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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


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          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.


          To evaluate the efficacy and safety of PRP prepared by automatic blood cell separator combined with topical 5% minoxidil therapy in male AGA.


          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.


          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.


          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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          Most cited references24

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          Androgenetic alopecia: a review.

          Androgenetic alopecia, commonly known as male pattern baldness, is the most common type of progressive hair loss disorder in men. The aim of this paper is to review recent advances in understanding the pathophysiology and molecular mechanism of androgenetic alopecia.
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            The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial.

            Platelet-rich plasma (PRP) has emerged as a new treatment modality in regenerative plastic surgery, and preliminary evidence suggests that it might have a beneficial role in hair regrowth. Here, we report the results of a randomized, evaluator-blinded, placebo-controlled, half-head group study to compare, with the aid of computerized trichograms, hair regrowth with PRP versus placebo. The safety and clinical efficacy of autologous PRP injections for pattern hair loss were investigated. PRP, prepared from a small volume of blood, was injected on half of the selected patients' scalps with pattern hair loss. The other half was treated with placebo. Three treatments were administered to each patient at 30-day intervals. The endpoints were hair regrowth, hair dystrophy as measured by dermoscopy, burning or itching sensation, and cell proliferation as measured by Ki67 evaluation. Patients were followed for 2 years. Of the 23 patients enrolled, 3 were excluded. At the end of the 3 treatment cycles, the patients presented clinical improvement in the mean number of hairs, with a mean increase of 33.6 hairs in the target area, and a mean increase in total hair density of 45.9 hairs per cm² compared with baseline values. No side effects were noted during treatment. Microscopic evaluation showed the increase of epidermis thickness and of the number of hair follicles 2 weeks after the last PRP treatment compared with baseline value (p < .05). We also observed an increase of Ki67(+) keratinocytes in the epidermis and of hair follicular bulge cells, and a slight increase of small blood vessels around hair follicles in the treated skin compared with baseline (p < .05). Relapse of androgenic alopecia was not evaluated in all patients until 12 months after the last treatment. After 12 months, 4 patients reported progressive hair loss; this was more evident 16 months after the last treatment. Those four patients were re-treated. Our data clearly highlight the positive effects of PRP injections on male pattern hair loss and absence of major side effects. PRP may serve as a safe and effective treatment option against hair loss; more extensive controlled studies are needed.
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              Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing.

              Growth factors released from activated platelets initiate and modulate wound healing in both soft and hard tissues. A recent strategy to promote the wound-healing cascade is to prepare an autologous platelet concentrate suspended in plasma, also known as platelet-rich plasma, that contains growth factors and administer it to wound sites. The purpose of this study was to quantitate platelet number and growth factors released from a prepared platelet concentrate. Whole blood was drawn from 10 healthy patients undergoing cosmetic surgery and concentrated into platelet-rich plasma. Platelet counts on whole blood and platelet-rich plasma were determined using a Cell-Dyn 3200. Platelet-derived growth factor-BB, transforming growth factor-beta1, vascular endothelial growth factor, endothelial growth factor, and insulin-like growth factor-1 were measured in the platelet-rich plasma using the enzyme-linked immunosorbent assay method. In addition, platelet activation during the concentration procedure was analyzed by measuring P selectin values in blood serum. An 8-fold increase in platelet concentration was found in the platelet-rich plasma compared with that of whole blood (baseline whole blood, 197 +/- 42 x 10 platelets/microl; platelet concentrate, 1600 +/- 330 x 10 platelets/microl). The concentration of growth factors also increased with increasing platelet number. However, growth factor concentration varied from patient to patient. On average for the whole blood as compared with platelet-rich plasma, the platelet-derived growth factor-BB concentration increased from 3.3 +/- 0.9 ng/ml to 17 +/- 8 ng/ml, transforming growth factor-beta1 concentration increased from 35 +/- 8 ng/ml to 120 +/- 42 ng/ml, vascular endothelial growth factor concentration increased from 155 +/- 110 pg/ml to 955 +/- 1030 pg/ml, and endothelial growth factor concentration increased from 129 +/- 61 pg/ml to 470 +/- 320 pg/ml. No increase was found for insulin-like growth factor-1. In addition, no increase in platelet activation occurred during the concentration procedure as determined by the platelet surface receptor P selectin (45 +/- 16 pg/ml to 52 +/- 11 pg/ml, p = 0.65). In conclusion, a variety of potentially therapeutic growth factors were detected and released from the platelets in significant levels in platelet-rich plasma preparations. Sufficient concentrates and release of these growth factors through autologous platelet gels may be capable of expediting wound healing in a variety of as yet undetermined specific wound applications.

                Author and article information

                Skin Res Technol
                Skin Res Technol
                Skin Research and Technology
                John Wiley and Sons Inc. (Hoboken )
                20 June 2023
                July 2023
                : 29
                : 7 ( doiID: 10.1111/srt.v29.7 )
                : e13315
                [ 1 ] Department of Dermatology Provincial Hospital Affiliated to Anhui Medical University Hefei China
                [ 2 ] Department of Dermatology The First Affiliated Hospital of the University of Science and Technology of China Hefei China
                [ 3 ] Department of Transfusion The First Affiliated Hospital of the University of Science and Technology of China Hefei China
                Author notes
                [*] [* ] Correspondence

                Siping Zhang, Department of Dermatology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

                Email: zsp3285@ 123456163.com

                Chi Zhang, Department of Dermatology, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, China.

                Email: zcwill@ 123456163.com


                These authors contributed equally to this work.

                © 2023 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                : 01 March 2023
                : 22 March 2023
                Page count
                Figures: 4, Tables: 4, Pages: 9, Words: 4786
                Original Article
                Original Articles
                Custom metadata
                July 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.9 mode:remove_FC converted:20.06.2023

                androgenetic alopecia,male pattern alopecia,platelet‐rich plasma,minoxidil


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