THE EFFICACY OF PLATELET RICH PLASMA IN TREATMENT OF ANDROGENETIC ALOPECIA

Dermoscopy is a non-invasive diagnostic technique for the observation of pigmented skin lesions, permitting the recognition of morphologic structures not visible by the naked eye. The technique consists of placing mineral oil, alcohol or even water on the skin lesion that is subsequently inspected using a hand-held lens, a hand-held dermatoscope, a stereomicroscope, a camera, or a digital imaging system. The magnifications of these various instruments range from 6x even up to 100x.The fluid placed on the lesion eliminates surface reflection and renders the cornified layer translucent, thus allowing a better visualization of pigmented structures within the epidermis, the dermoepidermal junction and the superficial dermis. Male-pattern hair loss (MPHL), also known as androgenic alopecia and male pattern baldness, is hair loss that occurs due to an underlying susceptibility of hair follicles toshrinkage due to the influence of androgenic hormones. Male-pattern hair loss is the most common cause of hair loss and will affect up to 70% of men and 40% of women at some point in their lifetimes.Men typically present with progressive hair loss at the temples and vertex balding, whereas women typically present with diffuse hair loss over the top of their scalps.Platelet-rich plasma is defined as a volume of the plasma fraction of autologus blood with an above baseline platelet concentration usually more than 1,000,000 platelets/μL.PRPs regenerative potential depends on the levels of released GFs.Alpha granules of platelets contain GFs, which upon activation, are responsible for the initiation and maintenance of the healing response. PRP is known to carry more than 20 GFs and other protein molecules, such as adhesion molecules, chemokines, which interact to promote inflammation, cell proliferation, differentiation, and regeneration.In this study, the aim was to objectively assess the proposed therapeutic effect of PRP in treatment of AGA through measuring hair density using dermoscopic evaluation, hair pull test, gross pictures and patients satisfaction scale.The study included 30 patients of different grades of androgenetic alopecia, our patients were 15 males and 15 females ranging from grade Ι to ΙΙΙ by Ludwig classification for FPHL and from grade 3 to grade 6 for Norwood and Hamilton classification for male androgenetic alopecia of a total 6 sessions, 4 successive ones with 3 weeks apart of a total 12 weeks and 2 separate sessions, 24wk and the last evaluation was done 1 year later to the 1st session.The results were classified depending on the lasting effect of the PRP into short term results lasting up to 4 months from the start of the sessions which gave statistically positive values regarding the hair pull test results and hair follicles counted by dermoscope and the long term results starting from the 5th month up to 1 year duration from the start of the sessions which showed decline in both numbers of hair pull test and Which indicatesthe needfo retreatment or addition of another line o medical treatment e.g., minoxidil or finasteride. Also PRP can be considered ahumble tool in the treatment of AGA, as it is sufficient alone without the medical treatment