ENHANCING TREATMENT OUTCOMES IN ANDROGENETIC ALOPECIA: A PROSPECTIVE COMPARATIVE EVALUATION OF PLATELET-RICH PLASMA AND MINOXIDIL THERAPY

Authors

1. Madhukumar M G
   Associate Professor, Department of General Surgery, Sri Siddhartha Institute of Medical Sciences and Research Centre, Bangalore, India.
   https://orcid.org/0009-0007-9108-8755
2. Suwarna
   Professor, Department of Community Medicine, MVJ Medical College, Bangalore, India.

Abstract

Androgenetic alopecia (AGA) is the most common form of progressive hair loss in adult men. Topical minoxidil is an established first-line therapy, but its onset is slow and adherence to long-term application is variable. Autologous platelet-rich plasma (PRP) has emerged as a promising adjunctive treatment. Objective of the present study was to compare the clinical efficacy, safety and tolerability of intradermal PRP therapy with topical minoxidil 5% solution in male patients with AGA. Methods. In this single-centre prospective comparative study, 60 male patients with clinically diagnosed AGA were randomly allocated using sealed opaque envelopes containing computer-generated random numbers to receive either intradermal PRP once monthly for four sessions (Group A; n = 30) or topical minoxidil 5% applied twice daily for six months (Group B; n = 30). Treatment response was evaluated at six months using global photography, the hair pull test, a validated patient hair- growth questionnaire and a 10-point patient satisfaction score. Platelet counts in whole blood and in the prepared PRP were also recorded. Fifty-one patients (25 in Group A and 26 in Group B) completed the protocol. A negative hair pull test at six months was significantly more frequent in the PRP group than in the minoxidil group (72.0% vs. 38.5%; p = 0.0336). Self- reported moderate increase in hair growth (40.0% vs. 7.7%; p = 0.006), perceived effectiveness in slowing hair loss (60.0% vs. 19.2%; p = 0.0042) and satisfaction with vertex hair appearance (60.0% vs. 19.2%; p = 0.004) were all significantly greater with PRP. Mean overall satisfaction score (1–10) was 7.55 ± 1.02 in the PRP group versus 5.05 ± 1.45 in the minoxidil group (p < 0.001). The mean platelet concentration in PRP rose from 3.07 ± 0.5 × 10⁵/mm³ in whole blood to 12.4 ± 1.7 × 10⁵/mm³, an approximately fourfold enrichment. Five patients in Group A discontinued because of procedural pain, and four patients in Group B discontinued because of perceived lack of efficacy. Intradermal PRP therapy produced significantly better clinical and patient-reported outcomes than topical minoxidil 5% over six months in male patients with AGA, with a favourable safety profile. PRP appears to be a useful adjunct to standard therapy and may be particularly valuable in patients with limited adherence to topical regimens.

Keywords

Androgenetic alopecia, platelet-rich plasma, minoxidil, hair loss,

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