Stevens Hieronymus P, Donners Simone, de Bruijn Julia
Plastic surgeon in private practice in The Hague, Netherlands.
Departments of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, The Netherlands.
Aesthet Surg J. 2018 Jul 13;38(8):811-822. doi: 10.1093/asj/sjy029.
Androgenetic alopecia (AGA) is characterized by miniaturization of the hair follicles gradually causing conversion of terminal hairs into vellus hairs, leading to progressive reduction of the density of hair on the scalp. Approved therapeutic options are limited and show side effects.
To evaluate injections of stromal vascular fraction (SVF), which is rich in adipose-derived stromal cells (ASCs) in combination with platelet-rich plasma (PRP) in the upper scalp as a new autologous treatment option for AGA.
Ten male patients (age range, 25-72 years), suffering from AGA at stage II to III according to the Norwood-Hamilton scale, have been treated with a single injection of autologous PRS (ACPSVF: combination of PRP and SVF) in the upper scalp. Preinjection and 6 and 12 weeks postinjection changes in hair density were assessed using ultra high-resolution photography (Fotofinder).
Hair density was significantly increased after 6 weeks and 12 weeks postinjection (P = 0.013 and P < 0.001). In hair-to-hair matching analyses, new hair grew from active follicles. Furhtermore nonfunctioning hair follicles filled with hyperkeartotic plugs, up to today assumed incapable of forming new hair, proved to grow new hair. No side effects were noted after treatment.
A single treatment of platelet-rich stroma injected in the scalp of patients with AGA significantly increased hair density within 6 to 12 weeks. Further research is required to determine the optimal treatment regimen. Preferred options to our opinion include the repetition of PRS or additional treatments with PRP.
雄激素性脱发(AGA)的特征是毛囊逐渐变小,导致终毛转化为毳毛,从而使头皮上的头发密度逐渐降低。现有的获批治疗方案有限且存在副作用。
评估在上头皮注射富含脂肪来源基质细胞(ASC)的基质血管成分(SVF)与富血小板血浆(PRP)的组合,作为AGA的一种新的自体治疗选择。
10名年龄在25至72岁之间、根据诺伍德 - 汉密尔顿量表处于II至III期AGA的男性患者,在上头皮接受了单次自体富血小板基质(ACPSVF:PRP和SVF的组合)注射治疗。使用超高分辨率摄影(Fotofinder)评估注射前以及注射后6周和12周时头发密度的变化。
注射后6周和12周时头发密度显著增加(P = 0.013和P < 0.001)。在毛发与毛发匹配分析中,新头发从活跃毛囊中生长出来。此外,充满角化过度栓子的无功能毛囊,直至今日一直被认为无法形成新头发,但事实证明也能长出新头发。治疗后未观察到副作用。
对AGA患者头皮进行单次富血小板基质注射治疗,在6至12周内显著增加了头发密度。需要进一步研究以确定最佳治疗方案。我们认为首选方案包括重复注射富血小板基质或用PRP进行额外治疗。