Different Routes Of Administration Of Platelet-rich Plasma For The Treatment Of Androgenetic Alopecia Clinical Studies

Androgenetic alopecia(AGA)is one of the most widespread types of hair loss in the world.It has a significant impact on the appearance of patients,thus affecting their psychological well-being and quality of life,and is therefore receiving more and more attention.As thecurrent conventional treatment is not effective and has many adverse effects,platelet-rich plasma(PRP)has received a lot of attention as an emerging treatment for androgenetic alopecia.Currently,the main route of administration of PRPfor the treatment of androgenetic alopecia in China is intra-scalp injection,but its clinical use is limited by the pain and low injection efficiency of intra-dermal injection.Microneedles can form tiny channels on the skin surface to break through the skin barrier and substantially increase the amount of drug absorbed percutaneously.The introduction of PRP into the scalp through microneedles is a new route of drug delivery,and microneedle introduction is less painful,has fewer side effects,and is more efficientthan intradermal injection.Objective:This study is intended to compare the clinical efficacy of microneedle introduction of PRP and intradermal injection of PRPfor the treatment of androgenetic alopecia,and to evaluate the safety and pain of both routes of administration in order to seek a new route of PRP administration for the treatmentof androgenetic alopecia.Methods:Twenty patients with AGA requiring PRP treatment were selected according to inclusion and exclusion criteria,informed about the treatment and signed an informed consent form.20patients’ scalp was divided into two treatment areas using the median line as the dividing line and randomly assigned to intra-scalp injection administration and microneedle introduction administration once a month for a total of three treatments.To facilitate the dermoscopic examination,each patient is required to shave a coin-sized piece of hair in each of the 2different treatment areas,which are set up as observation areas.Before and every other month after treatment,changes in hair density,proportion of individual hair follicles,mean hair diameter and dermoscopic signs in the treated area were examined by dermatoscopy.2dermatologists not involved in this trial scored the patients on the global aesthetic improvement scale(GAIS)after 3 months of treatment,and Patients completed a self-satisfaction score in the form of a questionnaire.Patients wereassessed for painusing thepain numeric rating scales(NRS)at the time of the first intradermal injection and microneedle introduction.Throughout the treatment,patients’ adverse effects were observed and recorded.Follow-up visits were performed 1 month and 3 months after the end of treatment,again using dermoscopy to observeand record hair-related indices.Results:1.The hair density of both microneedle group and intradermal injection group was significantly increased after one course of treatment(P<0.001),but there was no significant difference between the two groups after treatment(P>0.05);The percentage of hair follicles in single hair of microneedle group and intradermal injection group decreased after treatment(P<0.001),but there was no significant difference between the two groups(P>0.05).As for the average hair diameter,the hair diameter of both groups increased significantly after treatment compared with before treatment(P<0.001),but the hair diameter of intradermal injection group increased morethan that ofmicroneedle introduction group(P<0.05).2.In terms of the changes of various dermoscopic signs before and after treatment,the variation rate of hair diameter >20% in the intradermal injection group after one course of treatment was significantly reduced compared with that before treatment(P<0.05),while the variation rate of hair diameter >20% in the microneedle injection group before and after treatment had no significant difference(P>0.05).After one course of treatment,the proportion of dendritic vascular morphology of scalp in 2 groups decreased compared with that before treatment(P<0.05).The proportion of yellow spot in 2 groups was decreased compared with beforetreatment(P<0.05).3.In the subjective evaluation,there was no significant difference between the two groups in the global aesthetic Scale score after one course of treatment(P>0.05);There was no significant difference in self-satisfaction scores between the two groups after treatment(P>0.05).For the evaluation of pain degree,the pain degree score of intradermal injection group was significantly higher than that ofmicroneedle introduction group(P<0.001).4.Twenty patients were followed up at 1 month and 3 months after the end of treatment,3 patients were lost to follow up at the third month after the end of treatment,and the rest patients showed that the hair density was still increasing after the end of treatment and began to declineafterreaching the peak onemonth later.Conclusion:The overall efficacy aftermicroneedleintroduction of PRPtreatment was similar tothat of intradermal injection,and although the increase in hair diameter after treatment was inferior to that of the intradermal injection group,the pain degree was significantly lower than that in the intradermal injection group,and microneedle introduction of PRPis expected to become a new PRPintroduction method instead of intradermal injection.