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      Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol ☆☆

      review-article
      , BS a , * , , MD b
      International Journal of Women's Dermatology
      Elsevier
      androgenetic, alopecia, platelet, rich, plasma

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          Abstract

          Androgenetic alopecia (AGA) is a common hair loss disorder caused by genetic and hormonal factors that are characterized by androgen-related progressive thinning of scalp hair in a defined pattern. By the age of 60 years, 45% of men and 35% of women develop AGA. Currently, U.S. Food and Drug Administration-approved treatments for AGA include oral finasteride and topical minoxidil. Due to the limited number of effective therapies for AGA, platelet-rich plasma (PRP) has become an effective alternative treatment. PRP is an autologous concentration of platelets in plasma with numerous growth factors that contribute to hair regeneration. The growth factors contained within the alpha granules of platelets act on stem cells in the bulge area of the hair follicles and stimulate the development of new follicles along with neovascularization. PRP has become a promising treatment modality for AGA. Although there have been several studies previously reported, a standard practice for PRP preparation and administration as well as a method to evaluate results have not been established. This literature review was conducted to evaluate the effectiveness of PRP for AGA and discuss the various treatment protocols that have been proposed.

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          Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF).

          The topical use of platelet concentrates is recent and its efficiency remains controversial. Several techniques for platelet concentrates are available; however, their applications have been confusing because each method leads to a different product with different biology and potential uses. Here, we present classification of the different platelet concentrates into four categories, depending on their leucocyte and fibrin content: pure platelet-rich plasma (P-PRP), such as cell separator PRP, Vivostat PRF or Anitua's PRGF; leucocyte- and platelet-rich plasma (L-PRP), such as Curasan, Regen, Plateltex, SmartPReP, PCCS, Magellan or GPS PRP; pure plaletet-rich fibrin (P-PRF), such as Fibrinet; and leucocyte- and platelet-rich fibrin (L-PRF), such as Choukroun's PRF. This classification should help to elucidate successes and failures that have occurred so far, as well as providing an objective approach for the further development of these techniques.
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            Platelet-rich plasma (PRP): what is PRP and what is not PRP?

            R Marx (2001)
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              Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective

              The utility of platelet-rich plasma (PRP) has spanned various fields of dermatology from chronic ulcer management to trichology and aesthetics, due to its role in wound healing. Though PRP is being used over a long time, there is still confusion over proper terminology to define, classify and describe the different variations of platelet concentrates. There is also a wide variation in the reported protocols for standardization and preparation of PRP, in addition to lack of accurate characterization of the tested products in most articles on the topic. Additionally, the high cost of commercially available PRP kits, precludes its use over a larger population. In this article, we review the principles and preparation methods of PRP based on available literature and place our perspective in standardizing a safe, simple protocol that can be followed to obtain an optimal consistent platelet yield.
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                Author and article information

                Contributors
                Journal
                Int J Womens Dermatol
                Int J Womens Dermatol
                International Journal of Women's Dermatology
                Elsevier
                2352-6475
                21 September 2018
                February 2019
                21 September 2018
                : 5
                : 1
                : 46-51
                Affiliations
                [a ]Northeast Ohio Medical University, Rootstown, Ohio
                [b ]Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
                Author notes
                [* ]Corresponding Author. jstevens1@ 123456neomed.edu
                Article
                S2352-6475(18)30031-5
                10.1016/j.ijwd.2018.08.004
                6374694
                30809579
                173ea699-70e3-4ac2-b3b8-56b23e8ff706
                © 2018 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 May 2018
                : 10 August 2018
                : 10 August 2018
                Categories
                Article

                androgenetic,alopecia,platelet,rich,plasma
                androgenetic, alopecia, platelet, rich, plasma

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