The additive value of platelet-rich plasma to topical Minoxidil in the treatment of androgenetic alopecia: A systematic review and meta-analysis.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Alopecia*/drug therapy ; Minoxidil*/administration & dosage ; Minoxidil*/therapeutic use ; Platelet-Rich Plasma* ; Administration, Topical*; Humans ; Treatment Outcome ; Randomized Controlled Trials as Topic

Objective: It still needs to be determined if platelet-rich plasma (PRP) has any added advantage over Minoxidil in treating androgenetic alopecia. We reviewed randomized controlled trials (RCTs) comparing scalp injections of PRP plus Minoxidil vs Minoxidil alone for managing androgenetic alopecia.
Methods: All RCTs published on Embase, Cochrane Library, and PubMed comparing PRP plus Minoxidil vs. Minoxidil alone were eligible. The literature search was completed on 5 March 2024. The review was registered on PROSPERO (CRD42024509826).
Results: Of five included RCTs, three had a high risk of bias, while one had some concerns. A systematic review of the studies showed that all trials reported better outcomes with PRP plus Minoxidil than with Minoxidil alone. Meta-analysis showed that hair density at one month (MD: 11.07 95% CI: 1.20, 20.94 I2 = 0%), three months (MD: 21.81 95% CI: 10.64, 33.00 I2 = 57%) and 5/6 months (MD: 17.80 95% CI: 7.91, 27.69 I2 = 80%) of follow-up was significantly better in the PRP plus Minoxidil vs the Minoxidil alone group. Meta-analysis of adverse events showed that the risk of adverse events was comparable in both groups (OR: 0.55 95% CI: 0.22, 1.36 I2 = 0%). The certainty of evidence on the GRADE assessment was "low to very low."
Conclusion: Very low-quality evidence shows that the addition of injectable PRP to topical Minoxidil may improve outcomes in patients with androgenetic alopecia. The addition of PRP was found to improve hair density and patient satisfaction significantly. However, the small number of studies with a high risk of bias and heterogeneity in PRP preparation methods are significant limitations of current evidence. Further studies with larger sample sizes and uniform PRP preparation protocols are needed.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Yao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Musculoskelet Sci Pract. 2020 Apr;46:102108. (PMID: 31999615)
Cureus. 2022 Aug 31;14(8):e28647. (PMID: 36196318)
Indian Dermatol Online J. 2021 Nov 25;12(Suppl 1):S12-S23. (PMID: 34976877)
J Clin Med. 2023 May 03;12(9):. (PMID: 37176700)
J Cosmet Dermatol. 2021 Dec;20(12):3759-3781. (PMID: 34741573)
J Dermatolog Treat. 2022 Feb;33(1):498-511. (PMID: 32410524)
Growth Factors. 2024 Feb;42(1):36-48. (PMID: 38058166)
Plast Reconstr Surg. 2023 May 1;151(5):739e-747e. (PMID: 36729475)
Ann Intern Med. 1981 Jan;94(1):61-5. (PMID: 6108737)
Int J Trichology. 2019 May-Jun;11(3):128-131. (PMID: 31360042)
Dermatol Ther. 2016 Nov;29(6):424-432. (PMID: 27424565)
Skin Appendage Disord. 2023 Dec;9(6):397-406. (PMID: 38058547)
Br J Dermatol. 1998 Mar;138(3):407-11. (PMID: 9580790)
Arch Dermatol Res. 2023 Dec;315(10):2775-2785. (PMID: 37665358)
Front Nutr. 2024 Jun 13;11:1402328. (PMID: 38938670)
Int J Mol Sci. 2020 Apr 13;21(8):. (PMID: 32295047)
Skin Appendage Disord. 2018 Jan;4(1):18-24. (PMID: 29457008)
Transfusion. 2009 Apr;49(4):771-8. (PMID: 19170984)
J Am Acad Dermatol. 2019 Jun;80(6):1497-1506. (PMID: 30312644)
Trends Biotechnol. 2009 Mar;27(3):158-67. (PMID: 19187989)
Indian J Dermatol Venereol Leprol. 2020 Mar-Apr;86(2):150-157. (PMID: 31823902)
J Am Acad Dermatol. 2011 Dec;65(6):1126-1134.e2. (PMID: 21700360)
J Cosmet Dermatol. 2021 May;20(5):1427-1434. (PMID: 33438346)
Aesthetic Plast Surg. 2020 Jun;44(3):962-970. (PMID: 32166351)
J Cosmet Dermatol. 2023 Jul;22(7):1995-2002. (PMID: 37195261)
J Invest Dermatol. 2001 Dec;117(6):1594-600. (PMID: 11886528)
JAMA Dermatol. 2022 Mar 01;158(3):266-274. (PMID: 35107565)
Aesthetic Plast Surg. 2024 Mar;48(5):977-984. (PMID: 37644190)
J Cutan Aesthet Surg. 2022 Jan-Mar;15(1):71-76. (PMID: 35655638)
Int J Surg. 2021 Apr;88:105906. (PMID: 33789826)

5965120SH1 (Minoxidil)

Date Created: 20240828 Date Completed: 20240828 Latest Revision: 20240831

20250114

PMC11356437

10.1371/journal.pone.0308986

39197003