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Effect of Platelet-Rich Plasma and other Key Factors on Hair Follicle Preservation
Thuangtong, R., Chaweekulrat, P., Thanomkitti, K., Triwongwaranat, D., Rujitharanawong, C.
International journal of trichology. 2023;15(2):50-55
Abstract
BACKGROUND Hair graft preservation is an important factor that influences graft survival in hair transplantation. OBJECTIVE To investigate the benefits of adding platelet-rich plasma (PRP), and the effect of different storage solutions and temperatures on hair follicle preservation. MATERIALS AND METHODS This randomized-controlled study included 10 androgenetic alopecia patients who underwent hair transplantation. Forty-five hair grafts were collected from each patient and then randomized to 8 different culture conditions for 7 days. Hair grafts were cultured in Williams' Medium E or Ringer's lactate solution (RLS) at either 4°C or 37°C, and with or without 10% PRP supplementation. RESULTS In vitro hair growth in Williams' Medium E was significantly greater than in RLS. The 37°C temperature condition was found to be significantly better than the 4°C condition. The growth of hair grafts cultured with PRP was not significance difference from those without PRP. However, immunofluorescence staining for cytokeratin 15 showed greater expression in hair graft cultured with PRP. CONCLUSION PRP may have a beneficial effect for preserving the viability of hair grafts. Williams' Medium E and 37°C temperature were found to be superior to RLS and 4°C relative to hair follicle growth in organ culture.
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A Comparative Study of Topical Procapil With Platelet-Rich Plasma Therapy Versus Topical Redensyl, Saw Palmetto, and Biotin With Platelet-Rich Plasma Therapy in the Treatment of Androgenetic Alopecia
Tr, P., Ts, R., K, S. K., Prasanna, H.
Cureus. 2023;15(5):e38696
Abstract
Background and aim Androgenetic alopecia (AGA) is a well-known hair loss disorder in both men and women affecting approximately 80% and 50% of the population, respectively. Various treatment options for AGA are available with varying efficacy. Combination therapy is a new dictum to combat AGA. Hence, this study aimed to compare the efficacy of commonly used topical therapies such as Procapil with platelet-rich plasma (PRP) and redensyl, saw palmetto (SP), and biotin (RSB) with PRP. Materials and methods This was a randomized controlled trial conducted on 54 male patients with AGA attending the outpatient department in a tertiary care hospital. Participants were randomly assigned into two equal groups (A and B). Group A participants were treated with Procapil with PRP, and group B participants were treated with redensyl, saw palmetto, and biotin with PRP at three weeks intervals for a total period of four sessions. Clinical improvement was assessed by serial hair photography by a third blinded observer and was recorded. Results A total of 54 individuals were included and were distributed into 27 each in group A and group B. AGA grading score was found significant between the groups with P < 0.05. Conclusion PRP with adjuvants redensyl, saw palmetto, and biotin can be a better alternative to the current therapies of PRP.
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Platelet-rich plasma for pilonidal disease: a systematic review
Zhuang, Y., Feng, W. Z.
The Journal of international medical research. 2023;51(12):3000605231216590
Abstract
OBJECTIVE To examine the use of platelet-rich plasma (PRP) for treatment of pilonidal disease (PD) and thus provide a reference for clinical application. METHODS A systematic review of PubMed and the Cochrane Library was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We considered all studies that reported the use of PRP for treatment of PD. Extracted data included the first author's name, year of publication, study type, number of included patients, inclusion and exclusion criteria, interventions, anesthesia, application of PRP (source, preparation, dose, and operation), antibiotics, follow-up time, therapeutic outcomes, and adverse events. RESULTS In total, eight randomized controlled trials and one prospective cohort study involving 809 patients were included. PRP reduced pain, accelerated healing, and reduced adverse events. The application of combined minimally invasive surgery achieved better results. However, overfilling of the wound with PRP in minimally invasive surgeries was shown to potentially increase the risk of adverse events. CONCLUSION PRP can be used as an adjuvant treatment in PD surgery to improve the therapeutic effect and reduce adverse events. The optimal combination of PRP and various factors is an important direction of future research.INPLASY registration number: INPLASY2023100070.
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Comparative Efficacy of Topical Minoxidil Alone Against Combination of Topical Minoxidil and Platelet Rich Plasma in Women with Female Pattern Hair Loss-A Pilot, Open Randomised Trial
Agarwal A, Mendiratta V
Indian journal of dermatology. 2023;68(1):121
Abstract
BACKGROUND Female pattern hair loss (FPHL) affects a significant proportion of population and poses a major therapeutic challenge. AIMS AND OBJECTIVES To compare the efficacy and safety profile of combination of topical minoxidil 2% plus platelet rich plasma (PRP) (group 1) and topical minoxidil 2% solution alone (group 2) in women having FPHL. MATERIALS AND METHODS 26 females with FPHL were randomised into two treatment groups. They were evaluated for increase in hair density, reduction in hair pull test (HPT), patient satisfaction score (PSS) and side effects. RESULTS Mean change of 34.92 ± 8.39 hairs/cm(2) in group 1 (P < 0.001) and 31.21 ± 8.30 hair/cm(2) in group 2 (P < 0.001) was seen. 16.7% and 28.6% patients in Group 1 and 2, respectively, had PSS of highly satisfied. The reduction in HPT was significant with P = 0.0123 (group 1) and P = 0.0128 (group 2). There was no statistically significant difference between the two groups. No major side effects were reported. CONCLUSION Minoxidil-PRP combination therapy is an effective modality for FPHL but is not superior to topical 2% minoxidil therapy alone. PRP is a promising option in patients with minoxidil related compliance issues.
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Platelet-Rich Plasma for the Treatment of Plaque Psoriasis: A Systematic Review
Bunjaj, A., Brandao, L., Siracuse, K., Soti, V.
Cureus. 2023;15(12):e50356
Abstract
Psoriasis is a chronic and recurring condition characterized by scaly red plaques. The most common variant, plaque-type psoriasis, presents distinct clinical features. It profoundly impacts psychological and mental well-being, resulting in depression, anxiety, and suicidal thoughts. Psoriasis occurs due to disruptions in the skin's innate and adaptive immune response triggered by trauma, infection, or medications. Treatment options include topical therapies such as corticosteroids and vitamin D analogs, phototherapy, conventional systemic agents such as methotrexate (MTX), and biologics that target pro-inflammatory cytokines. There has been growing interest in platelet-rich plasma (PRP) as a potential treatment option for plaque psoriasis, given its lower toxicity compared to existing approaches. However, its use is not yet widespread in clinical practice due to the limited awareness of its effectiveness. This review aims to investigate the efficacy of PRP therapy for plaque psoriasis. To conduct a comprehensive analysis, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, thoroughly searching PubMed, Elton Bryson Stephens Company (EBSCO), and ClinicalTrials.gov between February and July 2023. Our focus was on patients diagnosed with plaque psoriasis, and we found multiple studies that demonstrated promising results of PRP either as monotherapy or in combination with current treatments such as MTX. The clinical evidence strongly supports the effectiveness of PRP in treating plaque psoriasis. PRP significantly improves dermatological symptoms and enhances patient and physician satisfaction. Research suggests that PRP reduces the expression of interleukin (IL) 17, a pro-inflammatory mediator, explaining its mechanism of action in treating plaque psoriasis. However, additional clinical trials with larger sample sizes, including PRP as a separate treatment group and comparisons with positive and control groups, are necessary to reinforce its efficacy in plaque psoriasis patients and elucidate other potential mechanisms underlying its beneficial effects.
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Comparing Single-spin Versus Double-spin Platelet-rich Plasma (PRP) Centrifugation Methods on Thrombocyte Count and Clinical Improvement of Androgenetic Alopecia: A Preliminary, Randomized, Double-blind Clinical Trial
Legiawati, L., Yusharyahya, S. N., Bernadette, I., Novianto, E., Priyanto, M. H., Gliselda, K. C., Iriyanty, S., Mutiara, R.
The Journal of clinical and aesthetic dermatology. 2023;16(12):39-44
Abstract
OBJECTIVE Platelet-rich plasma (PRP) is widely known as an alternative therapy for androgenetic alopecia (AGA); however, there is no standardized method for its preparation and application. This study aims to compare the thrombocyte count elevation and clinical AGA improvements between single- and double-spin PRP preparation methods. METHODS This preliminary, double-blind, randomized clinical trial included 30 male subjects with AGA aged 25 to 59 years with Hamilton-Norwood stages III to VI. Subjects were divided into a single-spin group (3,000rpm for 15 minutes) and a double-spin group (first spinning at 1,500rpm for 6 minutes, continuing at 2,500rpm for 15 minutes). The study was conducted for six weeks, with a two-week visit interval. Baseline and PRP thrombocyte counts were assessed on the initial appointment. A total of 1cc of PRP was intradermally injected into a 6×4cm predetermined area, administered at Weeks 0, 2, and 4. At every visit, clinical progress was assessed by overall hair appearance, photography, trichoscopy, and trichoscan. All subjects were instructed to use minoxidil twice daily during the study. This study has been registered at clinicaltrials.gov (ID No. NCT05681897). RESULTS Both groups increased thrombocyte counts by 4 to 5 times from their initial levels; however, the increase in the single-spin group was more significant. Significant improvements were observed in both groups, including hair density, hair rate, and hair count of anagen, telogen, vellus, and terminal hair. LIMITATIONS Limitations include lack of placebo or vehicle control. CONCLUSION Both PRP preparation methods significantly raise thrombocyte counts, substantially improve nearly all hair parameters, and have tremendous therapeutic promise for treating AGA. Clinicians may designate one of the two techniques.
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The use of platelet-rich plasma in wound healing and vitiligo: A systematic review and meta-analysis
Wang, Z., Feng, C., Chang, G., Liu, H., Li, S.
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2023;29(9):e13444
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Abstract
OBJECTIVE To critically assess the effect and safety of platelet-rich plasma (PRP) in chronic wounds and vitiligo. METHODS A systematic literature searching was performed. Results were expressed as weight mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Pooled estimates were performed using a fixed-effects model or random-effects model, depending on the heterogeneity among studies. RESULTS A total of 27 studies were included in this meta-analysis. In patients with chronic diabetic ulcers, PRP significantly increased proportion of complete wound healing, percentage of wound area healed, and shortened the complete wound healing. In venous ulcers, PRP improved the epithelialized area and percentage of wound area healed. In vitiligo, PRP had better results in degree of improvement and mean repigmentation than controls. Regarding the safety profile, PRP did not increase the risk of infection in patients with chronic diabetic ulcers. Meta-regression revealed that source of PRP and preparation method of PRP significantly affected the proportion of complete wound healing, whereas age, gender, country, duration of wound, and wound size had no impact on this outcome. CONCLUSION PRP is effective and safe, and can be used as a potential therapeutic adjunct or alternative treatment in chronic wounds of multiple etiologies and vitiligo.
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Injections of platelet-rich plasma prepared by automatic blood cell separator combined with topical 5% minoxidil in the treatment of male androgenetic alopecia
Wei, W., Zhang, Y., Long, B., Zhang, Y., Zhang, C., Zhang, S.
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2023;29(7):e13315
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Abstract
BACKGROUND Platelet-rich plasma (PRP) has been increasingly accepted as a potential therapy in the treatment of androgenetic alopecia (AGA), However, there remains a dearth of data on the effectiveness of PRP prepared by automatic blood cell separator with a combination of topical minoxidil for the treatment of AGA. OBJECTIVE To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA. METHODS Thirty male patients with mild/moderate AGA were enrolled in a randomized double-blind controlled study. Patients were randomly divided into two treatment arms: (group A) PRP prepared by automatic blood cell separator combined with topical 5% minoxidil group; (group B) PRP prepared by automatic blood cell separator combined with a topical placebo group. Trichoscopic assessments regarding hair density/quantity and mean hair diameter were performed at baseline and follow-up. Clinical efficacy of global photography and patient satisfaction were conducted to verify the therapeutic efficacy of the treatment, and the occurrence of adverse reactions was recorded. RESULTS We detected a significant increase in all patients in hair density and quantity after PRP treatment (p < 0.05), and there was no significant difference in mean hair diameter. Although hair density/quantity was more pronounced in group A than in group B, the difference between groups was not statistically significant (p > 0.05). In terms of clinical efficacy and patient satisfaction, group A was superior to group B, and no serious adverse reactions occurred. CONCLUSION We hereby conclude that the injections of PRP prepared by an automated method are effective and safe in the treatment of mild-to-moderate male AGA patients, and its combination with topical 5% minoxidil therapy was superior to PRP monotherapy with better clinical efficacy and higher patient satisfaction.
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Platelet rich plasma use for treatment of acne scars: an overview of systematic reviews
Cruciani, M., Masiello, F., Pati, I., Pupella, S., De Angelis, V.
Blood transfusion = Trasfusione del sangue. 2023
Abstract
BACKGROUND A reappraisal of the conclusions of systematic reviews (SRs) and meta-analyses validity related to Platelet-rich plasma (PRP), alone or in combination with other treatments, compared to regimens PRP-free for the treatment of acne scars. MATERIALS AND METHODS An overview of SRs. The methodological quality of the reviews was assessed using AMSTAR-2 checklist; quality of the evidence of primary studies was appraised following the GRADE approach. RESULTS Fifteen SRs were included in this overview. Data were from 124 overlapping reports, based on 34 individual primary studies (10 parallel arm randomized trials, 21 split-face studies, and 3 uncontrolled studies). Most of the studies evaluated combination of PRP with microneedling or with laser therapy compared to microneedling or laser therapy without PRP. Clinical improvement (reported as degree of improvement or improvement score) and patient's satisfaction rate were significantly higher in PRP recipients compared to controls. Crusting time and duration of erythema were significantly shorter in PRP recipients compared to controls. Most of the reviews considered in this overview can be considered of low methodological quality due to the fact that several critical methodological requirements of AMSTAR-2 checklist were unmet or partially met; only 6 of the 15 reviews incorporated study quality in their conclusions, and no GRADE assessment was performed for the reported outcomes in any of the SRs. With the GRADE approach, the quality of the evidence for the outcomes analysed ranged from very low to low due to risk of bias in the primary studies, inconsistency between the studies, and imprecision. DISCUSSION The low or very low certainty of evidence does not support clear clinical decision about the PRP use in combination with microneedling or laser therapy for the treatment of acne scars. Further well-designed studies are required to improve the evidence base for PRP combination therapy for acne scars.
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Efficacy of autologous Platelet-rich plasma therapy versus topical Minoxidil in men with moderate androgenetic alopecia: A randomized open-label trial
Balasundaram M, Kumari R, Ramassamy S
The Journal of dermatological treatment. 2023;:1-20
Abstract
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.