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| HAIR GROWTH | PEER-REVIEW


Figure 1 Phototrichogram evaluation of a frontal bald area before treatment. The goal is to increase the caliber of the miniaturised hair


have been used since at least 1970, in a variety of specialist areas, such as plastic surgery, rheumatology, dentistry and orthopaedics. Being an autologous product, tolerance is excellent and no serious adverse effects have been observed to date. However, for use in hair-loss surgery, the challenge


remains to evaluate the results using objective parameters. To assess the effect of PRP treatment on the skin, two studies have been published, one of which used biometric parameters (i.e. anisotropy, hydration, transepidermal water loss)3 histology4


and the other using human The most researched and 0.64 cm2


Total hair count 60 Hair < 40 μm 12 Hair > 40 μm 48


1 cm2 94 19


% 20 75 80 The most researched and publicised medical


treatment available for male pattern baldness is 5% minoxidil lotion, and 2% minoxidil for female baldness. The first signs of improvement generally appear after 3 months of therapy. The side-effects of minoxidil are minimal, but include itching, eczema and hypertrichosis (the latter is more common in female patients). For male baldness, finasteride taken orally and daily


(1 mg) works by inhibiting the 5α-reductase from forming DHT. The decreased DHT levels allow some intermediate follicles to enlarge and regrow normal terminal hairs. Side-effects may include decreased libido. Cyproterone acetate (in Europe) can effectively block


the increased levels of male hormones that cause hair-loss in some women. Spironolactone (in the US) appears to be a competitive inhibitor of DHT-receptor binding. New interest in preventing hair-loss and baldness has


been stimulated by cellular therapy with traumatising and then infusing PRP into the scalp, which normalises hair-loss after the first treatment, and reverses hair miniaturisation of male and female baldness after a second treatment.


Importance of growth factors For a number of years, the expectations of physicians and patients in medical and surgical procedures were to improve tolerance, obtain satisfying results, and to make the treatment process easier to carry out. As a result, the use of PRP therapy began to take a prominent place in this context. The process consists of using autologous platelet extracts as a cell-repairing product. The revitalising qualities of the platelets are well known and


publicised medical treatment available for male pattern baldness is 5% minoxidil lotion,


and 2% minoxidil for female


baldness.


. Most clinical evaluations are based on subjective evaluations, patient satisfaction, and before and after picture evaluations. Those publications that offer objective parameters are based on biometrology or human histology. For this reason, future studies that investigate the use of PRP and hair- loss must consider objective parameters. The process begins by taking a


blood sample through an anticoagulated tube, with or without separating gel. The tubes are then centrifuged for approximately


5 minutes at 600 G (the speed and time will depend on the specific kit protocol). As a result of their density, the red cells sink in the tube, while at the upper part of the tube the plasma and platelets collect. PRP is usually referred to when a concentration of three-to-five-times normal standards has been collected. Once injected into the dermal layer, the platelets are


activated; they inflate and growth factors are released. The most important growth factors in terms of PRP for hair application are: ■ Platelet-derived growth factor (PDGF) ■ Vascular endothelial growth factor (VEGF) ■ Epidermal growth factor (EGF) ■ Insulin-like growth factor 1 (IGF-1) ■ Fibroblast growth factor (FGF) ■ Nerve growth factor (NGF).


Figure 2 (A) Before and (B) 12 weeks after one session of platelet-rich plasma treatment prime-journal.com | June 2013





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