Comparative study between fractional carbon dioxide laser vs intralesional steroid injection in treatment of alopecia areata

Few studies have reported Fractional Carbon Dioxide (FCO2) laser use in treating alopecia areata (AA), yet, effectiveness of this therapy has not been comparatively analyzed. To assess efficacy and safety of FCO2 laser in comparison to traditional intralesional corticosteroids injection (ILCs) in treatment of AA. This study included 20 patients with at least two patches of AA. Patients were subjected to history taking, general, dermatological and folliscopic examination. One patch was treated by FCO2 laser every 2 weeks for 3 to 6 sessions, while the other treated with intradermal injection of Triamcinolone Acetonide monthly for three sessions maximally. Evaluation of treatment response was done by physician clinical assessment using Mean Improvement Score (MISP), patient satisfaction and folliscopic examination measuring hair density (hair/cm²) before each session, 1 month and 3 months after end of sessions. The obtained data were tabulated and statistically analyzed. There was a highly significant improvement with FCO2 laser rather than ILCs 3 months after last session according to MISP, patient satisfaction and hair density without serious side effects or relapse. FCO2 laser could be a better therapeutic alternative for treating AA in comparison to traditional ILCs.     

Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation

Alopecia areata is a common cause of nonscarring alopecia that occurs in a patchy, confluent, or diffuse pattern. Dermoscopy is a noninvasive technique for the clinical diagnosis of many skin diseases. Topical minoxidil solution 5% and platelet rich plasma are important modalities used in treatment of alopecia areata. We aimed to evaluate the efficacy of PRP versus topical minoxidil 5% in the treatment of AA by clinical evaluation and trichoscopic examination. Ninety patients were allocated into three groups; the first was treated with topical minoxidil 5% solution, the second with platelets rich plasma injections, and the third with placebo. Diagnosis and follow up were done by serial digital camera photography of lesions and dermoscopic scan before and every 1 month after treatment for 3 months. Patients treated with minoxidil 5% and platelets rich plasma both have significant hair growth than placebo (p < .05). Patients treated with platelets rich plasma had an earlier response in the form of hair regrowth, reduction in short vellus hair and dystrophic hair unlike patients treated with minoxidil and control (p < .05). In conclusion, platelets rich plasma is more effective in the treatment of alopecia areata than topical minoxidil 5% as evaluated by clinical and trichoscopic examination.     

The effect of platelet rich plasma on hair regrowth in patients with alopecia areata totalis: A clinical pilot study

Autologous rich plasma (PRP) is blood plasma with enhanced concentration of platelets and is enriched with several growth factors which stimulate tissue regeneration. The current study aimed to investigate the effect of PRP on hair regrowth in patients with alopecia areata (AA) totalis. Ten subjects (28.9 ± 6.28 years; five males and five females) with clinically diagnosed AA totalis for at least 3 years who had not received any treatment within 3 months prior to the study were recruited. Blood sample was collected in thrombocyte harvesting tubes. The PRP was separated via centrifugation. The patients' scalp was divided sagittally into two approximately equal parts. In each patient, 4 mL of PRP was injected intradermally into the left or right side of the scalp; in each point, 0.1 mL of PRP was injected. Each patient was followed up monthly for 4 months. No hair regrowth was seen in eight patients and in two patients only <10% hair regrowth was observed. Totally, no significant effect was found for PRP on hair regrowth (p > .05). There was no side effect during treatment. Single dermal PRP injection did not prove to have any effect on hair regrowth in these patients.     

Topical and intralesional therapies for alopecia areata

Alopecia areata is a common form of nonscarring alopecia. It affects males and females equally and has no racial predilection. It usually affects the scalp, but any hair-bearing area can be involved. It presents as patchy hair loss, loss of hair on the entire scalp (alopecia totalis), or the whole body (alopecia universalis). The histopathology varies according to the disease stage, but usually a perifollicular lymphocytic infiltrate is seen. The course of the disease and response to treatment are unpredictable. Various therapeutic modalities are used including topical, intralesional, and systemic agents, although none are curative or preventive. This article will review the available topical and intralesional agents that are used in the treatment of alopecia areata and suggest a management approach based on the age of the patient and extent of the disease.     

富血小板血浆治疗斑秃的研究进展

目前有文献报道富血小板血浆治疗斑秃安全有效,血小板血浆可通过释放大量的细胞因子促进毛囊干细胞的增殖、分化并改善毛囊周围环境,从而促进毛发生长,本文对富血小板血浆治疗斑秃的研究进展进行了综述。     

Platelet‐rich plasma as a novel treatment for lichen planopillaris

Treatment of lichen planopillaris (LPP) remains a significant challenge due to the irreversible damage inflicted on hair follicles combined with the low efficacy of existing treatments. We hypothesized that growth factors released by the use of platelet‐rich plasma (PRP) may arrest the development of LPP. To test our hypothesis, we treated an LPP patient that has failed previous treatments with a new PRP regimen. Following PRP treatment and six months follow‐up, the patient experienced complete regression of itching and hair shedding. To the best of our knowledge, this is the first report of successful treatment of LPP with a PRP regimen.