Abstract
Androgenetic alopecia (AGA) is the most common form of progressive hair loss in adult men. Topical minoxidil is an established first-line therapy, but its onset is slow and adherence to long-term application is variable. Autologous platelet-rich plasma (PRP) has emerged as a promising adjunctive treatment. Objective of the present study was to compare the clinical efficacy, safety and tolerability of intradermal PRP therapy with topical minoxidil 5% solution in male patients with AGA. Methods. In this single-centre prospective comparative study, 60 male patients with clinically diagnosed AGA were randomly allocated using sealed opaque envelopes containing computer-generated random numbers to receive either intradermal PRP once monthly for four sessions (Group A; n = 30) or topical minoxidil 5% applied twice daily for six months (Group B; n = 30). Treatment response was evaluated at six months using global photography, the hair pull test, a validated patient hair- growth questionnaire and a 10-point patient satisfaction score. Platelet counts in whole blood and in the prepared PRP were also recorded. Fifty-one patients (25 in Group A and 26 in Group B) completed the protocol. A negative hair pull test at six months was significantly more frequent in the PRP group than in the minoxidil group (72.0% vs. 38.5%; p = 0.0336). Self- reported moderate increase in hair growth (40.0% vs. 7.7%; p = 0.006), perceived effectiveness in slowing hair loss (60.0% vs. 19.2%; p = 0.0042) and satisfaction with vertex hair appearance (60.0% vs. 19.2%; p = 0.004) were all significantly greater with PRP. Mean overall satisfaction score (1–10) was 7.55 ± 1.02 in the PRP group versus 5.05 ± 1.45 in the minoxidil group (p < 0.001). The mean platelet concentration in PRP rose from 3.07 ± 0.5 × 10⁵/mm³ in whole blood
to 12.4 ± 1.7 × 10⁵/mm³, an approximately fourfold enrichment. Five patients in Group A discontinued because of procedural pain, and four patients in Group B discontinued because of perceived lack of efficacy. Intradermal PRP therapy produced significantly better clinical and patient-reported outcomes than topical minoxidil 5% over six months in male patients with AGA, with a favourable safety profile. PRP appears to be a useful adjunct to standard therapy and may be particularly valuable in patients with limited adherence to topical regimens.
Keywords: Androgenetic alopecia, platelet-rich plasma, minoxidil, hair loss,