Effect of Platelet-Rich Plasma on Hair Growth and Graft Survival Following Direct Hair Implantation in Androgenetic Alopecia Patients
Azkha Erdhianto *
Biomedical Anti-Aging Medicine Magister Program, Udayana University, Bali, Indonesia.
Agung Wiwiek Indrayani
Department of Pharmacology and Therapy, Faculty of Medicine, Udayana University, Indonesia.
Indira Vidiari Juhanna
Department of Physiology, Faculty of Medicine, Udayana University, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Aims: Androgenetic alopecia is the most common form of hair loss, particularly affecting men, and has a significant psychological impact on patients’ quality of life. This study aims to evaluate the effectiveness of Platelet-Rich Plasma (PRP) administration following hair transplantation using the Direct Hair Implantation (DHI) method in improving hair growth rate and survival rate of transplanted hair in patients with androgenetic alopecia.
Study Design: This study was a randomized controlled trial (RCT) involving two treatment groups: one receiving DHI and the other receiving DHI combined with PRP injections.
Place and Duration of Study: This study was done in 6 months (within period of May-September 2025) at Farmanina Aesthetic & Hair Clinic, Denpasar, Bali.
Methodology:
A total of 14 subjects were recruitted, which were randomly assigned into 2 groups, namely the DHI and DHI+PRP. Androgenetic alopecia grade was categorized using Norwood criteria. The primary outcome of this study was hair length after transplant. The secondary outcome was the follicle density (graft density). Hair length and graft density were assessed at baseline (day 0), week 4, week 12, and week 16 at two measurement points: 2 cm and 4 cm from the midline of the hairline. Hair length was measured from 10 hairs from a certain area using vernier caliper using milimeter (mm), and the results were averaged. Graft density measurements are carried out using a cosmetic camera equipped with Skin and Hair Analysis Software (HairSys). Statistical analyses included the Mixed Annova.
Results: Subjects mean age were 34 ± 3.26 years old in DHI and 35.71 ± 3.4 years old in DHI+PRP group. Most of them met Norwood criteria 5 (57.14%). The results showed that the DHI+PRP group experienced a significant increase in hair length and graft density compared to the DHI group. The results of the hair length analysis showed that DHI+PRP provided a mean difference in hair length of up to 9.218 cm (P < 0.001) in the 2 cm from midline area and 9.164 cm (P < 0.001) in the 4 cm from midline area. At week 16, the DHI+PRP group had a mean difference of 1.036 follicles/cm2 in the 2 cm from midline area and 1.929 follicles/cm2 in the 4 cm from midline area (P < 0.001). However, further studies are needed to explore the effect of PRP in post-transplant setting, considering this study has small sample size and short follow-up period.
Conclusion: PRP administration following DHI hair transplantation significantly enhances hair growth rate and survival rate in patients with androgenetic alopecia, supporting its role as a promising adjuvant therapy in the management of hair loss.
Keywords: Alopecia androgenetic, direct hair transplantation, platelet-rich plasma, hair growth, survival rate