Comparative efficacy and safety of platelet-rich plasma (PRP), injectable platelet-rich fibrin (i-PRF) and concentrated growth factors (CGF) for female pattern hair loss (FPHL): a prospective multicenter randomized clinical trial

Clinical Snapshot

Key Findings

• P Value: p < 0.05 for CGF and i-PRF vs PRP comparison

• Effect Size: CGF and i-PRF approximately 80% more effective than PRP for hair count increase

• Primary Outcome: Target area hair count increase at 24 weeks: CGF 27.11±14.80%, i-PRF 26.54±11.46%, PRP 14.53±8.65%

• Nnt Or Sensitivity: Not calculable from available data

• Confidence Interval: Not reported

Clinical Application

Requires specialised equipment for platelet concentrate preparation and trained dermatologists for injection procedures These treatments are available through private dermatology practices in Australia; not PBS-subsidised but may be considered for patients failing conventional therapies like minoxidil Women with moderate female pattern hair loss (Sinclair grade II-III) seeking non-surgical treatment options

Abstract

BACKGROUND: Comparative studies among different autologous platelet concentrate types for FPHL remain lacking. METHODS: Patients with FPHL (Sinclair gradeII-III) were enrolled and randomized to receive 4 sessions of PRP, i-PRF or CGF treatment at 4-week intervals. The primary endpoint was the inter-group comparison of the non-vellus target area hair count (TAHC)-increase (%) at 24 weeks. Secondary endpoints included: within-group changes in TAHC from baseline; within-group changes in hair diameter (HD) from baseline and inter-group comparison of HD-increase (%) at 24 weeks; Growth factor concentrations were quantified to explore correlations with efficacy. RESULTS: Seventy-four patients completed the study. Post-treatment TAHC increased significantly from baseline in all groups (all p < 0.05). The TAHC-increase(%) was significantly greater in the CGF (27.11 ± 14.80%) and i-PRF (26.54 ± 11.46%) groups compared to the PRP group (14.53 ± 8.65%; p < 0.05), with no significant difference between CGF and i-PRF. Regarding HD increase, all three groups showed improvement, with no statistically significant differences observed among groups (p > 0.05). The i-PRF group showed the lowest adverse event rate. Vascular endothelial growth factor (VEGF) concentration demonstrated a significant positive correlation with the percentage increase in TAHC (r = 0.527, R2=0.278, p < 0.05). CONCLUSIONS: CGF and i-PRF demonstrated superior efficacy in increasing TAHC in FPHL patients. The i-PRF group had the lowest adverse event rate. VEGF levels may play a potential role in promoting hair growth.