Title : Deciphering clinical response patterns to platelet-rich plasma therapy in Female Pattern Hair Loss: a case series
Abstract:
Background: Female Pattern Hair Loss (FPHL) is a chronic, progressive alopecia characterized by diffuse thinning over the mid-frontal scalp and crown with relative preservation of the frontal hairline. Although standard therapies such as topical minoxidil are widely used, clinical benefit may be limited by delayed onset, adherence challenges, and variable effectiveness. Platelet-Rich Plasma (PRP) has emerged as a regenerative option in hair disorders. Platelet-Rich Plasma (PRP) is a platelet concentrate rich in growth factors and cytokines that may enhance perifollicular angiogenesis, modulate inflammatory signaling, support dermal papilla function, and promote transition into the anagen phase. This case series evaluates clinical response patterns to Platelet-Rich Plasma (PRP) in women with Female pattern hair loss (FPHL) following a standardized short-course protocol.
Observation: This case series included 10 female patients with clinically diagnosed Female Pattern Hair Loss (FPHL) involving the central scalp and/or vertex, graded at baseline using the Ludwig classification system. None of the patients had received recent procedural treatment for hair loss prior to enrollment. All patients underwent a standardized Platelet-Rich Plasma (PRP) protocol consisting of three intradermal scalp injections administered at 1-month intervals (baseline/Day 0, Day 30, and Day 60). Each session involved uniform Platelet-Rich Plasma (PRP) delivery across affected scalp regions using the same preparation and injection technique. Clinical outcomes were assessed at month 3 (Day 90), corresponding to 90 days after the initial injection and 30 days after completion of the third Platelet-Rich Plasma (PRP) session. At follow- up, patients demonstrated heterogeneous response trajectories. Several patients with moderate baseline severity (Ludwig grade II) showed visible improvement in crown coverage and hair density, whereas those with milder disease (Ludwig grade I) predominantly exhibited stabilization with reduced shedding and subtle cosmetic improvement. Patients with more advanced thinning (Ludwig grade III) demonstrated partial responses, characterized by improved hair texture and reduced scalp visibility without complete grade reversal. Notably, some patients initially classified as Ludwig grade II demonstrated clinical improvement to Ludwig grade I, while a subset of patients presenting with Ludwig grade III improved to Ludwig grade II at follow-up. Treatment was well tolerated, with no significant adverse events reported.
Key message: This case series supports Platelet-Rich Plasma (PRP) as a feasible and well-tolerated therapeutic option for female pattern hair loss, with clinically observable benefit following a three-session, monthly Platelet-Rich Plasma (PRP) regimen. Using an identical Platelet-Rich Plasma (PRP) technique across sexes, these findings suggest that Female pattern hair loss (FPHL) may exhibit distinct response patterns, ranging from stabilization to visible density improvement, despite comparable intervention protocols. Larger controlled studies with standardized outcome measures are warranted to identify predictors of response, optimize patient selection, and determine durability of benefit.
