Systematic review of Platelet-Rich Plasma use in Androgenetic Alopecia vs Minoxidil

“Systematic review of Platelet-Rich Plasma use in Androgenetic Alopecia vs Minoxidil, Finasteride, Adult Stem-Cell Based Therapy”.

Gentile, Garcovich; 2020

Abs: A big increase in Platelet Rich Plasma (PRP) studies for the treatment of Androgenetic Alopecia (AGA), with very successful results (84% showed positive results); most importantly, no major side effects.

Intro: Autologous Activated PRP (AA-PRP) has become a standard routine for hair growth; what is missing however is a standardised procedure for it: need of a protocol.

Some important proteins:

  • Bcl-2: anti-apoptotic effect; delays cell self-destruction, increases life span and numbers of hair follicles.
  • Akt: directly impacts survival of dermal papilla cells.
  • FGF-7 and β-catenin: prolong anagen phase (growing phase of hair) and recruit stem cells.


AGA symptoms include miniaturisation of hair follicles, shorter anagen phase and longer and earlier telogen phase (when hairs die and fall off), decrease in stem cell activity and differentiation.

As much as PRP has promise, clinics are put off due to various preparation instructions available, with no standardisation of manufacturing; need consistency in production of PRP.

  • Differences in production include centrifugation time and speed, number of spin cycles, blood volume used, platelet count, growth factors and chemokines released.


Other possible treatments include Adult stem-cell based therapy, hair follicle stem-cell injections, and “common” treatments (Minoxidil and Finasteride).


Discussion: “common” treatments compared to AA-PRP

  • Minoxidil: topical agent; prolongs anagen phase, thicker hair, better cell survival.
  • Finasteride: oral agent; prolongs anagen phase, stimulates hair growth, reduces hair loss pattern.

Biggest issue is dependency to both treatments: need to be used daily without fail, for 12 to 24 months before visible results.

  • Adult Stem-Cell based Therapy: will trigger the recruitment and release of growth factors, very high recruitment, and differentiation of stem cells; major issue is harvesting stem cells, very invasive and painful, yield may vary.

Conclusion: AA-PRP comes across as more suitable treatment for AGA, with clear and significant results after 3rdinjection; only needs 3 rounds of treatments with the possibility of a booster treatment after 6 months; has no side effects recorded to this day.


What to take away from paper:

  • AA-PRP is a viable and suitable treatment for AGA.
  • Current treatments have obvious limitations, even when expanding horizon to stem cells.
  • Angel system and its benefits are briefly mentioned, its superiority highlighted.