Alopecia Areata

Alopecia Areata ( AA) is a chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair bearing skin including nail deformities. A wide range of clinical presentations can occur, from a single patch of hair loss to complete loss of hair on the scalp (alopecia totalis) or the entire body (alopecia universalis). Strong direct and indirect evidence supports an autoimmune etiology for alopecia areata. Spontaneous remission frequently occurs in mild forms of the disease, whereas this is very unlikely in severe form. A number of treatments can induce hair growth in AA, but they do not cure the condition 2

Platelet-rich plasma (PRP) has emerged as a new treatment modality in dermatology, and preliminary evidence has suggested that it might have a beneficial role in hair growth.. Uebel et al.6 have shown that storing hair grafts in PRP can enhance graft survival, improve hair density and stimulate the growth of transplanted follicular units 5 .I also use PRP as grafts holding solution and since then follicular growth was observes as early as three months after hair transplant procedure . The role of PRP in promoting hair growth has been investigated .First pilot study done by A. Trink et al, was to investigate the effects of PRP on AA, reported that PRP administration leads to major improvement in chronic relapsing AA. 4

Alopecia Universalis
PRP treatment in my patient with Alopecia Universalis

In my opinion ,PPR,  should  be included in the first line of treatment   , in all types of alopecia Areata,   ; it has the best safety profile and can be used  as stand alone treatment in acute and longstanding  severe Alopecia Areata
However, there is a need to standardise the protocol with an intent in improving the outcomes and need of further  research in order to establish its efficacy comparing the nonactivated and activated prp as an alternative treatment for Alopecia Areata.

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