Evaluation of the safety and efficacy of platelet-rich plasma in the treatment of female patients with chronic telogen effluvium: A randomised, controlled, double-blind, pilot clinical trial

Background: Chronic telogen effluvium is characterised by diffuse loss of hair of the scalp. One of the emerging lines of treatment is platelet-rich plasma. However, not much of published data exist. Aims: A pilot study was conducted on chronic telogen effluvium patients to evaluate the efficacy and safety of platelet-rich plasma, and to compare two different methods of platelet-rich plasma preparation. Methods: The study included 30 female patients with chronic telogen effluvium. Patients were randomised into three groups: Group (1): Special platelet-rich plasma tubes centrifuged at 3500 rpm; Group (2): Ordinary laboratory tubes centrifuged at 1000 rpm; Group (3): Normal saline as a placebo. Patients' evaluation was done with visual analog scale, hair pull test, trichoscopy, photos, satisfaction questionnaire, and safety. All patients received four monthly sessions. Patients were evaluated one month and three months after the last session. Results: The hair pull test,visual analogue scale, and patient satisfaction results showed a statistically significant difference between group 1 vs. group 3 and group 2 vs.group 3 at one and three months after the sessions, while there was no difference between group1 vs. group 2. Trichoscopy results (baseline, one and three months after treatment) showed a significant increase in hair density and thickness in the frontal area, temporal area, and the vertex in groups 1 and 2 only. There was no statistically significant difference between the three groups with regards to side effects. Limitations: The sample size was small with ten patients in each group. Furthermore, the follow-up of patients was for only three months. Conclusions: Platelet-rich plasma could be considered as a promising therapy for patients with chronic telogen effluvium with an excellent safety profile. The ordinary laboratory low-cost tubes might be a reliable alternative to the expensive special platelet-rich plasma kits tubes. The trial registry number is PACTR202006539654415

Comparative Evaluation of Hair Density and Grouped Hair Unit Pattern between Androgenetic Alopecia and Normal Scalp

BACKGROUND: Human hair usually emerges from the scalp in groups of 2 or 3-hair units. Hair densities and grouping patterns in androgenetic alopecia (AGA) patients are known to be different from those in normal adults, but no comparative study has ever before been made in Korea. Therefore we have developed some technical improvements on phototrichogram methodology to evaluate the differences between these two groups. BACKGROUND: Objectives: This study was performed to quantify Koreans' hair characteristics at each site (vertex, occipital, temporal) of the scalp according to the age and to compare the differences of hair characteristics of AGA and normal adults using phototrichogram. METHODS: Hairs in the precisely defined circle at each (vertex, temporal, occipital) site of the scalp in 37 AGA male patients and 15 healthy male volunteers were evaluated according to age. Each circumscribed area of the scalp, centered with a dot tattoo to ensure reproducibility, was photographed just after shaving, and named 'primary image'. Two days later, the same area was again photographed, and named 'secondary image', from which the hair density and the grouping pattern of hair follicular units were determined by the image analyzer program. RESULTS: The results can be summarized as follows: 1. In normal adult males, the range of hair density was 117~13/cm2~140~16/cm2, with the hair density of the occiput being significantly higher than that of the temple. No significant differences in hair density were shown between vertex and occiput. 2. In AGA male patients, the range of hair density was 102~23/cm2-137~17/cm2, and the differences of the hair density between vertex and occiput were statistically significant. 3. The numbers of grouped hair units per square centimeter in the non-bald adult male group ranged from 59~11/cm2 to 73~14/cm2. The most common grouped hair unit was a 2-hair unit, followed by a 1-hair unit and a 3-hair unit group. 4. In the AGA group, the numbers of grouped hair units per square centimeter ranged from 57~6/cm2 to 72~12/cm2, showing no significance with the control group. The most common grouped hair unit was a 1-hair unit, followed by a 2-hair unit and a 3-hair unit group. CONCLUSIONS: The AGA group compared remarkably with the normal adult male group, showing a lower hair density with a larger proportion of 1-grouped hair units. Based on the data about hair density and hair grouping patterns in AGA patients, surgeons can estimate the area of donor scalp with the most probable number of follicular units in hair trans-plantation procedures.

Quantitative Analysis on the Scalp Hair Characteristics in Koreans using Phototrichogram / 대한피부과학회지

BACKGROUND: Although the diagnosis of hair disease depends on the comparison of normal and abnormal findings, data on normal hair characteristics in Koreans have not been reported. We have developed some technical improvements on phototrichogram methodology to assess hair characteristics. OBJECTIVE: This study was performed to quantify Koreans' hair characteristics at each site(eg. vertex, occipital, temporal) of the scalp according to the age and sex using the phototrichogram and to compare the differences of hair characteristics between Caucasian and Korean population. METHODS: Hairs in the precisely defined circle at each(vertex, temporal, occipital) area of the scalp in 42 healthy volunteers(16 men and 26 women) were evaluated according to sex and age groups, respectively. Each circumscribed area of the scalp, centered with a dot tattoo to ensure reproducibility, were first shaved: The shaven area was first photographed just after shaving. Two days later, grouping pattern of grouped hair unit, total and anagen hair counts were determined from low magnification image. The linear hair growth rate(micrometer/day) and hair shaft diameter were obtained from high magnification image. RESULTS: The results can be summarized as follows: 1. The range of hair density was 119+/-13/cm2~137+/-12/cm2 in male and 92+/-24/cm2~139+/-23/cm2 in female. Hair density of the occiput was significantly higher than that of temple. 2. The range of linear hair growth rate was 300+/-19micrometer/day~319+/-27micrometer/day in males and 289+/-17micrometer/day~327+/-54micrometer/day in females. Hair growth rate in each group decreased in order of vertex, occiput and temple. Most of the hairs on the vertex in older males have slower growth rate than in other groups. 3. The range of hair thickness was 70+/-6micrometer~89+/-10micrometer in males and 75+/-7micrometer~87+/-6micrometer in females. Hairs of the vertex in the older male group(age>or=45 year-old) were thinner than those of the occiput. The population of thin hair(<40micrometer) on the vertex in older males was 7.6% larger than that of other sites. 4. The range of anagen ratio was 91.0% ~ 93.7% in males and 91.9%~94.1% in females. CONCLUSIONS: Lower hair density, larger hair diameter and slower hair growth rate were remarkable in Koreans than in Caucasian. In addition, considering the hair characteristics of Koreans, the newer, improved method of phototrichogram will be a promising tool in the study of the hair disease including androgenetic alopecia, and in the quantitative analysis of the effects of agents stimulating hair growth.