April 2020 HSC Section 4 - Plastic and Reconstructive Problems

Reprinted by permission of Aesthetic Plast Surg. 2019; 43(5):1326-1336.

Aesth Plast Surg https://doi.org/10.1007/s00266-019-01391-9

ORIGINAL ARTICLE

NON-SURGICAL AESTHETICS

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

Guangyu Mao 1,2

• Guohui Zhang 2

• Weixin Fan 1

Received: 4 March 2019 / Accepted: 29 April 2019 Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Abstract Background Platelet-rich plasma (PRP) contains a variety of growth factors and proteins that can accelerate tissue repair. Androgenic alopecia is a genetic disorder charac- terized by atrophy of hair follicles and hair loss. At present, PRP injections for hair restoration have become a popular though controversial practice. We conducted a meta-anal- ysis to compare the differences between patients treated with local injections of PRP and control group subjects to explore the effectiveness of PRP treatment for androgenic alopecia. Materials and Methods We searched PubMed, EMBASE and the Cochrane Library until Jan 2019 for human studies evaluating the efficacy of PRP for the treatment of andro- genic alopecia. Results We retrieved 132 papers; 11 articles matched our inclusion criteria and comprised 262 androgenic alopecia patients. Through a meta-analysis, we found a significantly locally increased hair number per cm 2 after PRP injections in the treatment group versus the control group (mean difference 38.75, 95% CI 22.22–55.28, P \ .00001). Similarly, a significantly increased terminal hair density was found in the PRP group compared with the control group (mean difference 22.83, 95% CI 0.28–45.38, P = 0.05). Conclusion Most studies suggest that subcutaneous injec- tion of PRP is likely to reduce hair loss, increase hair

diameter and density in patients with androgenic alopecia. Because of the low quality of the studies, small sample sizes, different treatment regimens and possible publication bias, the results of this meta-analysis should be interpreted with caution. Furthermore, more randomized controlled studies should be performed. Level of Evidence III 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 .

Keywords Androgenic alopecia Platelet-rich plasma Meta-analysis

Introduction

Androgenic alopecia (AGA) is the most common type of hair loss. It is a hereditary disease, and about half of the population suffers from it. The pathogeny of the illness is that the scalp hair follicles of patients are sensitive to dihydrotestosterone, which causes hair follicles to shrink and gradually disappear, resulting in hair loss [ 1 ]. For patients, hair loss affects not only their appearance but also their psychology, and there is a high prevalence of depression in AGA patients [ 2 ]. Platelet-rich plasma (PRP) is an autologous product manufactured by the centrifugation of a patient’s own venous blood. The normal human platelet count number is 1.5–4.5 9 10 5 /ml, whereas the count in PRP is about four to five times higher than that in normal plasma. PRP contains various growth factors, including platelet, epi- dermal, transforming, fibroblast, insulin-like and vascular

& Weixin Fan

13327805737@189.cn

1 Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China 2 Department of Dermatology, Baotou Central Hospital, Baotou, China

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