Alopecia areata

The third application field for PRP concerns alopecia areata. For this indication, evaluation is particularly difficult; indeed, the evolution is naturally capricious. It must therefore be concluded that the case has been developing for more than 1 year without success. Also, digital measurements are delicate as the areas of regrowth are irregular. Macrophotograhy is the best method evaluation in this disease. For now, only case studies rather than standardised evaluations are available. Nevertheless, obvious improvements can be seen (Figure 5).


In the authors’ evaluation, other than objective measurements, the subjective appreciation of patients is evaluated. There is a large chasm between objective measures and patient feelings; for example, the patient may feel satisfied with a small increase (10%), but dissatisfied with a significant result (40%).

With regard to the standardisation of photography, many factors must considered, including colour,  length, hairdressing, and lighting. For these reasons, to get suitable results, an objective parameter is essential (i.e. the phototrichogram). Further guidelines for effective analysis are those tools which allow the authors to obtain the best phototrichogram possible (e.g. tattoo points, short cut, and dyeing solution). Most authors also agree that 50 patients is a minimum requirement to obtain efficient statistic results.

Once the efficacy of PRP for hair-loss is demonstrated, it would be interesting to compare the impact of different factors in future studies. For example, with or without dermaroller, with or without activation, or different volumes, as well as other hair pathologies, such as alopecia areata and telogen effluvium.

Those explorations are very important regarding the poor panel of treatments at our disposal almost for some of them which are disputed for long last using. PRP protocol can be an alternative solution.


The use of PRP for applications in hair-loss is far from being minor. In the future, the authors hope to improve the protocol and show that PRP also has a preventive effect on hair disorders. This method will not replace the hair graft, but may be useful to delay such treatment and provide betterresults. The authors hope that this article will encourage clinicians to use objective measurements for their evaluation, respecting the standard guidelines.

Declaration of interest None

Figures 1, 5, 6  © Amgar and Bouhanna, 2 Reproduced with kind permission of Dr Kiyozawa, 3, 4, 7 © Greco

The Hair PRP study tubes used for the authors’ study were produced by MyCells.