in treating hair loss, wound healing, and tissue repair. This study aims to evaluate the effects of human amniotic fluid (hAF) on hair follicle (HF) regeneration and immune system modulation. Materials and Methods: The hAF used was pooled, acellular, and gamma-irradiated to standardize its contents and enhance its stability. Both irradiated (FAFI) and non-irradiated (FAF) hAF were assessed for their efficacy and safety in promoting hair growth and modulating immune responses in a rat model of hair loss. The study examined HF regeneration, transition to the anagen phase, and macrophage polarization from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype. Results: Both FAF and FAFI treatments significantly increased HF density, with FAFI exhibiting enhanced effects. Histological analysis demonstrated improved HF regeneration, increased M2 macrophages, and reduced collagen fiber deposition in treated areas. Gamma irradiation likely improved the efficacy of FAFI by stabilizing active components and inhibiting protease activity. Conclusions: Irradiated hAF is a safe and effective therapeutic candidate for alopecia and HF growth disorders. These findings support further evaluation of hAF in clinical trials to validate its potential for hair regeneration therapies.
... As a result, there is an ongoing demand for novel and effective treatments for hair loss [56,57]. AGA is a prevalent hair loss condition influenced by genetic and hormonal factors, characterized by androgen-driven progressive thinning of scalp hair in a specific pattern [58,59]. The current treatments for AGA are oral finasteride and topical minoxidil. ...
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Hair loss is influenced by various stresses and disruptions in the hair growth cycle within hair follicles. The activation of these follicles is primarily driven by dermal papilla cells, which play a central role in the progression of the hair growth cycle and formation. Many studies are being carried out on various natural plants to improve hair loss. In this study, we assessed the potential of Astragalus sinicus, known as a pharmacological herb, in mitigating damage to human follicle dermal papilla cells (HFDPCs) caused by dihydrotestosterone (DHT). We found that Astragalus sinicus extracts (ASEs) facilitated wound healing and elevated alkaline phosphatase expression in DHT-damaged HFDPCs. ASEs also significantly reduced reactive oxygen species (ROS) generated by DHT and increased ATP levels by restoring mitochondrial membrane potential in damaged cells. Furthermore, we demonstrated that ASEs substantially enhanced the phosphorylation levels of the AKT/ERK pathway and activated the Wnt signaling pathway in DHT-damaged HFDPCs. Taken together, we suggest that ASEs may be a potential ingredient for enhancing hair loss treatment.
... Therefore, recent efforts to treat hair loss have focused on increasing the telogen-to-anagen transition. Representative methods aimed at increasing anagen follicles include topical minoxidil application, platelet-rich plasma therapy, and low-level laser therapy (Avci et al., 2014;Stevens and Khetarpal, 2019;Feaster et al., 2023). From a cellular perspective, the activation of hair follicle stem cells (HFSCs) and dermal papilla cells (DPCs) is crucial for the transition from telogen to anagen (Hsu et al., 2011). ...
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Background Scalp hair plays a crucial role in social communication by expressing personal appearance and self-identity. Consequently, hair loss often leads to a perception of unattractiveness, negatively impacting an individual’s life and mental health. Currently, the use of Food and Drug Administration (FDA)-approved drugs for hair loss is associated with several side effects, highlighting the need for identifying new drug candidates, such as plant-derived phytochemicals, to overcome these issues. Objective This study investigated the hair growth-promoting effects of araliadiol, a polyacetylene compound found in plants such as Centella asiatica. Methods We employed an in vitro model comprising human hair follicle stem cells (HHFSCs) and human dermal papilla cells (HDPCs) to evaluate the hair growth-promoting effects of araliadiol. The proliferation-stimulating effects of araliadiol were assessed using water-soluble tetrazolium salt assay, adenosine triphosphate content assay, and crystal violet staining assay. In addition, we performed luciferase reporter assay, polymerase chain reaction analysis, cell fractionation, Western blot analysis, and enzyme-linked immunosorbent assay (ELISA) to elucidate the mechanism underlying the hair growth-inductive effects of araliadiol. Results Araliadiol exhibited both proliferation- and hair growth-promoting effects in HHFSCs and HDPCs. Specifically, it increased the protein expression of cyclin B1 and Ki67. In HHFSCs, it elevated the expression of hair growth-promoting factors, including CD34, vascular endothelial growth factor (VEGF), and angiopoietin-like 4. Similarly, araliadiol increased the expression of hair growth-inductive proteins such as fibroblast growth factor 7, VEGF, noggin, and insulin-like growth factor 1 in HDPCs. Subsequent Western blot analysis and ELISA using inhibitors such as GW9662 and SB202190 confirmed that these hair growth-promoting effects were dependent on the p38/PPAR-γ signaling in both HHFSCs and HDPCs. Conclusion Araliadiol promotes hair growth through the p38/PPAR-γ signaling pathway in human hair follicle cells. Therefore, araliadiol can be considered a novel drug candidate for the treatment of alopecia.
... Additionally, Stevens, et al., investigated the use of SVF in 10 patients with AGA combining this technique with PRP in a method called Platelet-Rich Stroma (PRS) [34]. At the end of the study, hair density significantly increased without any side effects [34]. ...
... Additionally, Stevens, et al., investigated the use of SVF in 10 patients with AGA combining this technique with PRP in a method called Platelet-Rich Stroma (PRS) [34]. At the end of the study, hair density significantly increased without any side effects [34]. A similar study by Butt, et al., also reported the efficacy of SVF combined with PRP (hair density increased by 51.6% in patients treated with SVF-PRP versus 21.5% in those who only got PRP) [12]. ...
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Androgenetic alopecia is considered the most frequent form of progressive hair loss. In this disease, an alteration of the hair cycle dynamics leads to progressive miniaturization of the hair follicle and possible baldness as a final outcome. A few treatments have been proposed to reduce the progression of hair loss. In this study, a search for relevant literature was performed using PubMed. We reviewed about 165 articles from 2012 to 2022 using the keywords “regenerative medicine”, “stem cells” and “androgenetic alopecia”. As a result, we described the hair follicle cycle, assessed how a change in its homeostasis can impact androgenetic alopecia and investigated the advent of new therapeutic techniques for hair regrowth, highlighting the use of stem cells and its impact on androgenetic alopecia prognosis.
... In addition to traditional drug therapies and hair transplantation, new therapies have been developed for the treatment of alopecia. For example, platelet-rich plasma (PRP) [164], MSCs [165], and MSCs-derived exosomes [166] or conditioned media [167] are injected into the scalp to stimulate HFSCs. A common mechanism behind these therapies is that the injected substances contain growth factors. ...
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As an appendage of the skin, hair protects against ultraviolet radiation and mechanical damage and regulates body temperature. It also reflects an individual’s health status and serves as an important method of expressing personality. Hair loss and graying are significant psychosocial burdens for many people. Hair is produced from hair follicles, which are exclusively controlled by the dermal papilla (DP) at their base. The dermal papilla cells (DPCs) comprise a cluster of specialized mesenchymal cells that induce the formation of hair follicles during early embryonic development through interaction with epithelial precursor cells. They continue to regulate the growth cycle, color, size, and type of hair after the hair follicle matures by secreting various factors. DPCs possess stem cell characteristics and can be cultured and expanded in vitro. DPCs express numerous stemness-related factors, enabling them to be reprogrammed into induced pluripotent stem cells (iPSCs) using only two, or even one, Yamanaka factor. DPCs are an important source of skin-derived precursors (SKPs). When combined with epithelial stem cells, they can reconstitute skin and hair follicles, participating in the regeneration of the dermis, including the DP and dermal sheath. When implanted between the epidermis and dermis, DPCs can induce the formation of new hair follicles on hairless skin. Subcutaneous injection of DPCs and their exosomes can promote hair growth. This review summarizes the in vivo functions of the DP; highlights the potential of DPCs in cell therapy, particularly for the treatment of hair loss; and discusses the challenges and recent advances in the field, from basic research to translational applications.
... In an effort to identify the most effective preparation method, Stevens J et al. conducted a review of the available literature. 59 Their findings suggested several recommendations, including the use of subdermal bolus injections to minimize discomfort, the incorporation of an activator, monthly treatment intervals, and preparation using the single-spin method. These suggestions aimed to enhance treatment outcomes by optimizing the PRP preparation process. ...
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Fundamentals Platelet-rich plasma (PRP) has been progressively more used in androgenetic alopecia (AGA). Objectives The authors aimed to evaluate PRP efficacy compared to placebo in AGA. Methods A comprehensive search was conducted across seven databases, until 01/04/2023. Randomized clinical trials focusing on AGA and PRP use to increase hair density were included. Patients aged between 15 and 63 years, diagnosed with AGA characterized by Norwood I‒VII and Ludwig I‒III scales, were included. Studies with a sample size <10, lacking PRP processing method, focusing on complementary therapies or other alopecias, were excluded. The authors conducted subgroup analysis for activator, spin method, study design, risk of bias, and gender. Meta-regression was conducted for activator, spin method, design, and gender. The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias. Asymmetry was measured through a Funnel plot followed by Egger’s test. The protocol was registered at PROSPERO (CRD42023407334). Results The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis, with 13 studies included in the meta-analysis. Meta-analysis demonstrated a mean difference of 27.55 hairs/cm² and 95% CI (14.04; 41.06), I² = 95.99%, p < 0.05. Hair diameter meta-analysis presented a mean difference of 2.02 μm, 95% CI (−0.85 μm; 4.88 μm), and I² = 77.11% (p = 0.02). That is, low quality evidence. Study limitations Studies were highly heterogeneous, of low quality, and presented evident publication bias. Conclusions Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA, so further high-quality randomized clinical trials are recommended to strengthen the evidence.
... Georgescu et al. did not observe a significant increase in hair density with more total treatment sessions and a larger volume of PRP injections, but they did observe a significant increase with more sessions per month. 16 Gentile et al., 17 Stevens et al., 18 and Sharma et al. 19 suggested, for AGA treatment, a minimum of three to five sessions sion. An increase in hair density was observed in both groups. ...
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Background Stromal vascular fraction (SVF) cells derived from adipose tissue and platelet‐rich plasma (PRP) are among novel treatments for androgenetic alopecia (AGA). We aimed to investigate the effect of adding SVF to PRP and compare it to administering PRP injection alone. Methods Eighteen patients were randomly divided into two groups of nine. The PRP group was treated with PRP at all three visits at 1‐month intervals, while the SVF‐PRP group received an SVF injection on the first visit and a PRP injection on the second and third visits. Each group was evaluated at baseline and 20 weeks after the therapy's initiation. Results Changes in mean hair diameter and hair count compared to baseline were significant in both groups. The PRP group experienced a greater increase in mean hair count than the SVF‐PRP group, and the SVF‐PRP group had a marginally greater increase in hair diameter than the PRP group. These differences were not statistically significant compared to each other. The patient and physician assessment scores exceeded the mean (on a scale from 0: poor to 3: excellent) in both groups. Conclusion Adding one SVF injection to two PRP treatment sessions versus three PRP injections alone had no significant difference in evaluated variables. If additional research demonstrates the same results, we suggest that multiple SVF injection sessions may be required to produce a statistically significant difference compared to PRP injection alone. Moreover, considering lower cost and greater accessibility of PRP, it can be used before SVF in the treatment of AGA.
... SVF extracted from the adipose tissue is widely used due to the capability of multipotent cells to differentiate into different cell types and their expression of growth factors and cytokines. [8] In addition, SVF is believed to have a higher and prolonged anti-inflammatory and immunomodulatory activity than PRP. [15] As mentioned above, a PRP activation step is crucial to a release growth factor and might be performed in two ways: an endogenous method by mechanical trauma or an exogenous method by chemicals. ...
Article
Platelet-rich plasma (PRP) is an autologous platelet concentrate in plasma enriched with growth factors that may stimulate tissue regeneration, collagen formation, re-epithelization, and angiogenesis. PRP is widely used as an androgenetic alopecia treatment option. The present work aims to test the efficacy of various PRP methods, including those with single-spin and double-spin centrifugation. We performed a review of articles published from 2011 to 2021 in PubMed and ScienceDirect. The studies vary in the preparation procedure, dose, number, intervals between the procedures, and the injection technique because of low standardization of PRP preparation, complicating the evaluation of the clinical efficacy of the method. Based on the conducted statistical analysis, we came to the conclusion that the double-spin PRP preparation method was superior to the single-spin technique, which may be taken into account for AGA management.
... This disease is characterized by the gradual thinning of scalp hair in a specific pattern, leading to the individual's psychological well-being and a significant decrease in self-esteem. (Stevens & Khetarpal, 2019) Until now, there have been several therapies for patients with androgenic Alopecia. One of them is platelet-rich plasma (PRP). ...
... PRP therapy also offers more affordable costs compared to hair restoration surgery. PRP therapy is a preparation of autologous platelets in concentrated plasma, generally above 1,000,000 platelets/μL or 2-7 times the original concentration of whole blood (Stevens & Khetarpal, 2019). ...
Article
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Androgenic Alopecia is characterized by progressive, patterned hair loss due to excessive sensitivity to androgens in genetically predisposed individuals. It is characterized by the gradual thinning of scalp hair in a specific pattern, causing a significant decrease in the individual's self-esteem and psychological well-being. Currently, there are several therapies for patients with androgenic Alopecia. One of them is platelet-rich plasma (PRP) and Minoxidil. This systematic review aims to compare PRP and minoxidil therapy use in men with androgenic Alopecia. This systematic review was prepared based on the references contained in the Priority Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. This systematic review was prepared by searching research articles using three databases, namely PubMed, ScienceDirect, and Cochrane. Data was extracted from each study included in this systematic review using a pilot-tested data extraction form. The data that has been collected is then interpreted qualitatively and quantitatively. Based on the six studies reviewed in this systematic review, the majority stated that therapy with PRP on the scalp effectively treats androgenetic Alopecia in men. All studies in this review reveal PRP use's benefits and positive impacts.