From the Guidelines
Alopecia treatment should prioritize the use of autologous platelet concentrates, such as platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), in combination with topical minoxidil for optimal results, as supported by the most recent and highest quality study 1.
Overview of Alopecia
Alopecia refers to hair loss, which can occur for various reasons including genetics, hormonal changes, medical conditions, or medications. The most common type is androgenetic alopecia (male or female pattern baldness), but other forms include alopecia areata (an autoimmune condition), telogen effluvium (stress-related hair loss), and scarring alopecias.
Treatment Options
Treatment depends on the specific type and cause of alopecia. For androgenetic alopecia, medications like minoxidil (Rogaine) applied topically twice daily and finasteride (Propecia) 1mg taken orally once daily for men can help slow hair loss and potentially regrow hair. However, the most recent study 1 suggests that combining PRP or PRF with topical minoxidil is the most effective treatment modality.
Autologous Platelet Concentrates
Numerous clinical trials have studied the growth of hair using PRP, showing a significant increase in hair density and thickness compared to controls 1. PRF has also shown great potential in managing androgenetic alopecia, with studies demonstrating an increase in hair density and patient satisfaction 1.
Key Considerations
- The number of platelets is an important factor in the effectiveness of PRP, with higher concentrations having a greater effect on hair density and follicle diameter 1.
- The method of application, such as microneedling or injection, can also impact the effectiveness of PRP treatment 1.
- Genetics and individual response to treatment can vary, and some forms of alopecia may be resistant to treatment or recur despite intervention.
Recommendation
Based on the most recent and highest quality study 1, the use of autologous platelet concentrates, such as PRP or PRF, in combination with topical minoxidil is recommended for the treatment of androgenetic alopecia. Early intervention and consultation with a dermatologist are crucial to determine the specific type of alopecia and develop an appropriate treatment plan.
From the Research
Causes and Types of Alopecia
- Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women, mediated by dihydrotestosterone (DHT) 2, 3, 4, 5, 6
- AGA is characterized by a receding frontal hairline in men and diffuse hair thinning in women, with frontal hairline retention 5
Treatment Options for Alopecia
- Topical minoxidil and oral finasteride are traditionally the standard of care for AGA, but new treatments such as Low-Level Laser Therapy (LLLT), microneedling, platelet-rich plasma (PRP), and others have been extensively studied 2, 3, 4, 5
- Novel therapies such as oral minoxidil, topical finasteride, topical spironolactone, botulinum toxin, and stem cell therapy offer alternative treatment options for patients 2
- Combination therapies have been tested to assess potential synergistic relationships between multiple modalities 2, 3
Efficacy of Treatments for Alopecia
- LLLT and PRP have demonstrated encouraging results in treating AGA, but standardized treatment protocols are needed to inform clinicians on their use 2, 3
- A systematic review and meta-analysis found that minoxidil, finasteride, and LLLT are effective for promoting hair growth in men with AGA, and minoxidil is effective in women with AGA 4
- A network meta-analysis found that PRP, LLLT, and dutasteride are among the most effective treatments for male AGA, while LLLT and minoxidil are among the most effective for female AGA 3
Challenges and Considerations in Treating Alopecia
- Treatment selection involves ethical, evidence-based decision-making and consideration of individual patient needs, compliance, budget, extent of hair loss, and aesthetic goals 5
- The quality of evidence for various treatments varies greatly, and there is a need for randomized double-blinded clinical trials to assess the clinical efficacy of some treatments 2, 3