Efficacy of Fractional Carbon Dioxide Laser Alone and Combined with Platelet-Rich Plasma in the treatment of Male Androgenetic Alopecia

Abstract

A ndrogenetic alopecia is the most common cause of hair loss in males and manifests as a gradual conversion of terminal hairs into vellus-like hairs, called miniaturized hairs. Several treatment lines were prescribed for treatment of AGA. PRP is an autologous blood product containing high concentrations of platelets in a small volume of plasma. Platelets contain hundreds of growth factors, cytokines, and cell adhesion molecules. These growth factors have a role in enhancing the formation of keratin, regeneration of hair matrix and increasing cell proliferation. Recently, laser treatment for hair loss has become very popular; it has also been promoted as a preventative measure against AGA as there is evidence that laser light stimulates hair growth at some wavelengths. Laser-assisted drug delivery (LAD) is an evolving technology with potentially broad clinical applications. The current study aimed to evaluate and compare the efficacy of ablative fractional CO2 laser alone and combined with PRP in the treatment of AGA. This study is a split-scalp included 35 male patients, aged 20-50 years old with male pattern AGA. All patients received bilateral ablative fractional CO2 laser treatment on the alopecic scalp then the right side of the scalp was covered with 1 ml of PRP and the other half of the scalp was covered with saline after the laser at the same session. The combined therapy showed statistically significant increase in TH count in frontal, vertex and fronto-temporal regions compared to the monotherapy, while the combined therapy didn’t show any significant difference in VH count in frontal, vertex and fronto-temporal regions compared to the monotherapy. The combined therapy showed statistically significant increase in hair thickness in frontal, vertex and fronto-temporal regions compared to the monotherapy. These observations suggest that fractional CO2 laser with PRP is effective in improving AGA in the frontal region, vertex and fronto-temporal region as evident by the increase of TH count and hair thickness in all 3 regions accompanied by the decrease in the VH count which suggests reversal of hair miniaturization. In conclusion, the fractional CO2 laser in low power can stimulate hair growth. Furthermore, a fractional laser-assisted drug system can be used to supply adjuvant care for patients with AGA; however, it cannot totally substitute traditional treatment methods. Preferably, the technique could potentially be used in association with standard treatments.