Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia

Pietro Gentile; Simone Garcovich; Maria Giovanna Scioli; Alessandra Bielli; Augusto Orlandi; Valerio Cervelli

doi:10.3791/56406

A subscription to JoVE is required to view this content. Sign in or start your free trial.

Method Article

Mechanical and Controlled PRP Injections in Patients Affected by Androgenetic Alopecia

15.2K views

⸱

DOI:

10.3791/56406

⸱

January 27th, 2018

Pietro Gentile¹^,² , Simone Garcovich³ , Maria Giovanna Scioli⁴ , Alessandra Bielli⁴ , Augusto Orlandi⁵ , Valerio Cervelli⁶

¹Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata, ²Chief of Teaching of Plastic and Reconstructive Surgery, Catholic University, ³Dermatology Department, Catholic University, ⁴Anathomic Pathology Department, University of Rome Tor Vergata, ⁵Chief of Anathomic Pathology Department, University of Rome Tor Vergata, ⁶Chief of Plastic and Reconstructive Surgery Department, University of Rome Tor Vergata

Summary

This paper aims to describe the interfollicular autologous platelet-rich plasma injections (0.20 mL x cm²) in the scalp of 23 patients affected by androgenetic alopecia at a depth of 5 mm using a medical injector gun equipped with a 30 gauge needle, in three sessions.

Abstract

23 patients (18 male and 5 female) aged 21-70 years who displayed male pattern hair loss (MPHL) in Stage 1 to Stage 5 as determined by the Norwood-Hamilton classification scale, and female pattern hair loss (FPHL) in Stage 1 to Stage 2 as determined by the Ludwig classification scale, were treated with non-activated autologous platelet-rich plasma (A-PRP). Autologous blood (55 mL) was harvested using sodium citrate as an anticoagulant. A-PRP (23 mL) was produced for all cases using a closed system according to the transfusion service protocol. Following centrifugation (260 x g for 10 min) the A-PRP was inserted in a laser light selector device, and after the centrifugation, 9 mL of A-PRP was collected.

The scalp of the patients affected by androgenetic alopecia (AGA) was divided into four areas (frontal, parietal, vertex, and occipital); local anesthesia was not performed. Interfollicular A-PRP injections (0.2 mL x cm²) were performed by controlled and mechanical injections scheduled at a depth of 5 mm using a medical injector gun. Treatment sessions were performed with a 30-day interval. For each patient, three treatment sessions were performed.

PRP was injected in the androgen-related areas of scalp affected by hair loss. Placebo (normal saline solution) was loaded in another syringe (10 mL) and injected on the adjacent side in a similar fashion.

Introduction

The clinical injection of non-activated A-PRP has become an attractive resource for targeting hair growth. Here, the protocol of the A-PRP application in AGA is reported, using mechanical and controlled injections. Currently, only oral selective 5-α-reductase inhibitor, topical diaminopirimidilpiperidin-N-ossido (2.0% and 5.0%), and low-level laser therapy (LLLT) are approved by the US Food and Drug Administration (FDA) to combat MPHL¹^,².

Diaminopirimidilpiperidin-N-ossido 5% foam is also approved by the FDA for FPHL. The selective 5-α-reductase inhibitor has proven largel....