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 ÃŽÂ™ 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.