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Platelet-Rich Plasma For Treatment Of Hair Loss Improves Patient-Reported Quality Of Life
Abigail Meyers, BS, Alison Jin, BA, Grzegorz J. Kwiecien, MD, James Gatherwright, MD, James Zins, MD.
Cleveland Clinic, Cleveland, OH, USA.

PURPOSE:
Platelet-rich plasma (PRP) is popular for treatment of hair loss, a common and psychologically taxing condition. PRP is promoted for its autologous nature as a therapeutic treatment with few complications or side effects and has been shown to increase both hair count and density. While there are many studies reporting the efficacy and safety of PRP for androgenetic alopecia, there is a lack of sufficient research on quality-of-life improvement. This study aims to assess the psychological impact of PRP treatment using HAIRDEX 48, a validated survey for quality of life and emotional/psychological well-being related to conditions causing hair loss.
METHODS:
A prospective investigation of patients receiving PRP injections to the scalp for hair loss was conducted. Injections were repeated monthly for the first3 months, then quarterly for 1 year, and annually thereafter.HAIRDEX surveys were administered before PRP and at each subsequent visit. HAIRDEX is a disease-specific validated scale used to assess quality of life (QoL) for patients with androgenic alopecia (AGA) or alopecia areata (AA). Scores were interpolated on a 0-100 scale: 0 representing highest quality of life and 100 lowest. Score differences pre and post-PRP were compared using paired t-tests with each patient serving as their own control. P value ≤ 0.05 was considered significant.
RESULTS: Ninety-two patients receiving PRP treatments were analyzed, and males. Mean age was 48.2 17.4 years and males accounted for 55%. Patients had an average of 42 treatments; most (60%) had four or more, while 17% had three, 11% had two, and 12% had one. Thirty-two percent of patients (n=30) completed both pre and post-PRP questionnaires. Prior to PRP treatments at our institution, 61% of patients had tried minoxidil, 16% finasteride, and 1% hair transplant, while 20% had not tried any other hair loss treatments. Twenty-eight percent of patients had stage II Hamilton-Norwood classification of hair loss, 25% III, 19% V, 11% each I and IV, and 3% each VI and VII.
Total HAIRDEX scores revealed a significant improvement from a mean of 23.215.4 to 19.711.3 3-5 months after PRP (p<0.001). There was also a significant decrease in the symptoms domain scores from 10.012.0 to 9.610.8 (p<0.001) between 3-5 months. Within the functioning domain, scores decreased from 16.118.1 at baseline to 13.312.6 at 3-5 month follow up (p<0.001). Additionally, the emotions domain revealed a significant improvement from 37.724.1 to 32.218.9 3-5 months after PRP (p<0001).
For the stigmatization domain, the difference in scores from pre-PRP (21.216.8) was significant at both 3-5 month follow-up with an average score of 17.412.1 (p<0.001) and 18.913.9 at follow-up >6 months (p<0.001). This was also seen in the self-confidence domain, in which scores decreased from 24.817.7 to 20.915.5 between 3-5 months (p<0.001) and 19.518.6 >6 months post-PRP (p=0.008).
CONCLUSION:
PRP treatment was associated with a statistically significant overall improvement in quality of life. Emotional well-being, symptoms, functioning, stigmatization, and self-confidence significantly improved following treatment. PRP should be considered as a safe and effective treatment option for hair loss and included as part of multimodal therapy.


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