Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Local Injection versus Topical Microneedling of Platelet-Rich Plasma for Androgenetic Alopecia: A Systematic Review

  • Received : 2023.12.11
  • Accepted : 2024.12.29
  • Published : 2025.03.15
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Abstract

Autologous platelet-rich plasma (PRP) has gained popularity for hair restoration due to its effectiveness and safety. PRP could be administered through direct local injections to the scalp or applied topically with the aid of microneedling therapy. This systematic review aims to elaborate on the effectiveness of PRP administered with syringe injection and topical PRP with microneedling combination for the treatment of androgenetic alopecia (AGA). A literature search was employed through PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and Scopus. The database was searched using terms and keywords: "platelet-rich plasma" and "microneedling" and "androgenetic alopecia." Inclusion criteria are human study, patients with AGA, studies that compare PRP with syringe injection and the combination of PRP and microneedling. Exclusion criteria are animal study, review, case reports, or studies on other form of alopecia. A total of 108 articles found in the database. Title and abstract screening yield 12 articles. After full-text reading three articles were included in the review. A combination of PRP and microneedling appears to yield more superior results than direct syringe injection. Topical PRP and microneedling potentially give better results on AGA cases. Further high-quality studies with uniform protocol are needed to confirm these findings. Level of Evidence I.

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References

  1. Meah N, Wall D, Fagan N, York K, Sinclair R. Advances in hair growth. Fac Rev 2021;10(84) https://doi.org/10.12703/r/11-1
  2. Nazarian RS, Farberg AS, Hashim PW, Goldenberg G. Nonsurgical hair restoration treatment. Cutis 2019;104(01):17–24
  3. Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M. Androgenetic alopecia: therapy update. Drugs 2023;83(08):701–715 https://doi.org/10.1007/s40265-023-01880-x
  4. Heymann WR. The inflammatory component of androgenetic alopecia. J Am Acad Dermatol 2022;86(02):301–302 https://doi.org/10.1016/j.jaad.2021.11.013
  5. Alsalhi W, Alalola A, Randolph M, Gwillim E, Tosti A. Novel drug delivery approaches for the management of hair loss. Expert Opin Drug Deliv 2020;17(03):287–295 https://doi.org/10.1080/17425247.2020.1723543
  6. Katzer T, Leite Junior A, Beck R, da Silva C. Physiopathology and current treatments of androgenetic alopecia: going beyond androgens and anti-androgens. Dermatol Ther 2019;32(05):e13059 https://doi.org/10.1111/dth.13059
  7. Saceda-Corralo D, Domínguez-Santas M, Vañó-Galván S, Grimalt R. What's new in therapy for male androgenetic alopecia? Am J Clin Dermatol 2023;24(01):15–24 https://doi.org/10.1007/s40257-022-00730-y
  8. Chamata ES, Bartlett EL, Weir D, Rohrich RJ. Platelet-rich plasma: evolving role in plastic surgery. Plast Reconstr Surg 2021;147(01):219–230 https://doi.org/10.1097/PRS.0000000000007509
  9. Almohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert Opin Drug Saf 2018;17(11):1115–1128 https://doi.org/10.1080/14740338.2018.1533549
  10. Justicz N, Derakhshan A, Chen JX, Lee LN. Platelet-rich plasma for hair restoration. Facial Plast Surg Clin North Am 2020;28(02):181–187 https://doi.org/10.1016/j.fsc.2020.01.009
  11. Haq MI, Smith E, John DN, et al. Clinical administration of micro-needles: skin puncture, pain and sensation. Biomed Microdevices 2009;11(01):35–47 https://doi.org/10.1007/s10544-008-9208-1
  12. Muhammad A, Iftikhar N, Mashhood A, et al. Comparison of efficacy of platelet-rich plasma (PRP) with PRP microneedling in androgenetic alopecia. Cureus 2022;14(10):e30418 https://doi.org/10.7759/cureus.30418
  13. Ramadan WM, Hassan AM, Ismail MA, El Attar YA. Evaluation of adding platelet-rich plasma to combined medical therapy in androgenetic alopecia. J Cosmet Dermatol 2021;20(05):1427–1434 https://doi.org/10.1111/jocd.13935
  14. Ozcan KN, Sener S, Altunisik N, Turkmen D. Platelet rich plasma application by dermapen microneedling and intradermal point-by-point injection methods, and their comparison with clinical findings and trichoscan in patients with androgenetic alopecia. Dermatol Ther 2022;35(01):e15182 https://doi.org/10.1111/dth.15182
  15. Moher D, Shamseer L, Clarke M, et al; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4(01):1 https://doi.org/10.1186/2046-4053-4-1
  16. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372(71):n71 https://doi.org/10.1136/bmj.n71
  17. Akers J, Aguiar-Ibáñez R, Sari AB-A, et al. Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care. 3rd ed. York: Centre for Reviews and Dissemination, University of York; 2009:8
  18. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17(01):1–12 https://doi.org/10.1016/0197-2456(95)00134-4
  19. Liu Y, Li Z, Li H, Zhang Y, Wang P. Protective effect of surgery against early subtalar arthrodesis in displaced intra-articular calcaneal fractures: a meta-analysis. Medicine (Baltimore) 2015;94(45):e1984 https://doi.org/10.1097/MD.0000000000001984
  20. Sasaki GH. Micro-needling depth penetration, presence of pigment particles, and fluorescein-stained platelets: clinical usage for aesthetic concerns. Aesthet Surg J 2017;37(01):71–83 https://doi.org/10.1093/asj/sjw120
  21. Yepuri V, Venkataram M. Platelet-rich plasma with microneedling in androgenetic alopecia: study of efficacy of the treatment and the number of sessions required. J Cutan Aesthet Surg 2021;14(02):184–190 https://doi.org/10.4103/0974-2077.323638
  22. Herakal KC, Vallabhbhai PP, Siddalingappa K, Shale M, Deepika MG, Kusuma MR. Microneedling with platelet-rich plasma versus microneedling with topical 5% minoxidil in patients with androgenetic alopecia- a comparative study. J Evol Med Dent Sci 2017;6(26):2182–2186 https://doi.org/10.14260/Jemds/2017/473
  23. Shah KB, Shah AN, Solanki RB, Raval RC. A comparative study of microneedling with platelet-rich plasma plus topical minoxidil (5%) and topical minoxidil (5%) alone in androgenetic alopecia. Int J Trichology 2017;9(01):14–18 https://doi.org/10.4103/ijt.ijt_75_16
  24. Aggarwal K, Gupta S, Jangra RS, Mahendra A, Yadav A, Sharma A. Dermoscopic assessment of microneedling alone versus micro-needling with platelet-rich plasma in cases of male pattern alopecia: a split-head comparative study. Int J Trichology 2020;12(04):156–163 https://doi.org/10.4103/ijt.ijt_64_20
  25. Steward EN, Patel H, Pandya H, et al. Efficacy of platelet-rich plasma and concentrated growth factor in treating androgenetic alopecia - a retrospective study. Ann Maxillofac Surg 2020;10(02):409–416 https://doi.org/10.4103/ams.ams_154_19
  26. Jha AK, Vinay K, Zeeshan M, Roy PK, Chaudhary RKP, Priya A. Platelet-rich plasma and microneedling improves hair growth in patients of androgenetic alopecia when used as an adjuvant to minoxidil. J Cosmet Dermatol 2018;00:1–6
  27. Jha AK, Udayan UK, Roy PK, Amar AKJ, Chaudhary RKP. Platelet-rich plasma with microneedling in androgenetic alopecia along with dermoscopic pre- and post-treatment evaluation. J Cosmet Dermatol 2018;17(03):313–318 https://doi.org/10.1111/jocd.12394
  28. Gentile P, Dionisi L, Pizzicannella J, de Angelis B, de Fazio D, Garcovich S. A randomized blinded retrospective study: the combined use of micro-needling technique, low-level laser therapy and autologous non-activated platelet-rich plasma improves hair re-growth in patients with androgenic alopecia. Expert Opin Biol Ther 2020;20(09):1099–1109 https://doi.org/10.1080/14712598.2020.1797676
  29. Morkuzu S, McLennan AL, Kanapathy M, Mosahebi A. Use of activated platelet-rich plasma (A-PRP) on alopecia: a systematic review and meta-analysis. Aesthet Surg J 2023;43(08):NP631–NP649 https://doi.org/10.1093/asj/sjad073
  30. Evans AG, Mwangi JM, Pope RW, et al. Platelet-rich plasma as a therapy for androgenic alopecia: a systematic review and meta-analysis. J Dermatolog Treat 2022;33(01):498–511 https://doi.org/10.1080/09546634.2020.1770171
  31. English RS Jr, Ruiz S, DoAmaral P. Microneedling and its use in hair loss disorders: a systematic review. Dermatol Ther (Heidelb) 2022;12(01):41–60 https://doi.org/10.1007/s13555-021-00653-2
  32. Hori H, Moretti G, Rebora A, Crovato F. The thickness of human scalp: normal and bald. J Invest Dermatol 1972;58(06):396–399 https://doi.org/10.1111/1523-1747.ep12540633