Introduction

Female pattern hair loss (FPHL) is a prevalent, nonscarring form of hair loss that predominantly affects adult females. Platelet-rich plasma (PRP) has been found to promote hair regeneration¹. Anticoagulants in PRP therapy have aroused concerns due to their hypersensitivity potential. Platelet-rich fibrin (PRF), an autologous biomaterial, can solve the problem. Ghannati and Choukran² initially introduced the concept of differential centrifugation and presented the concept of PRF. Their findings indicated that employing slow-speed centrifugation results in a greater quantity of cells and growth factors. The distinctive characteristic of this substance is its ability to remain in a liquid state for roughly 20 minutes, following which fibrin polymerization occurs, resulting in the formation of a solid membrane. The structure consists of a three-dimensional network of fibrin, with the cellular components evenly spread across the mesh. This facilitates the gradual and controlled release of growth factors over an extended period of time, resulting in a prolonged effect and thereby minimizing the frequency of sessions required. In contrast, it was discovered that the growth factors in PRP were released almost entirely during the initial 15 minutes of injection, necessitating a higher number of sessions at regular intervals. Given the benefits of PRF over PRP, we sought to assess the safety and efficacy of PRF injections in the treatment of FPHL rather than the typical usage of PRP.

Methodology

30 mL of venous blood was used and divided equally into two conical-bottom centrifuge plastic tubes. The tubes were centrifuged at 800 RPM for 4 minutes. The yellow-orange liquid was the injectable PRF. The PRF was given quickly to prevent in vitro gel formation. Four PRF injections were given at three-week intervals³. The final evaluation was conducted one month following the last PRF injection. The investigator assessed hair growth using digital photography on a 7-point scale. The terminal to vellus hair (T/V) ratio, adverse effects, and patient satisfaction were also examined⁴. The point of intersection between the midsagittal line and the coronal line joining the points of the tragus⁵, known as the ''V'' (Kang's point), has been utilized as a standard location for dermoscopy.

Results

Ten FPHL patients were offered our therapeutic plan after diagnosis. The average participant age was 37 years ± 11.07. The terminal to vellus hair ratio (T/V) significantly increased after four PRF injections, from 34.30 ± 127.66 to 53.87 ± 282.30 (P-value = 0.027, paired t-test). The average investigator assessment score was 1.3 ± 1.15. The average patient satisfaction with treatment outcomes was 7 ± 2.26 on a scale of 1 to 10. Six patients reported mild pain after PRF injections. There have been no reports of fever, lymph node enlargement, infection, erythema, edema, or bleeding.

Conclusion

This research is the first to extensively analyze PRF's efficacy in treating FPHL. Our findings are comparable to PRP, showing excellent patient satisfaction and safe adverse effects. The utilization of PRF offers the supplementary advantage of incorporating fibrin, hence furnishing a framework for the proliferation of novel cells. This method may improve PRF's ability to promote hair follicle growth. Further research is warranted to compare the efficacy of PRP with the more recent PRF therapies.

References
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