Background: Hair is an important part of self-image, and in most societies, hair is associated with youth, health and virility. Cicatricial Alopecia causes irreversible hair loss and negatively affects self-image and self-esteem of the patient. It leads to permanent damage of the stem cells in the hair follicle bulge. Hair transplant into a scarred area is not as straightforward as transplant into a healthy scalp, mainly because of poor vascular supply of the recipient area. PRP with its action of tissue regeneration and remodeling with angiogenesis has the potential to revitalize the scarred tissue, improve its vascularity to make it more receptible for hair transplant.
Aim of the study: the aim is to compare the outcome of follicular unit extraction with and without platelet rich plasma in cases of cicatricial alopecia as regards quantitative and qualitative characteristics of hair growth.
Patients and Methods: Forty-five patients suffering from limited defects of cicatricial alopecia were divided into three groups: Group A (15 patients) follicular unit extraction hair transplantation , Group B (15 patients) follicular unit extraction hair transplantation with intra-operative platelet rich plasma injection locally in recipient site, Group C (15 patients) follicular unit extraction hair transplantation with two sessions of platelet rich plasma locally in recipient site (intra-operative and three months post-operative). The age of patients ranged from 18 to 60 years. We evaluated the patients according to patient satisfaction score, histological evaluation of specimens using hematoxylin and eosin (H&E) stain and immunohistochemical examination using anti-Ki67 antibody for morphometric study.
Results: PRP injections resulted in directly propotional increase in patient satisfaction, cellular proliferation, antiapoptotic activity and number of mitotically active immune-positive cells regarding transplanted hair in cicatricial alopecia
Conclusions: The PRP regimen protocol together with FUE hair transplantation show better outcome with higher patient satisfaction in groups treated with PRP in comparison to other groups not managed with PRP injections, also this effect is directly proportional with the number of injections.