Platelet Rich Plasma Therapy and Scarring Alopecia

Over the past five years there has been a greater acceptance in the use of Platelet Rich Plasma (PRP) Therapy for hair loss as we have seen many successful studies.  However, most of the research and studies focused on patients with androgenic alopecia, which is tied to genetics and is the most common cause of hair loss.  As the benefits of PRP Therapy are being more understood, we are seeing its uses expanded, including in the treatment of Alopecia Areata and some Scarring Alopcias.  There was an exciting case study shared in the July 2019 journal of Dermatologic Surgery on the successful treatment of two patients with scarring alopecia using PRP Therapy.

While less common than androgenic alopecia, according to the Canadian Medical Association Journal, patients with scarring alopecia make up 7% of patients experiencing hair loss.  While the cause of scarring alopecia is not entirely known, scarring alopecia causes inflammation around that hair follicle that eventually leads to the permanent destruction of the follicle.  There are various types of scarring alopecias, with the most common being Lichen Planopilaris (LPP), Frontal Fibrosing (Alopecia), and Cicatricial Alopecia (CCCA).  For each type of scarring alopecia treatment can vary slightly, with the exception of topical or injected steroids, which are typically the first recommended treatment for all types of scarring alopecia.

So is PRP Therapy a treatment option for scarring alopecia?  It is important to remember that the case study in the July 2019 journal of Dermatologic Surgery included only two patients, but below describes the patients and their outcomes:

Patient 1 Patient 2
Age 53 70
Gender Female Female
Race African – American Caucasian
Hair Loss History Decreased density along the scalp vertex since her mid-40s. Several years of gradual hair loss diffusely across the scalp. Diminished hair density along frontal hairline and scalp vertex.
Diagnosis Cicatricial Alopecia (CCCA) with mild component of Androgenic Alopecia Lichen Planopilaris (LPP)
Other Treatments Spironolactone, steroids (topical and injections), topical minoxidil.  All were considered ineffective and were stopped prior to PRP Therapy. Steroid (topical and injections), hydroxychloroquine 400mg daily. Did not lead to improvement, but continued topical and hydroxychloroquine during PRP Treatment.
Outcome Normal follicular density was noted along temporal hair line and greater than 50% improvement in hair density along scalp vertex. Normal density was noted diffusely across scalp and hairline.

This case study shows that there is a place for the use of PRP Therapy in the treatment of some scarring alopecias.  At Medi Tresse we have had success in utilizing PRP as a treatment for some patients with scarring alopecia, especially when there is a component of androgenic alopecia as well.  While more research needs to continue, this case study is great news for patients with scarring that have not had success with traditional treatments, like steroids, as it gives them another potential option.  If you think you could benefit from Platelet Rich Plasma (PRP) Therapy contact our office to schedule a free consultation.