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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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Comparative Study of Combination of Oral Tranexamic Acid With Modified Kligman's Formula Versus Oral Tranexamic Acid With Azelaic Acid 15% in the Treatment of Melasma
Singh, R., Maheshwari, P., Madke, B., Singh, A., Jawade, S.
Cureus. 2023;15(6):e40908
Abstract
Background Melasma is a persistent skin condition affecting individuals of Asian, African, and Hispanic backgrounds. It causes dark patches on sun-exposed areas of the face. The exact causes are unclear, but UV light and hormonal factors play a role. Melasma significantly impacts physical appearance and quality of life, causing emotional and social distress. Objective The objective was to compare the efficacy of a combination of oral tranexamic acid and modified Kligman's formula vs. oral tranexamic acid and 15% azelaic acid. Material and methods This two-year interventional study occurred at the Outpatient Department of Dermatology, Venereology, and Leprosy in Sawangi, Maharashtra. It included male and female patients aged 18-50 with melasma seeking treatment. Ethical approval was obtained, and data collection involved medical histories, skin examinations, and calculating the Melasma Area and Severity Index (MASI). Results The study found no significant association between age groups and subject distribution in Groups A and B. Significant differences were observed in MASI scores within each group over time. There was a significant difference in mean MASI scores between Group A and Group B at the eight-week mark. A burning sensation was significantly associated with the groups, while no significant association was found for erythema. Conclusion This study concludes that combining oral tranexamic acid with a modified Kligman's formula is more effective in treating melasma than combining oral tranexamic acid with azelaic acid 15%.
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Effect of platelet counts and activator in platelet-rich plasma on the treatment of androgenetic alopecia, split-head comparison: A randomised, double-blind study
Singh SK, Singh S
Indian journal of dermatology, venereology and leprology. 2023;:1-9
Abstract
Background Androgenetic alopecia is a common, chronic, non-scarring alopecia. It is characterised by stepwise miniaturisation of the hair follicles, due to alteration in the hair cycle dynamics, leading to the transformation of terminal hair follicles into a vellus ones. Oral finasteride and topical minoxidil are the only approved drugs for treating this condition. Due to a limited number of effective therapies for androgenetic alopecia, platelet-rich plasma may be an effective alternative treatment. Aims To study the effect of activator in platelet-rich plasma and baseline platelet count in platelet-rich plasma on the treatment of androgenetic alopecia. Methods A randomised, double-blind split-head comparative study. The sample size was calculated and randomisation was done. Patients with androgenetic alopecia were allocated into two groups; in the first group, autologous activated platelet-rich plasma was injected in the right half of the affected scalp and autologous non-activated platelet-rich plasma was injected in the left half of the affected scalp and vice versa in the second group. Patients were also categorised on the basis of platelet counts in their platelet-rich plasma in three groups; group A (6-8 lakh/mm3), group B (8.1-10 lakh/mm3) and group C (>10 lakh/mm3). Interventions were done monthly for three months and followed up for the next three months. Effects of interventions were assessed by hair density, hair thickness, patient self-assessment and clinical photography. Results A total of 80 patients were included in the study. Activated platelet-rich plasma produced significant improvement of hair density after four months and hair thickness at 6 months. An increase in platelet count led to a significant increase in hair density and hair thickness after three and four months respectively and a highly significant increase in both parameters at the end of the study. Limitations Long-term follow-up of cases was not done and no measurement of vellus hair count was done. Conclusion There is a significant effect of activator and platelet count of the platelet-rich plasma on hair density as well as hair thickness.
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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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Healing effects of autologous platelet gel and growth factors on cutaneous leishmaniasis wounds in addition to antimony; a self-controlled clinical trial with randomized lesion assignment
Shadmand, E., Solhjoo, K., Taghipour, A., Tayer, A. H., Sadeghi, F., Meshkin, A.
BMC research notes. 2023;16(1):200
Abstract
OBJECTIVE Autologous platelet gel (APG) is used in most surgeries to treat a variety of tissue defects because of its healing factors composition. This randomized parallel clinical trial was conducted to investigate the healing effects of APG on cutaneous leishmaniasis (CL) wounds. Eighteen male patients with CL wounds were recruited and followed for two months. The patients had more than one cutaneous wound, one of which was examined as the control and the other one as the intervention wound. APG was applied to the intervention wounds once a week, up to eight times. The primary endpoint was wound healing which defined as complete epithelialization and tissue granulation. Other clinical evaluation criteria were assessment of the wound size, and histopathology analyses. RESULTS Of 18 patients, 15 patients completed the trial (83.3%, mean age 28 years). The use of APG on the wounds was associated with complete and faster healing in 66% of the wounds and partial healing in 34% of the wounds. During the study, none of the control wounds were completely healed. The wound area in the intervention cases showed a statistically significant decrease throughout the study (P < 0.01) compared with controls. Following treatment of CL lesions with APG, the inflammatory process in the epidermis and dermis were decreased significantly (P < 0.01) compared with controls. CONCLUSION Our preliminary results confirm the clinical healing improvement described in the literature for APG-GF treatment of chronic non-leishmania wounds via immunomodulation. TRIAL REGISTRATION IRCT, IRCT20190212042694N1. Registered 20 February 2019, https://en.irct.ir/trial/37522.
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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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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.
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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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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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Evaluation of the safety and efficacy of platelet-rich plasma in the treatment of female patients with chronic telogen effluvium: A randomised, controlled, double-blind, pilot clinical trial
El-Dawla RE, Abdelhaleem M, Abdelhamed A
Indian journal of dermatology, venereology and leprology. 2022;:1-9
Abstract
BACKGROUND Chronic telogen effluvium is characterised by diffuse loss of hair of the scalp. One of the emerging lines of treatment is platelet-rich plasma. However, not much of published data exist. AIMS A pilot study was conducted on chronic telogen effluvium patients to evaluate the efficacy and safety of platelet-rich plasma, and to compare two different methods of platelet-rich plasma preparation. METHODS The study included 30 female patients with chronic telogen effluvium. Patients were randomised into three groups: Group (1): Special platelet-rich plasma tubes centrifuged at 3500 rpm; Group (2): Ordinary laboratory tubes centrifuged at 1000 rpm; Group (3): Normal saline as a placebo. Patients' evaluation was done with visual analog scale, hair pull test, trichoscopy, photos, satisfaction questionnaire, and safety. All patients received four monthly sessions. Patients were evaluated one month and three months after the last session. RESULTS The hair pull test,visual analogue scale, and patient satisfaction results showed a statistically significant difference between group 1 vs. group 3 and group 2 vs.group 3 at one and three months after the sessions, while there was no difference between group1 vs. group 2. Trichoscopy results (baseline, one and three months after treatment) showed a significant increase in hair density and thickness in the frontal area, temporal area, and the vertex in groups 1 and 2 only. There was no statistically significant difference between the three groups with regards to side effects. LIMITATIONS The sample size was small with ten patients in each group. Furthermore, the follow-up of patients was for only three months. CONCLUSIONS Platelet-rich plasma could be considered as a promising therapy for patients with chronic telogen effluvium with an excellent safety profile. The ordinary laboratory low-cost tubes might be a reliable alternative to the expensive special platelet-rich plasma kits tubes. The trial registry number is PACTR202006539654415.