Platelet-rich plasma (PRP) is effective for men with moderate grades of androgenetic alopecia (AGA), with comparable efficacy to minoxidil, according to study findings published in Journal of Dermatological Treatment.
Researchers conducted a randomized, open-label, 24-week trial at a tertiary care center in South India from January 2020 to February 2022. Eligible participants were men aged 20 to 50 years with AGA type III, III vertex, or IV based on the Modified Hamilton-Norwood classification.
Participants were randomly assigned to receive either PRP or minoxidil. Those in the minoxidil arm received topical minoxidil 5% 1 mL twice daily for 6 months. Participants in the PRP arm received 3 treatment sessions at monthly intervals with a final follow-up 3 months after the last treatment.
The primary outcome was global photographic assessment of improvement at the vertex and frontal views from baseline to week 24 as assessed by 2 dermatologists who were blinded to allocation and treatment arms. Other primary endpoints were change in total and terminal hair count, total hair density, and proportion of anagen hairs within a 2-cm diameter target minizone at 12 weeks.
The intent-to-treat population included 64 participants (minoxidil group, n=32; mean age, 27.09±3.13 years; and PRP group, n=32; mean age, 26.61±3.05 years). A total of 51 participants completed the study. The mean disease duration was 1.90±0.7 years in the minoxidil group and 1.74±0.5 years in the PRP group.
Dermatologists had fair to moderate agreement on score assignment for global photographic assessments at week 24, with kappa coefficients ranging from 0.39 to 0.61. The proportion of participants who had a response based on the median of the 2 scores of global photographic assessments at week 24 was 56% in the minoxidil group and 38% in the PRP group (P =.124). The global photographic assessment was associated positively with patient satisfaction score for hair density after treatment (r, 0.824; P <.00001).
Participants in the minoxidil group had a significant increase in basal hair count, hair density, terminal hair count, and density at week 12 (all, P <.001). Those in the PRP group also had significant increases in these parameters at week 12 (P =.014, .001, .029, and .046, respectively). No statistical difference was observed between the groups in the propensity to increase total hair count, terminal hair count, and density at week 12, although minoxidil seemed superior to PRP (P =.407, .763, and .509, respectively). PRP was associated with a larger increase in total hair density at week 12 vs minoxidil, although it was not significant (P =.713).
The proportion of anagen hairs in the minoxidil group was 0.87±0.07 at baseline and 0.89±0.04 at week 12. Participants in the PRP group had rates of 0.86±0.04 and 0.87±0.04, respectively. No significant increase in anagen proportion was found at 3 months within the groups (P =.94 and P =.19).
At week 24, the median patient satisfaction score for hair texture was higher in the minoxidil group vs the PRP group (P =.029), but not for hair density (P =.123).
Adverse events occurred in 37% of participants in the minoxidil arm and 53% in the PRP arm (P =.21). Most were mild in the minoxidil group, and the common side effects were mild headache (n=4) and scalp pruritus (n=4). Pain was the most frequently occurring side effect (n=17) associated with PRP injection.
Limitations of the study include the short follow-up period, as nonactivated PRP allows a sustained long-term response compared with activated PRP.
“Our study’s results are reliable, showing that both PRP and topical minoxidil are effective in therapy for AGA; however, PRP is not superior to minoxidil in treating men with moderate grades of AGA,” conclude the study authors.
Balasundaram M, Kumari R, Ramassamy S. Efficacy of autologous platelet-rich plasma therapy versus topical minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial. J Dermatolog Treat. Published online February 17, 2023. doi: 10.1080/09546634.2023.2182618