Intralesional Platelet-Rich Plasma Injection in Patients with Recalcitrant Alopecia Areata

Area of Science:

• Dermatology
• Immunology
• Regenerative Medicine

Background:

• Alopecia areata (AA) is a chronic autoimmune condition causing non-scarring hair loss.
• The relapsing-remitting nature of AA necessitates exploring novel and effective therapeutic strategies.
• Current treatments for AA often have limitations, driving research into alternative options.

Purpose of the Study:

• To compare the efficacy of intralesional platelet-rich plasma (PRP) versus intralesional steroid (ILS) injections for treating alopecia areata.
• To evaluate hair regrowth and treatment response in patients with AA receiving either PRP or ILS therapy.
• To assess the safety and side effect profiles of both intralesional PRP and ILS treatments.

Main Methods:

• A retrospective chart review of 75 patients with AA from 2020-2021.
• Patients received three sessions of either intralesional PRP (36 patients) or ILS (39 patients).
• Hair regrowth was assessed using the Hair Pull Test and Severity of Alopecia Tool (SALT) scores at baseline, 3 months, and 6 months.

Main Results:

• Both PRP and ILS treatments resulted in statistically significant reductions in SALT scores at 3 and 6 months, with PRP showing greater improvement (p=0.038 at 3 months, p<0.001 at 6 months).
• At 6 months, 83.4% of patients in the PRP group achieved a very good response, compared to a lower percentage in the ILS group.
• While PRP showed higher efficacy, it also had a statistically significant higher frequency of minor side effects (44.4% vs. 20.5%), such as itching and pain.

Conclusions:

• Intralesional PRP appears to be an effective and safe treatment option for limited patchy alopecia areata.
• Despite promising results, PRP's superiority over ILS in all aspects is not fully established.
• Intralesional steroids (ILS) are still considered the first-line treatment for alopecia areata, pending further comparative studies.