Abstract
BACKGROUND: Androgenetic alopecia (AGA) is a progressive, non-scarring hair loss condition caused by follicular miniaturization influenced by androgens and genetics. Pharmacologic treatments, such as minoxidil and finasteride, provide limited efficacy. In contrast, regenerative approaches, including platelet-rich plasma (PRP) and concentrated growth factor (CGF), are gaining the attention. This study aimed to evaluate and compare the clinical efficacy of PRP alone versus PRP combined with CGF in treating AGA. METHODOLOGY: A prospective, randomized, double-blind clinical trial was conducted on 20 patients diagnosed with androgenetic alopecia (12 males with Norwood-Hamilton grade II-IV and eight females with Ludwig grade I-II). Each patient's scalp was divided along the mid sagittal line. Site I was treated with PRP and microneedling, whereas Site II received PRP following microneedling and CGF. The primary outcome measures included hair count, hair density, macroscopic photographic changes, patient satisfaction, and hair pull test results, evaluated preoperatively and at subsequent intervals (1st day, 1st, 2nd, 3rd, and 6th months post-treatment). RESULTS: Both groups showed significant improvement, but Site II (PRP + CGF) demonstrated greater increases in hair count from 88.15 ± 10.35 to 135.95 ± 14.46 hair/0.65 cm(2) and hair density from 136.2 ± 8.27 to 162.5 ± 8.1 hair/cm(2), with higher patient satisfaction and superior hair pull test outcomes (p < 0.05). CONCLUSIONS: PRP combined with CGF is more effective than PRP alone in promoting hair regrowth in AGA subjects. The synergistic mechanism may offer a superior non-surgical, autologous therapeutic option. Further long-term studies are needed for protocol optimization.