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

Endocrinology and Metabolism

It remains to be determined whether platelet-rich plasma (PRP) offers an additional advantage over Minoxidil in the treatment of androgenetic alopecia. The authors reviewed randomised controlled trials (RCTs) comparing PRP + Minoxidil scalp injections versus Minoxidil alone for the management of androgenetic alopecia.

All RCTs published in Embase, Cochrane Library and PubMed comparing PRP plus Minoxidil with Minoxidil alone were eligible. The literature search was completed on 5 March 2024. The opinion was registered on PROSPERO (CRD42024509826).

Of five RCTs included, three had a high risk of bias, while one had some concerns.

A systematic review of the studies showed that all trials reported better results with PRP plus Minoxidil than with Minoxidil alone.

The meta-analysis showed that hair density at one month (DM: 11.07, 95% CI: 1.20, 20.94, I2 = 0%), three months (DM: 21.81, 95% CI: 10.64, 33.00, I2 = 57%) and 5/6 months (DM: 17.80, 95% CI: 7.91, 27.69, I2 = 80%) follow-up was significantly better in the PRP plus Minoxidil group compared to Minoxidil alone.

The 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 confidence level of the evidence on the GRADE assessment was ‘low to very low’.

CONCLUSION: There is very low quality evidence that the addition of injectable PRP to topical Minoxidil may improve outcomes in patients with androgenetic alopecia. The addition of PRP has been shown to significantly improve hair density and patient satisfaction.

However, the small number of studies with a high risk of bias and heterogeneity in PRP preparation methods is a major limitation of the current evidence. Further studies with larger sample sizes and uniform PRP preparation protocols are needed.

Source(s) :
Yao J ; Zhu L ; Pan M ; Shen L ; Tang Y ; Ventilateur L ;

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