Platelet-Rich Plasma for the Treatment of Female Pattern Hair Loss: A Patient Survey

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Although female pattern hair loss (FPHL) is extremely common, FDA-approved treatment is limited to minoxidil. Platelet-rich plasma (PRP) is a promising new option to fill the gap between medical and surgical options for FPHL. Animal models have suggested that PRP promotes hair growth, and several clinical studies have demonstrated PRP's efficacy for androgenetic alopecia on a variety of measures including hair density.1–4 We conducted a survey of patients with FPHL to determine satisfaction from a patient perspective.
After institutional review board approval, an anonymous, voluntary survey was sent through mail to 41 patients of 1 treating physician (MR). Eligible patients were women aged 18 to 90 years old with FPHL, who had received 1 or more PRP treatments starting at least 6 months before the start of the study. Patients underwent 1 to 3 treatments, performed at 2 to 3-month intervals. The materials and methods of the PRP preparation and procedure are described in Figure 1. Statistical analysis was performed using IBM SPSS Statistics and R Programming Language.
Thirty-one of 41 (76%) surveys were completed, with an average patient age of 51 years (range 22–87 years) (Table 1). All patients had tried other therapies previously, most commonly minoxidil (87%), biotin or vitamin supplements (81%), and finasteride (65%).
A majority of patients were satisfied (58%), with 65% of satisfied patients reporting either “marked” or “exceptional” improvement. Most satisfied patients noticed improvement in less than 6 months (72%). The most common subjective manifestations of improvement were hair feeling/looking fuller or thicker to the patient or others (94%) and less shedding (61%). Forty-five percentage of patients reported experiencing at least 1 side effect, most commonly swollen forehead/face (29%) and sore/painful scalp lasting over 3 days (26%). Excluding from analysis undecided patients, patients 40 years or older were more likely to be satisfied than younger patients (88% vs 38%, p = 0.02). Although not accounting for possible confounding variables, this challenges previous work that found younger patients may have better results2 and suggests that PRP should be considered in patients of all ages.
Analyzing satisfied patients, a multinomial linear regression model was performed to determine variables that predicted degree of satisfaction. This model (with low average in-sample error of 0.278) found that patients were more satisfied if they reported new hair growth as a manifestation of improvement, did not report any adverse reactions, or required 2 or fewer treatments to see improvement.
Although study patients had concurrent use of other therapies that may confound PRP's effects, this reflects the use of combination treatment in routine practice. Although limited to subjective data, it is important to determine if the objective efficacy described in other studies is apparent to patients, as patient satisfaction is the ultimate goal of treating an aesthetic condition.
In summary, most respondents were satisfied with PRP for the treatment of their FPHL, with a majority of satisfied patients reporting marked or exceptional results. Our study supports a growing body of literature that PRP is a promising new therapy in the treatment of FPHL.
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