Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review

Photothermal Biomodulated Platelet-rich Plasma Improves Preservation of Hair Grafts and Extends Their Viability

Hair transplantation effectively treats alopecia, and hair graft viability is crucial for its success. The study aimed to assess the use of preconditioned autologous platelet-rich plasma with photothermal biostimulation as a graft preservation solution to increase the viability time of follicular units before transplantation. The study was conducted as a proof of concept. The platelet-rich plasma photothermal biostimulation was conducted using the MCT System, exposing the sample for 15 minutes to 623 nm red light with an intensity of 0.5 J/cm2 and a temperature of 4 ºC to obtain the MCT Plasma. Grafts of volunteers were collected and preserved in 2 Petri dishes per preservation solution (MCT Plasma + phosphate-buffered saline, Ringer's lactate, and saline solution). Graft viability was evaluated in 6 random follicular units at 5, 6, 7, and 8 hours with 0.4% Trypan blue stain diluted at 1/6 with NaCl 0.9%. Twenty-eight male volunteers were included with a mean age of 41 (SD 8.14, range 29-59). A total of 240 grafts were collected from each subject and distributed equitably in 2 Petri dishes for each preservation solution. At 8 hours, only grafts preserved in MCT Plasma with phosphate-buffered saline survived. MCT Plasma maintained hair follicle viability more effectively before transplantation than the saline solution or Ringer's lactate, demonstrating its efficacy as a preservation solution. Hair grafts preserved in MCT plasma with phosphate-buffered saline remained viable for eight hours following extraction, 2 hours longer than with the other tested solutions.

Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials

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.

The role of platelet-rich plasma in androgenetic alopecia: A systematic review

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.

Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review

PRP contains growth factors that promote tissue repair. The authors conducted a meta-analysis comparing PRP treatment to a control group. However, there are concerns about the lack of standardized protocols and specific details about PRP preparation. Factors such as platelet counts, leukocyte concentration, and the use of activated or non-activated platelets can affect treatment outcomes. Further analysis is needed to establish more reliable conclusions about the effectiveness of PRP for androgenic alopecia. LEVEL OF EVIDENCE V: 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 www.springer.com/00266 .

A comprehensive review of platelet-rich plasma for the treatment of dermatologic disorders

Platelet-rich plasma (PRP) offers anti-inflammatory and regenerative properties through angiogenesis, cell differentiation, and proliferation. Although studied in many dermatologic conditions, its efficacy is not well-understood. Our objective is to review the use and effectiveness of PRP for dermatologic conditions. A literature search was performed through PubMed and yielded 54 articles published between January 2000 and November 2021; articles written in English were reviewed. Intradermal injections were associated with increased hair density in androgenic alopecia. Successful treatment of inflammatory nail diseases with PRP has been reported. Improvement in psoriasis was described, but only two studies were available. PRP was associated with higher patient self-assessment scores of photoaging and fine lines. Treatment with PRP in melasma has been associated with improved subjective satisfaction, but not with objective measures of disease improvement. PRP can serve as a safe and potentially effective adjunct for hair loss, vitiligo, nonhealing wounds, photoaging, and acne scars. An important barrier to interpreting PRP research is lack of standardization of PRP preparation protocols, inconsistent clinical endpoints, and frequent combination treatments. However, PRP is relatively noninvasive, has a well-established safety profile, and patient satisfaction is often high as patients perceive great benefit from treatment with PRP.

Hair Restoration Techniques

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.

Current Progress of Platelet-Rich Derivatives in Cartilage and Joint Repairs

In recent years, several types of platelet concentrates have been investigated and applied in many fields, particularly in the musculoskeletal system. Platelet-rich fibrin (PRF) is an autologous biomaterial, a second-generation platelet concentrate containing platelets and growth factors in the form of fibrin membranes prepared from the blood of patients without additives. During tissue regeneration, platelet concentrates contain a higher percentage of leukocytes and a flexible fibrin net as a scaffold to improve cell migration in angiogenic, osteogenic, and antibacterial capacities during tissue regeneration. PRF enables the release of molecules over a longer period, which promotes tissue healing and regeneration. The potential of PRF to simulate the physiology and immunology of wound healing is also due to the high concentrations of released growth factors and anti-inflammatory cytokines that stimulate vessel formation, cell proliferation, and differentiation. These products have been used safely in clinical applications because of their autologous origin and minimally invasive nature. We focused on a narrative review of PRF therapy and its effects on musculoskeletal, oral, and maxillofacial surgeries and dermatology. We explored the components leading to the biological activity and the published preclinical and clinical research that supports its application in musculoskeletal therapy. The research generally supports the use of PRF as an adjuvant for various chronic muscle, cartilage, and tendon injuries. Further clinical trials are needed to prove the benefits of utilizing the potential of PRF.

Meta-analysis on the Efficacy of Platelet-rich Plasma in Patients with Androgenetic Alopecia

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.

Young human PRP promotes the rejuvenation of aged bone marrow mesen -chymal stem cells and the therapeutic effect on ischemic heart disease

Bone marrow mesenchymal stem cell (BMSC) transplantation is an effective treatment for ischemic heart disease, but its effectiveness is limited in aging populations due to decreased viability and injury resistance of autologous BMSCs. The purpose of this study was to compare the differences between platelet-rich plasma (PRP) derived from young and aged donors, and to investigate whether it is possible to enhance the viability of elderly human BMSCs (hBMSCs) using PRP, and to apply the rejuvenated hBMSCs for the treatment of ischemia. The key growth factors in PRP, including IGF-1, EGF, and PDGF-BB, were found to have significant differences between young and old individuals. Our results showed that PRP could enhance the proliferation, cloning, and rejuvenation of aged hBMSCs, with a superior effect observed when using PRP derived from younger donors. In the SD rat infarct model, the application of hBMSCs optimized with PRP resulted in a smaller infarct area compared to the control group (NC-Old). Specifically, the infarct area in the group treated with hBMSCs cultured with PRP from young donors (YPRP-Old) was smaller than that in the group treated with PRP from older donors (OPRP-Old). The survival rate of hBMSCs after transplantation, the number of neovascularization in the infarct area of SD rats and the recovery of cardiac function were all higher in the YPRP-Old group than the OPRP-Old group, and both groups were better than the group treated with aged hBMSCs alone. In conclusion, PRP may provide a new stem cell transplantation therapy option for ischemic diseases.

An umbrella review of the use of platelet-rich plasma in the treatment of androgenetic alopecia

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.

Efficacy of autologous Platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: A randomized open-label trial

BACKGROUND

Platelet-rich plasma (PRP) is an adjunctive treatment in androgenetic alopecia (AGA). Its role as a monotherapy, when compared to FDA-approved therapies in moderate grades of androgenetic alopecia is not established.

OBJECTIVES

We sought to study the efficacy and safety of standardized non-activated PRP preparation against topical minoxidil in AGA.

METHODS

Men aged 20-50 with Grade III and IV (Modified Hamilton-Norwood) AGA were randomized to receive 5% Minoxidil (x6 months) or PRP injections (monthly x3). The primary endpoints were global photographic assessment at week 24, change in target area hair counts, density, and anagen hair at week 12. Other outcomes were subjects' satisfaction and adverse events.

RESULTS

In total, 64 participants were randomized. At week 24, 56% responded to Minoxidil arm and 38% to PRP (p= 0.124). There was a significant increase in target area hair count and density at week 12 within the groups. The difference between the groups was not statistically significant. Adverse events occurred in 53% and 37% of the PRP and minoxidil groups, respectively. Patient satisfaction was better with Minoxidil.

CONCLUSION

PRP is effective in the treatment of moderate grades of androgenetic alopecia in men, although perhaps not different from minoxidil. Side effects occur more frequently with PRP.

Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss

The hair cycle is composed of four primary phases: anagen, catagen, telogen, and exogen. Anagen is a highly mitotic phase characterized by the production of a hair shaft from the hair follicle, whereas catagen and telogen describe regression and the resting phase of the follicle, respectively, ultimately resulting in hair shedding. While 9% of hair follicles reside in telogen at any time, a variety of factors promote anagen to telogen transition, including inflammation, hormones, stress, nutritional deficiency, poor sleep quality, and cellular division inhibiting medication. Conversely, increased blood flow, direct stimulation of the hair follicle, and growth factors promote telogen to anagen transition and subsequent hair growth. This review seeks to comprehensively describe the hair cycle, anagen and telogen balance, factors that promote anagen to telogen transition and vice versa, and the clinical utility of a variety of lab testing and evaluations. Ultimately, a variety of factors impact the hair cycle, necessitating a holistic approach to hair loss.

Combination of Platelet-Rich Plasma and Platelet Gel in Treatment of Resistance Androgenic Alopecia: a Case Series Study

BACKGROUND

Androgenic alopecia is a common genetic disorder that characterized by progressive hair follicles and hair atrophy. Despite of all available therapeutic techniques, there is low patient satisfaction rate. It seems finding new treatment options for androgenic alopecia is necessary. In the past decade Platelet-rich plasma (PRP), an autologous collection of concentrated platelets with haemostatic and tissue repairing effects has received developing attention for androgenetic alopecia treatment as a valuable therapeutic technique.

METHODS

In this study 8 patients suffering from resistance androgenic alopecia were enrolled. The PRP and platelet gel was prepared and a total volume of 10 cc of the combination of PRP and platelet gel was injected in the scalp androgen-related areas using 23-gauge syringe. The treatment was performed one month, and 3 months after first injection (three times). The hair pull test was done before treatment. The outcome was evaluated 3, 6 and 9 months after treatment by hair pull test, dermoscopy, photography and patient's satisfaction.

RESULTS

A significant reduction in hair loss was observed before and after treatment. Hair count (density) increased from average number of 72 (hair/cm2) to 210 hair/cm2). Also the hair diameter was significantly increase before and after treatment for all patients (P<0.05). After the treatment, the pull test was significantly decrease in 8 patients (P<0.05).

CONCLUSION

This study supports the combination therapy of PRP and platelet gel for resistance androgenic alopecia treatment. This technique is an uncomplicated, feasible and cost effective treatment option for resistance androgenic alopecia, with high patient satisfaction.

Platelet Rich Plasma and Its Use in Hair Regrowth: A Review

Platelet rich plasma (PRP) was described as a small volume of plasma containing higher concentrations of platelets than those found in peripheral blood and initially used as a transfusion product for treatment of thrombocytopenia. To date, it was discovered that there are several growth factors and cytokines that can accelerate wound healing and tissue regeneration, leading to a wider range of applications in the medical field, such as in sport medicine, regenerative medicine, and aesthetic medicine. Several studies have shown that PRP can be used effectively for treatment of hair loss. Although it has been widely used, the exact mechanism of action of PRP is still not fully elucidated. In this article, we aim to review and update current information on the definition, classification, mechanism of action, clinical efficacy in hair regrowth, and adverse events of PRP.

The effect of placebo in split-scalp and whole-head platelet-rich plasma trials for androgenetic alopecia differs: Findings from a systematic review with quantitative evidence syntheses

BACKGROUND

Some studies have shown that platelet-rich plasma (PRP) improves androgenetic alopecia (AGA)-while others do not. We determined whether the placebo effect significantly varies between split-scalp and whole-head trials on PRP monotherapy for AGA. Our rationale was based on the plausibility of PRP diffusing to the control (i.e., 'placebo') side of split-scalp trials. This is not possible in whole head studies.

METHODS

We systematically searched the literature for available data. Our choice of analyses and outcomes were determined by the available data.

RESULTS

Our endpoint was change in total hair density six months after baseline. Our regression showed that total hair density after six months was significantly (p<0.05) higher in the placebo arm of split-scalp trials, compared to whole-head studies, by 37 hairs/cm² . Our one-arm meta-analyses showed that the pooled change in total hair density between the PRP side and placebo side in split scalp studies was -3 hairs/cm² (p=0.37), that is, a slight decrease in hair density in the placebo side of the scalp. For whole head stdies the corresponding difference in total hair density between patients receiving PRP and those on placebo was -30 hairs/cm² (p=0.000017), that is, a much larger decrease in hair density. Patients in the placebo group in whole-head trials lost significantly more hair than in the placebo side of the split-head trials where hair loss was comparatively reduced-presumably because of PRP diffusing from the treatment side of the scalp.

CONCLUSIONS

The association between design (i.e., split-scalp vs. whole-head) and outcome, in placebo arms of AGA trials on PRP monotherapy, had never been reported. This 'design effect' could partly reconcile the incongruent conclusions across the PRP literature for AGA; furthermore, clinical guidelines can consider 'design effect' when selecting evidence to base care practices on.

Female Pattern Hair Loss: Why the Follicular Unit Transplantation Surgical Technique Remains a Good Option

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.

Hair Transplant Practice Guidelines

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.

Lyophilized growth factor intralesional injection in female pattern hair loss: A clinical and trichoscopic study

Various therapeutic modalities have been tried for female pattern hair loss (FPHL) treatment. To our knowledge, no previous studies had evaluated the therapeutic effect of lyophilized growth factor (L-GF) intralesional injection in FPHL. The current study aimed to evaluate the efficacy and safety of intralesional L-GF injection in FPHL by clinical and trichoscopic evaluation. This study included 20 patients with FPHL. All patients received three treatment sessions of intralesional injection of L-GF 4 weeks apart. Patients were followed-up for further 3 months. The outcome was evaluated by trichoscopy, photography score, patient's satisfaction score and side effects were reported. Trichoscopic evaluation showed significant posttreatment increase in all hair parameters associated with a significant decrease in vellus hair count. Ludwig's grade II showed posttreatment significant differences in all trichoscopic parameters from the baseline. No significant differences were detected regarding all trichoscopic parameters between the two Ludwig's grades posttreatment. 80% of patients showed photography score improvement that was significantly higher in Ludwig's grade II than in grade I. 100% of patients showed improvement in patient's satisfaction score with insignificant difference between Ludwig's grades. Intralesional injection of L-GF is safe and improved various trichoscopic hair parameters and clinical scores in FPHL.

Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability

Considering the different forms, alopecia could be a very common condition with particular therapeutic concerns; thus, recent therapies still require further assessments. Aim of this systematic review was to evaluate efficacy, safety, and therapeutic durability of platelet rich plasma (PRP) in treating various forms of alopecia. A total of 64 articles were found through a systematic search, and eight original articles were included in the study, based on inclusion/exclusion criteria. In most studies (62.5%) patients' conditions had improved by receiving PRP therapy; these cases experienced an increase in growth and thickness of hair. Simultaneous use of PRP and Minoxidil demonstrated the highest rate of improvement and satisfaction. The highest efficacy in patients with alopecia areata was 76% and the lowest efficacy was 31.7% and in patients with androgenetic alopecia the highest efficacy was 42.75% and the lowest reported efficacy was 25.55%. The main side effect was pain due to PRP injection, which disappeared after ending the treatment and only one article reported more serious side effects. Recurrence after treatment was also reported in only one article. PRP is a safe and easy method for treating hair loss and has limited adverse effects. Optimization of this method depends on dosage, number of sessions and their intervals, and injection techniques. According to the results, the use of PRP due to its relatively high efficiency, low and tolerable side effects, and low recurrence rate can be a good method for the treatment of alopecia and hair loss.

PRP in wound healing applications

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.

Effect of Platelet Rich Plasma versus Saline Solution as a Preservation Solution for Hair Transplantation

Supplemental Digital Content is available in the text.

Background:

Hair transplantation is the only method available to regrow new hairs; hence, enhancing the results of this procedure using state-of-the-art methods has become mandatory in clinical practice. Recent studies have suggested that significant improvements in hair density and stimulation of hair growth occur when follicular units are pretreated with platelet plasma growth factors before implantation. This study aimed to investigate and compare the outcomes of this procedure using platelet-rich plasma (PRP)–preserved hair grafts and saline-preserved hair grafts.

Methods:

This is a randomized controlled study. The study included 27 men and 3 women aged 22–51 years. Clinical examination (general and local) and preoperative marking were performed in these patients. The surgical technique involved graft extraction, PRP preparation, and hair implantation. Postsurgical patient satisfaction and clinical improvement were evaluated.

Results:

There were significant differences between the groups in hair uptake and hair thickness after 1 year follow-up, with P value <0.05. Using PRP therapy with follicular unit extraction increases the success of follicular unit extraction hair transplantation. All participants in the PRP group had >75% hair regrowth after 6 months. They had more rapid improvements in hair density and skin recovery than those in the non-PRP group.

Conclusion:

Preserving hair grafts in PRP before implantation increases the hair density, the graft uptake, and the hair thickness compared with pretreatment preservation of hair grafts in saline.

Quality issues identified in systematic reviews on platelet-rich plasma therapy for pattern hair loss-A method study

BACKGROUND

Systematic reviews of healthcare interventions aim to evaluate the quality of clinical studies, but they might have quality issues in their own right.

OBJECTIVE

We aimed to evaluate methodological inconsistencies in systematic reviews.

METHODS

We searched the database MEDLINE and included systematic reviews and/or meta-analyses on platelet-rich plasma therapy for pattern hair loss.

RESULTS

We identified 15 relevant systematic reviews and/or meta-analyses, and we identified various overt methodological inconsistencies in five of those systematic reviews. These inconsistencies concerned including duplicate data, mixing data from various study designs, misclassifying study designs and treatment comparisons, misinterpreting heterogeneity, and mistaking reporting standards.

CONCLUSION

The identification of various inconsistencies in previous systematic reviews on platelet-rich plasma therapy for pattern hair loss should prompt future authors to consult the Cochrane Handbook and to implement the PRISMA statement.