Comparative efficacy and tolerability of platelet rich plasma and injectable platelet rich fibrin in male androgenetic alopecia: A prospective split-scalp interventional study

Abstract

Background: Androgenetic Alopecia is a leading cause of baldness in males characterized by follicular miniaturization. Platelet-rich plasma (PRP) is used as an autologous regenerative treatment for androgenetic alopecia (AGA), but direct comparative evidence for injectable platelet-rich fibrin (PRF) remains limited.

Methods: In this prospective split-scalp interventional study, 35 men with Hamilton-Norwood Grade II-IV AGA received PRP on the right scalp half and PRF on the left. Three sessions were administered four weeks apart, and final assessment was performed one month after the third session. Hair density based on Hamilton-Norwood grade, and adverse effects were compared using paired statistical tests.

Results: Baseline hair density was comparable between PRP and PRF sides (132.91 ± 12.02 vs 133.00 ± 11.87 hairs/cm²; P = 0.727). Mean hair-density gain was 19.06 ± 2.11 hairs/cm² with PRP and 25.77 ± 2.53 hairs/cm² with PRF; the paired difference favored PRF by 6.71 hairs/cm² (95% confidence interval, 6.39-7.04; P < 0.001). One-grade improvement occurred in 11 (31.43%) PRP-treated and 26 (74.29%) PRF-treated scalp halves. Adverse effects occurred on 8 (22.86%) PRP-treated sides and 1 (2.86%) PRF-treated side (P = 0.039); all were mild and self-limited.

Conclusion: Both preparations improved short-term hair density and clinical grade, but PRF produced a greater gain and fewer adverse effects under matched split-scalp conditions.

Keywords: Androgenetic alopecia; injectable platelet-rich fibrin; platelet-rich plasma; split-scalp; trichoscopy