DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20183254

A randomized, double blind, placebo controlled, split patch study to evaluate the effects of platelet rich plasma on alopecia areata

Bushra Khan, Ramesh Sharma, Milind A. Borkar

Abstract


Background: Alopecia Areata is a T-cell–mediated autoimmune, often reversible disease in which the gradual loss of protection provided by immune privilege of the normal hair follicle plays an important role. It manifests as smooth, slightly erythematous (peach color) or normal-colored alopecic patches with short broken hair at the margins. It involves scalp most commonly, although other regions of body may be affected. Platelet rich plasma is an autologous concentration of platelets with a greater count in a small volume of plasma. Study aimed to evaluate the safety and efficacy of PRP therapy in Alopecia Areata.

Methods: In this randomised, placebo controlled, split patch study, 30 patients of AA were recruited and injected with 1-1.5ml of autologous PRP made by double spin method into half the bald patch area and other half with placebo using insulin syringe once a month for 3 months. Outcome was assessed at the end of study by clinical photographs as regrowth of hair, dermoscopy findings as reduction in black dots, yellow dots and exclamation hair and Physician and patient self-assessment score.

Results: Administration of autologous PRP has led to observable improvement in 20% case of PRP and only 3.3% of control cases. Decrease in number of dystrophic hair and hair regrowth with PRP was seen in 20% cases and in 17% patches.

Conclusions: PRP in our setting was found to be minimally effective, but more efficacious than no treatment, and safe for AA patients.


Keywords


Alopecia areata, Autologous PRP, Hair disorder, Platelet rich plasma, T cell mediated

Full Text:

PDF

References


Picardi A, Pasquini P, Cattaruzza MS, Gaetano P, Baliva G, Melchi CF, et al. Psychosomatic factors in first-onset alopecia areata. Psychosomatics. 2003;44:374-81.

Paus R, Arck PJ. Neuroendocrine perspectives in alopecia areata: does stress play a role? J Invest Dermatol. 2009;129:1324-6.

Sachdeva SA. Alopecia areata: an update. 2013. Available from: http://www.jpad.org.pk/April%20 June%202013/18.%20Revieew%20article%20Alopecia%20areata.pdf. Accessed on 5th December 2016.

Gilhar A, Paus R, Kalish RS. Lymphocytes, neuropeptides, and genes involved in alopecia areata. J Clin Invest. 2007;117:2019-27.

Karadag Köse O, Güleç AT. Clinical evaluation of alopecias using a handheld dermatoscope. J Am Acad Dermatol. 2012;67(2):206-14.

Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British association of dermatologists’ guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012;166(5):916-26.

Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI. Involvement of platelet-derived growth factor receptor-alpha in hair canal formation. J Invest Dermatol. 1996;107:770-7.

Takikawa M, Nakamura S, Nakamura S, Ishirara M, Kishimoto S, Sasaki K, et al. Enhanced effect of platelet-rich plasma containing a new carrier on hair growth. Dermatol Surg. 2011; 37:1721-9.

Lee JW, Kim BJ, Kim MN Mun SN. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial. Dermatol Surg. 2011;37:931-8.

Chen TM, Tsai JC, Burnouf T. A novel technique combining platelet gel, skin graft, and fibrin glue for healing recalcitrant lower extremity ulcers. Dermatol Surg. 2010;36:453-60.

Li ZJ, Choi HI, Choi DK, Sohn KC, Im M, Seo YJ, et al. Autologous platelet-rich plasma: A potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38:1040-6.

Trink A, Sorbellini E, Bezzola P, Rodella L, Rezzani R, Ramot Y, et al. A randomized, double-blind, placebo and active-controlled, half-head study to evaluate the effects of platelet rich plasma on alopecia areata. British J Dermatol. 2013;169:690-4

El-Sharkawy H, Kantarci A, Deady J, Hasturk H, Liu H, Alshahat M, et al. Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J. Periodontol. 2007;78:661-9

Fricke VAC, Miteva M. Epidemiology and burden of alopecia areata: A systematic review. Clinical Cosmetetic Investigational Dermatol. 2015;8:397-403.

Kumar A, Sharma RP, Bali S, Arya P. Role of Platelet Rich Plasma Therapy in Alopecia Areata- A Prospective Study. Inter J Contem Med Res. 2016;3(8):2499-2502.

Bhat YJ, Manzoor S, Khan AR, Qayoom S. Trace element Trace element levels in alopecia areata levels in alopecia areata. Ind J Dermatol Venereol Lepro. 2009;75(1):29-3

Singh S. Role of platelet­rich plasma in chronic alopecia areata : Our centre experience. Indian J Plast Surg. 2015;48(1):57-9.