How effective is platelet-rich plasma in management of alopecia areata?

The efficacy of platelet-rich plasma in alopecia areata appears to be limited, but the treatment may help restore immune balance in the alopecic patches, suggest the results of a recent study.

This randomized, placebo-controlled, split-head study examined the effect of platelet-rich plasma on hair-regrowth and lesional T-cell cytokine expression in 27 patients with alopecia areata (Severity of Alopecia Tool score ≥25 percent).

The investigators randomized alopecia patches on either side of the scalp to receive three intradermal injections of platelet-rich plasma or normal saline at monthly intervals. The patches were assessed 3 months after the last session. Lesional T-cell cytokine messenger RNA expression was compared pre- and post-treatment in the platelet-rich plasma-treated sites.

Compared with baseline, the mean Severity of Alopecia Tool score did not change significantly with either of the two treatments at any visit, but the mean percentage reduction in the score was greater in the platelet-rich plasma arm than in the placebo arm (9.05±36.48 percent vs 4.99±33.88 percent; p=0.49) at final assessment.

Following platelet-rich plasma treatment, the mean interferon gamma (p=0.001) and interleukin 17 cytokine (p=0.009) messenger RNA expression decreased, while the mean interleukin 10 (p=0.049) and FOXP3 (p=0.011) messenger RNA expression increased significantly.

“Platelet-rich plasma was found to have limited efficacy in alopecia areata,” the investigators said. “However, it may play a role in restoring immune balance in the alopecic patches.”

This study was limited by its small sample size and relatively short follow-up.