PRP Therapy for Androgenic Alopecia

Date First Published:
July 17, 2026
Last Updated:
July 17, 2026
Report by:
Dr Sadaf Shahid Pervez/ Dr Irfan Khan, Dermatologist/Consultant Rheumatologist (Rafiq Medical Centre Karachi/Mediclinic Middle East Abu Dhabi)
Search checked by:
Dr Irfan Khan, Consultant Rheumatologist
Three-Part Question:
Androgenic Alopecia PRP Therapy Improving Hair Growth
Clinical Scenario:
32 year old female fit and healthy, presented with excessive hair loss for the past 1 year. She was investigated thoroughly and diagnosed with Androgenic Alopecia. She tried topical minoxidil and other oral supplements and found some improvements. She heard about PRP and wanted to have the treatment.
Search Strategy:
PubMed Advanced Search engine from 2011 to date
(Androgenic Alopecia and Platelet Rich Plasma)
Search Details:
Andropenic alopecia And PRP Therapy
Outcome:
286 papers were found, 54 papers were identified to be more relevant to the topic. Out of them, 12 articles were shortlisted based on the level of study and demographic variation of the studies. Nine of them were used for the table and the rest of the articles were included in the discussion and introduction.
Relevant Paper(s):
Study Title Patient Group Study type (level of evidence) Outcomes Key results Study Weaknesses
The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial Pietro Gentile , Simone Garcovich 09/2015 Italy 23 male patients Randomized, evaluator-blinded, placebo-controlled, half-head group study Patients who were treated with PRP in 3 different settings with an interval of 3 weeks, showed improvement in hair density compared to placebo. Gantile P et Al 2015 Gantile P et Al 2015
Italy

1 23 male patients
Randomized, evaluator-blinded, placebo-controlled, half-head group study Patients who were treated with PRP in 3 different settings with an interval of 3 weeks, showed improvement in hair density compared to placebo.
Primary Outcome(after 3 months)

Residual Hair count
Mean increase of 33.6 hairs in the PRP treated area
Decrease in 3.2 hairs in the placebo-treated area

Hair density:
Mean increase of 45.9 hairs per Cm 2 in PRP treated area.
Mean decrease of 3.8 hairs per cm 2 in placebo-treated area.


Secondary Outcome(after 2 weeks)

Epidermal thickness
Increase in the skin thickness in PRP treated area

Numbers of follicles
An increase in the number of follicles in the PRP treated area, also an increase in the small blood vessels around the follicles.

Areas of treatment were different with placebo and PRP injection I-e in the same person Frontal was injected with PRP and Parietal with placebo, it may have resulted in the false outcome as different scalp areas may respond differently with the treatment.

A limited number of patients and only male gender.

Long term effect of PRP was not evaluated.
Italy
1 23 male patients
Randomized, evaluator-blinded, placebo-controlled, half-head group study Patients who were treated with PRP in 3 different settings with an interval of 3 weeks, showed improvement in hair density compared to placebo.
Primary Outcome(after 3 months)
Residual Hair count
Mean increase of 33.6 hairs in the PRP treated area
Decrease in 3.2 hairs in the placebo-treated area
Hair density:
Mean increase of 45.9 hairs per Cm 2 in PRP treated area.
Mean decrease of 3.8 hairs per cm 2 in placebo-treated area.
Secondary Outcome(after 2 weeks)
Epidermal thickness
Increase in the skin thickness in PRP treated area
Numbers of follicles
An increase in the number of follicles in the PRP treated area, also an increase in the small blood vessels around the follicles.
Areas of treatment were different with placebo and PRP injection I-e in the same person Frontal was injected with PRP and Parietal with placebo, it may have resulted in the false outcome as different scalp areas may respond differently with the treatment.
A limited number of patients and only male gender.
Long term effect of PRP was not evaluated.
Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability Roohaninasab M, Goodarzi A 2021 Iran 451 Patients 342 M 71F Systematic review Roohaninasab M Simultaneous use of PRP and minoxidil resulted in significant improvement in hair growth and patient satisfaction. Roohaninasab M

Et al 2021
Iran

2 451 Patients
342 M
71F Systematic review Efficacy of PRP was demonstrated in Over 84% of studies with improvement in hair density and thickness. Simultaneous use of PRP and minoxidil resulted in significant improvement in hair growth and patient satisfaction.

The efficacy of PRP in Androgenic Alopecia was reported 25.5% to 42.75%.

Adverse side effects were reported in one study and it was 12.5%.
The side effects were atrophy and hypotension.

The pain was reported in a couple of papers. It was a haphazard review with more than one target group and multiple modalities of treatments were compared with PRP.
Et al 2021 The efficacy of PRP in Androgenic Alopecia was reported 25.5% to 42.75%.
Iran
Adverse side effects were reported in one study and it was 12.5%.
2 451 Patients The side effects were atrophy and hypotension.
342 M
71F Systematic review Efficacy of PRP was demonstrated in Over 84% of studies with improvement in hair density and thickness. Simultaneous use of PRP and minoxidil resulted in significant improvement in hair growth and patient satisfaction. The pain was reported in a couple of papers.
The efficacy of PRP in Androgenic Alopecia was reported 25.5% to 42.75%.
Adverse side effects were reported in one study and it was 12.5%.
The side effects were atrophy and hypotension.
The pain was reported in a couple of papers. It was a haphazard review with more than one target group and multiple modalities of treatments were compared with PRP.
Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review Mao G, Zhang G, Fan W 2019 China 11 Articles 262 patients 179 M 83 Meta-Analysis
Level Of Evidence III		 There was a significant increase in hair numbers and terminal hair density was found in the patients treated with PRP. Mao G 1. Placebo group should have been included to compare the efficacy of PRP and other treatment modalities

2. Unequal gender distribution


3. Histochemistry was only done for the PRP group,

4. No standard assessment tool was used to assess the outcome of the treatment
Et 2019
Side effects were mild
3 11 Articles
262 patients
179 M
83 F
Meta-Analysis
Level Of Evidence III There was a significant increase in hair numbers and terminal hair density was found in the patients treated with PRP.
Side effects were mild Hair Density:
Significant increase in the hair density was noted compared to the control group
n = 113, MD = 38.75, I 2 = 80%, 95% CI 22.22–55.28, P >0.00001
Hair Cross section:
The study showed improvement in the hair cross-section but statistically, it was not significant
Terminal Hair density:
5 studies mentioned terminal hair density, three studies showed significant improvement in the hair density. n = 52, MD = 22.83, I 2 = 32%, 95% CI 0.28-45.38, P = 0.05,
Patient Satisfaction Survey:
3 studies included this survey,
13.3% of subjects treated with PRP (vs 0% of the placebo subjects) claimed to have an improvement in the hair thickness and reduced hair loss, 26.7% of the patients in the study group (vs 18.2% of the control subjects) claimed that their hairs got heavier after the treatment.
Histological & Immunohistochemistry examination:
5 studies demonstrated the patients treated with PRP increased epidermis thickness, collagen fibres and fibroblasts proliferation, and the number of hair follicles and blood vessels around these fibres increased.
1. Placebo group should have been included to compare the efficacy of PRP and other treatment modalities
2. Unequal gender distribution
3. Histochemistry was only done for the PRP group,
4. No standard assessment tool was used to assess the outcome of the treatment.
Comparative Evaluation of the Clinical Efficacy of PRP-Therapy, Minoxidil, and Their Combination with Immunohistochemical Study of the Dynamics of Cell Proliferation in the Treatment of Men with Androgenetic Alopecia Pakhomova EE, Smirnova IO 2020 Russia 69 Men 3 groups PRP only PRP plus minoxidil minoxidil Randomised controlled trial Treatment with PRP demonstrated significant improvement in all the measures of hair growth with no side effects besides pain. Pakhomova EE Pakhomova EE
Et al 2020
Russia

4 69 Men

3 groups

PRP only

PRP plus minoxidil

minoxidil
Randomised controlled trial Treatment with PRP demonstrated significant improvement in all the measures of hair growth with no side effects besides pain.

Combination therapy with minoxidil was superior over PRP only therapy. Hair Density:
1. PRP group
Increased by 12% (p = 0.000067)
2. PRP and minoxidil
increased by 32% (p = 0.00004)
3. Minoxidil group
Increased by 16% (p = 0.00073)

Hair Diameter:
1. PRP group
Increased by 12% (p = 0.001947)
2. PRP and minoxidil
increased by 26% (p = 0.00004)
3. Minoxidil group
increased by 2% (p = 0.338)

The proportion of Vellus hair:
1. PRP group
decreased by 17% (p = 0.002225)
2. PRP and minoxidil
Decreased by 30% (p = 0.00082)
3. Minoxidil group
Increased by 2% (p = 0.7647)

Proportion of telogen hairs:
1. PRP group
Decreased by 16% (p = 0.02836)
2. PRP and minoxidil
Decreased by 39%(p= 0.00008)
3. Minoxidil group
increased by 5% (p = 0.338)

Evaluation of marker of Proliferative Activity of HF cells After PRP:

Increase in absolute and relative values of CD34 and area of β-catenin expression.
Significant increase in the Ki67+ index.




1. No placebo group

2. Only male patients.

3. Long term benefit of therapy was not assessed.
Et al 2020
Combination therapy with minoxidil was superior over PRP only therapy. Russia
4 69 Men
3 groups
PRP only
PRP plus minoxidil
minoxidil
Randomised controlled trial Treatment with PRP demonstrated significant improvement in all the measures of hair growth with no side effects besides pain.
Combination therapy with minoxidil was superior over PRP only therapy. Hair Density:
1. PRP group
Increased by 12% (p = 0.000067)
2. PRP and minoxidil
increased by 32% (p = 0.00004)
3. Minoxidil group
Increased by 16% (p = 0.00073)
Hair Diameter:
1. PRP group
Increased by 12% (p = 0.001947)
2. PRP and minoxidil
increased by 26% (p = 0.00004)
3. Minoxidil group
increased by 2% (p = 0.338)
The proportion of Vellus hair:
1. PRP group
decreased by 17% (p = 0.002225)
2. PRP and minoxidil
Decreased by 30% (p = 0.00082)
3. Minoxidil group
Increased by 2% (p = 0.7647)
Proportion of telogen hairs:
1. PRP group
Decreased by 16% (p = 0.02836)
2. PRP and minoxidil
Decreased by 39%(p= 0.00008)
3. Minoxidil group
increased by 5% (p = 0.338)
Evaluation of marker of Proliferative Activity of HF cells After PRP:
Increase in absolute and relative values of CD34 and area of β-catenin expression.
Significant increase in the Ki67+ index.
1. No placebo group
2. Only male patients.
3. Long term benefit of therapy was not assessed.
Comparison of the Efficacy of Homologous and Autologous Platelet-Rich Plasma (PRP) for Treating Androgenic Alopecia 5. Ince B, Yildirim MEC, Dadaci M, Avunduk MC, Savaci N 2018 Turkey 3 Groups each having 20 patients aPRP(activated) nPRP( non- activated) and hPRP(homologous) Comparative study

Level II		 Homologous PRP was found to be a more effective type of PRP for the treatment of androgenic alopecia Increase in hair density: Ince B

Et al 2019

Turkey

5 3 Groups each having 20 patients

aPRP(activated)

nPRP( non- activated)

and

hPRP(homologous)
Comparative study

Level II Homologous PRP was found to be a more effective type of PRP for the treatment of androgenic alopecia
Increase in hair density:

Group 1- nPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 11.2, 26.1, and 32.4%, respectively,

Group 2- aPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 8.1, 12.5, and 20.8%, respectively.

Group 3- hPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 16.09, 36.41, and 41.76%, respectively
Over 25% of drop-off hence reduced the number of patients to 15 only in each group.


The relatively young target group's mean age was around 29.


Should have included a placebo group as well.


Only one modality I-e hair density was observed.
Group 1- nPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 11.2, 26.1, and 32.4%, respectively,
Group 2- aPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 8.1, 12.5, and 20.8%, respectively.
Group 3- hPRP:
At 2, 6, and 12 months the increase in hair density was calculated as 16.09, 36.41, and 41.76%, respectively
. Treatment of male pattern alopecia with platelet-rich plasma: A double-blind controlled study with analysis of platelet number and growth factor levels 6. Rodrigues BL, Montalvão SAL, Cancela RBB, Silva FAR 2019 Brazil 26 Male patients 2 groups, Each one received PRP or normal saline in 4 settings Double-blinded
Randomised controlled trial.		 Autologous activated PRP was associated with an increase in hair density and hair count. Rodrigues BL Rodrigues BL
Et al
2019
Brazil

6 26 Male patients


2 groups,
Each one received PRP or normal saline in 4 settings. Double-blinded
Randomised controlled trial. Autologous activated PRP was associated with an increase in hair density and hair count.


Lack of correlation between PDGF, EGF, and VEGF levels was found for the outcome. Hair Growth:
PRP group- significant increase after 3 months (P = .016)

Saline group- no significant increase (P = .320)

Hair Density:
PRP group- significant increase in the hair density (P = .012)

Saline Group- No difference was found (P = .206).

Anagen Hair (%)
PRP group- Anogen percentage was significantly increased (P = .007) but not maintained in the third evaluation

Saline Group- no change noticed. The median age group was only 32.

In-equal numbers of patients in the two groups, more in the PRP group.

Limited heterogeneity of patients.

All growth factors and signalling pathways were not studied.
Et al
2019
Lack of correlation between PDGF, EGF, and VEGF levels was found for the outcome. Brazil
6 26 Male patients
2 groups,
Each one received PRP or normal saline in 4 settings. Double-blinded
Randomised controlled trial. Autologous activated PRP was associated with an increase in hair density and hair count.
Lack of correlation between PDGF, EGF, and VEGF levels was found for the outcome. Hair Growth:
PRP group- significant increase after 3 months (P = .016)
Saline group- no significant increase (P = .320)
Hair Density:
PRP group- significant increase in the hair density (P = .012)
Saline Group- No difference was found (P = .206).
Anagen Hair (%)
PRP group- Anogen percentage was significantly increased (P = .007) but not maintained in the third evaluation
Saline Group- no change noticed. The median age group was only 32.
In-equal numbers of patients in the two groups, more in the PRP group.
Limited heterogeneity of patients.
All growth factors and signalling pathways were not studied.
Platelet-rich plasma for androgenetic alopecia: a pilot study 7. Schiavone G, Raskovic D, Greco J, Abeni D 2014 Italy 64 patients 42M 22F Observational
Pilot study		 Patients treated with 2 injections of PRP, 3 months apart showed some degree of improvement in hair growth on 6 months follow-up. Schiavone G In equal gender distribution.

Should have a placebo group as well.

Age group was younger

The macro photographic protocol was used instead of the standard tricho-scan to evaluate the outcome.

Follow up period was limited- 6 months only.
Et al 2014
Italy
7 64 patients
42M
22F
Observational
Pilot study Patients treated with 2 injections of PRP, 3 months apart showed some degree of improvement in hair growth on 6 months follow-up.
Improvement was observed in 62/64 patients.
First Evaluator:
Overall change-3.2 (95% CI, 2.9-3.5))
,
The overall proportion of patients reaching a clinically important difference - 40.6%
Improvement in GPA levels- 21.7% to 60.0%
Second Evaluator:
Overall change- 3.9 (95% CI, 3.5-4.3)
The overall proportion of patients reaching a clinically important difference - 54.7%
Improvement in GPA Levels- 39.1% to 80.0%.
No significant changes were noted among different gender, age group and the number of platelets used.
In equal gender distribution.
Should have a placebo group as well.
Age group was younger
The macro photographic protocol was used instead of the standard tricho-scan to evaluate the outcome.
Follow up period was limited- 6 months only.
Comparison of 5% minoxidil lotion monotherapy versus its combination with autologous platelet rich plasma in androgenetic alopecia in hundred males 8. Ray R, Sharma A 2021 India 100 M Patients Divided into 2 groups I-e Minoxidil 5% monotherapy and Minoxidil plus PRP Schiavone G
Et al 2014
Italy

7 64 patients

42M
22F


Observational
Pilot study Patients treated with 2 injections of PRP, 3 months apart showed some degree of improvement in hair growth on 6 months follow-up.
Improvement was observed in 62/64 patients.

First Evaluator:
Overall change-3.2 (95% CI, 2.9-3.5))
,
The overall proportion of patients reaching a clinically important difference - 40.6%

Improvement in GPA levels- 21.7% to 60.0%

Second Evaluator:
Overall change- 3.9 (95% CI, 3.5-4.3)

The overall proportion of patients reaching a clinically important difference - 54.7%

Improvement in GPA Levels- 39.1% to 80.0%.

No significant changes were noted among different gender, age group and the number of platelets used.





In equal gender distribution.

Should have a placebo group as well.

Age group was younger

The macro photographic protocol was used instead of the standard tricho-scan to evaluate the outcome.

Follow up period was limited- 6 months only.
Ray R
Et al 2021
India

8 100 M
Patients

Divided into 2 groups
I-e Minoxidil 5% monotherapy
and

Minoxidil plus PRP Randomised
Comparative Observational study Combination therapy with minoxidil was superior then topical minoxidil alone, for hair growth both on trichoscopic and photographic assessment.

No major side effects were noted Group A(monotherapy therapy):
Global photographic assessment:
60% marked improvement
26.7 % moderate improvement

Mean hair diameter improvement- 16.72%
brown peripilar sign (BPPS)-40%
white peripilar sign-20%


Group B(combination therapy)
Global photographic assessment:
20%% marked improvement
40% % moderate improvement

Mean hair diameter improvement- 11.24%

Brown peripilar sign (BPPS)- 46.7%
White peripilar sign-26.7%
There was a difference in the age groups in the two arms, group 2 were 5 years average older than the first group.

Only male patients were included.		 Combination therapy with minoxidil was superior then topical minoxidil alone, for hair growth both on trichoscopic and photographic assessment. Global photographic assessment: Ray R
Et al 2021
India

8 100 M
Patients

Divided into 2 groups
I-e Minoxidil 5% monotherapy
and

Minoxidil plus PRP Randomised
Comparative Observational study Combination therapy with minoxidil was superior then topical minoxidil alone, for hair growth both on trichoscopic and photographic assessment.

No major side effects were noted Group A(monotherapy therapy):
Global photographic assessment:
60% marked improvement
26.7 % moderate improvement

Mean hair diameter improvement- 16.72%
brown peripilar sign (BPPS)-40%
white peripilar sign-20%


Group B(combination therapy)
Global photographic assessment:
20%% marked improvement
40% % moderate improvement

Mean hair diameter improvement- 11.24%

Brown peripilar sign (BPPS)- 46.7%
White peripilar sign-26.7%
There was a difference in the age groups in the two arms, group 2 were 5 years average older than the first group.

Only male patients were included.
60% marked improvement
No major side effects were noted 26.7 % moderate improvement
Mean hair diameter improvement- 16.72%
brown peripilar sign (BPPS)-40%
white peripilar sign-20%
Group B(combination therapy)
Global photographic assessment:
20%% marked improvement
40% % moderate improvement
Mean hair diameter improvement- 11.24%
Brown peripilar sign (BPPS)- 46.7%
White peripilar sign-26.7%
Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: A randomized controlled trial 9. Shapiro J, Ho A, Sukhdeo K, Yin L, Lo Sicco K. 2020 USA 35 , 17 F 18 M Randomized placebo-controlled split-scalp study Hair density was significantly increased in the PRP treated area compared to the placebo. Changes in hair density: 1. Patient satisfaction was only documented for the PRP group.

2. A small number of patients


3. No biopsy was performed to evaluate the benefit of PRP at the cellular level.
But no significant differences were found in quantitative measures among the two groups. PRP Group:
From 151 ± 39.82 hairs/cm2 to 170.96 ± 37.14 hairs/cm2
Placebo Group:
from 151.04 ± 41.99 hairs/cm2 to 166.72 ± 37.13 hairs/cm2
Changes in Hair diameter:
PRP group:
from 56.75 ± 11.62 μm to 61.23 ± 13.12 μm
Placebo group:
56.43 ± 10.63 μm at baseline to 62.63 ± 13.41 μm
Investigator Global assessment;
23 Patients showed mild to moderate improvement in PRP treated group
16 Patients showed mild to moderate improvement in Placebo.
Patients’ satisfaction and self-assessment:
45.8% in the PRP group noticed
Author Commentary:
Platelet Rich Plasma (PRP) is one of the emerging therapy for Androgenic Alopecia both in males and females. The types of PRP include autologous PRP (where the patient’s blood is used) and homologous PRP (where the same blood group is used). Methods of preparing PRP may vary from place to place but it involves identical steps which includes venous blood collection followed by separation of RBCs and concentration of platelets, through configuration the platelets numbers may increase to 3 to 8 folds. It may be activated to release the important growth factors which include platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) 6.
Several studies were performed to evaluate the benefits of PRP in Androgenic Alopecia. The majority suggested a beneficial effect of PRP with negligible side effects. But unfortunately, most of them are of poor quality due to the limited number of patients, criteria of post-therapy assessment etc. 7, 6. In our discussion above we tried to include trials performed in different parts of the world. We can conclude that the beneficial effect of PRP is not limited to a certain gender, race, age, or ethnic group.

Unfortunately, the available data does not provide sufficient information on the efficient type of PRP nor on the number of sessions. Ince B et al demonstrated the superiority of Homologous PRP over the other types. Ray R et al and Pakhomova EE, Suggested combination therapy with minoxidil.

None of the studies reported any significant side effects of the procedure.
Bottom Line:
PRP may be an effective treatment for Androgenic alopecia, further studies and guidelines are needed to provide the best place of this procedure in the treatment ladder.
Level of Evidence:
Level 2: Studies considered were neither 1 or 3
References:
  1. Pietro Gentile , Simone Garcovich. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial
  2. Roohaninasab M, Goodarzi A. Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability
  3. Mao G, Zhang G, Fan W. Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review
  4. Pakhomova EE, Smirnova IO. Comparative Evaluation of the Clinical Efficacy of PRP-Therapy, Minoxidil, and Their Combination with Immunohistochemical Study of the Dynamics of Cell Proliferation in the Treatment of Men with Androgenetic Alopecia
  5. 5. Ince B, Yildirim MEC, Dadaci M, Avunduk MC, Savaci N. Comparison of the Efficacy of Homologous and Autologous Platelet-Rich Plasma (PRP) for Treating Androgenic Alopecia
  6. 6. Rodrigues BL, Montalvão SAL, Cancela RBB, Silva FAR. . Treatment of male pattern alopecia with platelet-rich plasma: A double-blind controlled study with analysis of platelet number and growth factor levels
  7. 7. Schiavone G, Raskovic D, Greco J, Abeni D. Platelet-rich plasma for androgenetic alopecia: a pilot study
  8. 8. Ray R, Sharma A. Comparison of 5% minoxidil lotion monotherapy versus its combination with autologous platelet rich plasma in androgenetic alopecia in hundred males
  9. 9. Shapiro J, Ho A, Sukhdeo K, Yin L, Lo Sicco K.. Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: A randomized controlled trial