Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study


  • Abeer Attia Tawfik Department of Medical Applications of Laser, Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt image/svg+xml
  • Iman Mostafa Department of Dermatology, Faculty of Medicine, Imbaba General Hospital, Giza, Egypt image/svg+xml https://orcid.org/0000-0002-1728-6135
  • Mona Soliman Department of Medical Applications of Laser, Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt image/svg+xml
  • Mohamed Soliman Department of Medical Applications of Laser, Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt image/svg+xml
  • Noha Abdallah Department of Medical Applications of Laser, Dermatology Unit, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt image/svg+xml




Alopecia areata, Platelet-rich plasma, Folliscope, Photobiomodulation, Low level laser therapy



Background: Non-scarring alopecia areata (AA) is a disease that is mediated through autoimmunity. Recently, autologous platelet-rich plasma (PRP) and photobiomodulation (PBM), commonly known as low-level laser (or light, LLLT) have been suggested to provide a valuable role in stimulating the growth of hair follicles (HF)

Aim: Compare between the significance and wellbeing of PRP and LLLT in the management of AA.

Patients & methodology: Thirty patients, each having three patches of AA participated in the study. Patches were assigned randomly to have one of the two treatments: PRP or LLLT. The third patch served as a control and received placebo treatment. PRP was done once weekly whereas LLLT was done 3 sessions per week for a maximum of 6 weeks. Patients were followed up at one month and three months. The thickness and density of hair were evaluated by the folliscope.

Results: A noteworthy higher improvement was detected in the thickness and the density of hair in the PRP treated patches as evaluated by the folliscope and patients satisfaction. The obtained outcomes were sustained during the 12 week follow-up period in most of patients.

Conclusion: PRP and LLLT could be considered as efficacious alternatives for the treatments of  AA with the least morbidity in addition to a little cost profit ratio.

KEYWORDS: Alopecia areata, platelet-rich plasma, folliscope, photobiomodulation, low level laser therapy.



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Jabbari A, Sansaricq F, Cerise J, Chen JC, Bitterman A, Ulerio G, et al. An open-pilot study to evaluate the efficacy of tofacitinib in moderate to severe patch type alopecia areata, totalis and universalis. J Inv Dermatol. 2018;138(7):1539-45. http://doi.org/10.1016/j.jid.2018.01.032 PMid:29452121 DOI: https://doi.org/10.1016/j.jid.2018.01.032

Lee HH, Gwillim E, Patel KR, Hua T, Rastogi S, Ibler E, et al. Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;82(3):675-82. http://doi.org/10.1016/j.jaad.2019.08.032 PMid:31437543 DOI: https://doi.org/10.1016/j.jaad.2019.08.032

El Taieb MA, Hegazy EM, Ibrahim HM, Osman AB, Abualhamd M. Topical calcipotriol vs narrowband ultraviolet B in treatment of alopecia areata: A randomized-controlled trial. Arch Dermatol Res. 2019;311(8):629-36. https://doi.org/10.1007/s00403-019-01943-8 PMid:31236672 DOI: https://doi.org/10.1007/s00403-019-01943-8

Lai VW, Chen G, Gin D, Sinclair R. Cyclosporine for moderateto-severe alopecia areata: A double-blind, randomized, placebo-controlled clinical trial of efficacy and safety. J Am Acad Dermatol. 2019;81(3):694-701. https://doi.org/10.1016/j.jaad.2019.04.053 PMid:31048013 DOI: https://doi.org/10.1016/j.jaad.2019.04.053

Roohaninasab M, Goodarzi A, Ghassemi M, Sadeghzadeh-Bazargan A, Behrangi E, Nobari NN. Systematic review of platelet-rich plasma in treating alopecia: Focusing on efficacy, safety, and therapeutic durability. Dermatol Ther. 2021;34(2):e14768. https://doi.org/10.1111/dth.14768 PMid:33421285 DOI: https://doi.org/10.1111/dth.14768

Fukumoto T, Fukumoto R, Magno E, Oka M, Nishigori C, Horita N. Treatments for alopecia areata: A systematic review and network meta-analysis. Dermatolo Ther. 2021;34(3):e14916. https://doi.org/10.1111/dth.14916 PMid:33631058 DOI: https://doi.org/10.1111/dth.14916

Pratt CH, King LE Jr., Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3(1):17011. https://doi.org/10.1038/nrdp.2017.11 PMid:28300084 DOI: https://doi.org/10.1038/nrdp.2017.11

Alves R, Grimalt R. Platelet-rich plasma and its use for cicatricial and non-cicatricial alopecias: A narrative review. Dermatol Ther (Heidelb). 2020;10(4):623-33. https://doi.org/10.1007/s13555-020-00408-5 PMid:32557337 DOI: https://doi.org/10.1007/s13555-020-00408-5

El Taieb MA, Ibrahim H, Nada EA, Seif Al-Din M. Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: A trichoscopic evaluation. Dermatol Ther. 2017;30(1):e12437. https://doi.org/10.1111/dth.12437 PMid:27791311 DOI: https://doi.org/10.1111/dth.12437

El-Refai AM, Elhabak DM, Khashaba RA. More is not always better in hair growth factors. epidermal growth factor: Hair growth factor involved in alopecia areata pathogenesis. Int J Trichol. 2020;12(4):182-7. https://doi.org/10.4103/ijt.ijt_51_20 PMid:33376288 DOI: https://doi.org/10.4103/ijt.ijt_51_20

Bitan DT, Berzin D, Kridin K, Cohen A. The association between alopecia areata and anxiety, depression, schizophrenia, and bipolar disorder: A population-based study. Arch Dermatol Res. 2021;2021:2247. https://doi.org/10.1007/s00403-021-02247-6 DOI: https://doi.org/10.1007/s00403-021-02247-6

Toussi A, Barton VR, Le ST, Agbai ON, Kiuru M. Psychosocial and psychiatric comorbidities and health-related quality of life in alopecia areata: A systematic review. J Am Acad Dermatol. 2021;85(1):162-75. http://doi.org/10.1016/j.jaad.2020.06.047 PMid:32561373 DOI: https://doi.org/10.1016/j.jaad.2020.06.047

Pourang A, Mesinkovska NA. New and emerging therapies for alopecia areata. Drugs. 2020;80(7):635-46. http://doi.org/10.1007/s40265-020-01293-0 PMid:32323220 DOI: https://doi.org/10.1007/s40265-020-01293-0

Sterkens A, Lambert J, Bervoets A. Alopecia areata: A review on diagnosis, immunological etiopathogenesis and treatment options. Clin Exp Med. 2021;21(2):215-30. DOI: https://doi.org/10.1007/s10238-020-00673-w

Rubina A, Ramon G. A review of platelet-rich plasma: History, biology, mechanism of action, and classification. Skin Appendage Disord. 2018;4(1):18-24. DOI: https://doi.org/10.1159/000477353

Trink A, Sorbellini E, Bezzola P, Rodella L, Rezzani R, Ramot Y, et al. A randomized, double-blind, placebo-and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol. 2013;169(3):690-4. http://doi.org/10.1111/bjd.12397 PMid:23607773 DOI: https://doi.org/10.1111/bjd.12397

Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our center experience. Indian J Plast Surg. 2015;48(1):57-9. http://doi.org/10.4103/0970-0358.155271 PMid:25991888 DOI: https://doi.org/10.4103/0970-0358.155271

Shumez H, Prasad PV, Kaviarasan PK, Deepika R. Intralesional platelet rich plasma vs intralesional triamcinolone in the treatment of alopecia areata: A comparative study. Int J Med Res Health Sci. 2015;4(1):118-22. DOI: https://doi.org/10.5958/2319-5886.2015.00019.3

Donovan J. Successful treatment of corticosteroid-resistant ophiasis-type alopecia areata (AA) with platelet-rich plasma (PRP). JAAD Case Rep. 2015;1(5):305-7. http://doi.org/10.1016/j.jdcr.2015.07.004 PMid:27051761 DOI: https://doi.org/10.1016/j.jdcr.2015.07.004

Khan SS, Kamal T, Ellahi AA, Ahmad TJ. Role of autologous platelet rich plasma (PRP) in limited alopecia areata in local population. J Pak Assoc Dermatol. 2016;26(2):107-11.

Mubki T. Platelet-rich plasma combined with intralesional triamcinolone acetonide for the treatment of alopecia areata: A case report. J Dermatol Surg. 2016;20(1):87-90. DOI: https://doi.org/10.1016/j.jdds.2015.11.002

Kumar A, Sharma RP, Bali S, Arya P. Role of platelet rich plasma therapy in alopecia areata-a prospective study. Int J Contem Med Res. 2016;3(8):2499-502.

Elsaied F, Faraj M, Marwa R. Evaluation of platelet-rich plasma in treatment of alopecia areata: A placebo-controlled study. J Egypt Womens Dermatol Soc. 2018;15(2):100-5. DOI: https://doi.org/10.1097/01.EWX.0000540042.97989.cf

Albalat W, Ebrahim HM. Evaluation of platelet-rich plasma vs intralesional steroid in treatment of alopecia areata. J Cosmet Dermatol. 2019;18(5):1456-62. http://doi.org/10.1111/jocd.12858 PMid:31074201 DOI: https://doi.org/10.1111/jocd.12858

Ninama K, Mahajan R, Bilmoria FE, Faghani A. A clinical study on alopecia areata. Int J Res Dermatol. 2018;4(1):66-71. DOI: https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20180143

Fonseka S, Bandara YM, Subhani B. Successful management of treatment-resistant alopecia areata with platelet rich plasma: A case series. Serbian J Dermatol Venereol. 2019;11(2):50-2. DOI: https://doi.org/10.2478/sjdv-2019-0007

Velappan R, Nallu K, Ramasamy S, Chandrasekar M. A prospective study on the efficacy of platelet rich plasma in alopecia areata. Int J Res Dermatol. 2019;5(3):583-6. DOI: https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20192096

Ranpariya RH, Gupta SB, Deora MS, Agrawal PV, Mathur R, Raheja A. Intralesional triamcinolone acetonide versus platelet rich plasma: A comparative study in the treatment of alopecia areata of scalp. Int J Res Dermatol. 2019;5(3):521-7. http://doi.org/10.18203/issn.2455-4529 DOI: https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20193223

Khademi F, Tehranchinia Z, Abdollahimajd F, Younespour S, Kazemi-Bajestani SM, et al. The effect of platelet rich plasma on hair regrowth in patients with alopecia areata totalis: A clinical pilot study. Dermatol Ther. 2019;32(4):129-89. http://doi.org/10.1111/dth.12989 PMid:31172647 DOI: https://doi.org/10.1111/dth.12989

Hegde P, Relhan V, Sahoo B, Garg, VK. A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp. Dermatol Ther. 2020;33(6):e14388. http://doi.org/10.1111/dth.14388 PMid:33034942 DOI: https://doi.org/10.1111/dth.14388

Balakrishnan A, Joy B, Thyvalappil A, Mathew P, Sreenivasan A, Sridharan R. A comparative study of therapeutic response to intralesional injections of platelet-rich plasma versus triamcinolone acetonide in alopecia areata. Indian Dermatol Online J. 2020;11(6):920-4. http://doi.org/10.4103/idoj.IDOJ_6_20 PMid:33344340 DOI: https://doi.org/10.4103/idoj.IDOJ_6_20

Kapoor P, Kumar S, Brar BK, Kukar N, Arora H, Brar SK. Comparative evaluation of therapeutic efficacy of intralesional injection of triamcinolone acetonide versus intralesional autologous platelet-rich plasma injection in alopecia areata. J Cutan Aesthet Surg. 2020;13(2):103-11. http://doi.org/10.4103/JCAS.JCAS_16_19 PMid:32792771

Fawzy MM, Abdel Hay R, Mohammed FN, Sayed KS, Ghanem ME, Ezzat M. Trichoscopy as an evaluation method for alopecia areata treatment: A comparative study. J Cosmet Dermatol. 2021;20(6):1827-36. http://doi.org/10.1111/jocd.13739 PMid:32991045 DOI: https://doi.org/10.1111/jocd.13739

Gupta S, Bisht PB, Kannan C. Alopecia totalis successfully treated with modified platelet-rich plasma therapy in a patient recalcitrant to traditional treatment modalities. Clin Dermatol Rev. 2021;5(1):120-2. DOI: https://doi.org/10.4103/CDR.CDR_50_19

Ragab SE, Nassar SO, Morad HA, Hegab DS. Platelet-rich plasma in alopecia areata: Intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling. Acta Dermatoven APA. 2020;29(4):169-73. PMid:33348935 DOI: https://doi.org/10.15570/actaapa.2020.35

Hamblin MR. Photobiomodulation for the management of alopecia: mechanisms of action, patient selection and perspectives. Clin Cosmet Investig Dermatol. 2019;12:669-78. http://doi.org/10.2147/CCID.S184979 PMid:31686888 DOI: https://doi.org/10.2147/CCID.S184979

Mansouri V, Arjmand B, Tavirani MR, Razzaghi M, Rostami-Nejad M, Hamdieh M. Evaluation of efficacy of lowlevel laser therapy. J Lasers Med Sci. 2020;11(4):369-80. http://doi.org/10.34172/jlms.2020.60 PMid:33425286 DOI: https://doi.org/10.34172/jlms.2020.60

Darwin E, Arora H, Hirt PA, Wikramanayake TC, Jimenez JJ. A review of monochromatic light devices for the treatment of alopecia areata. Lasers Med Sci. 2018;33(2):435-44. http://doi.org/10.1007/s10103-017-2412-6 PMid:29250710 DOI: https://doi.org/10.1007/s10103-017-2412-6

Afifi L, Maranda EL, Zarie M, Delcanto GM, Falto-Aizpurua L, Kluijfhout WP, et al. Low-level laser therapy as a treatment for androgenetic alopecia. Lasers Surg Med. 2017;49(1):27-39. http://doi.org/10.1002/lsm.22512 PMid:27114071 DOI: https://doi.org/10.1002/lsm.22512

Zarie M, Wikramanayake TC, Falto-Aizpurua L, Schachner LA, Jiminez JJ. Low level laser therapy and hair regrowth: An evidence-based review. Laser Med Sci. 2016;31(2):363-71. http://doi.org/10.1007/s10103-015-1818-2 PMid:26690359 DOI: https://doi.org/10.1007/s10103-015-1818-2

Olsen E, Hordinsky M, McDonald-Hull S, Price V, Roberts J, Shapiro J. Alopecia areata investigational assessment guidelines. National alopecia areata foundation. J Am Acad Dermatol. 1999;40(2):242-6. http://doi.org/10.1016/s0190-9622(99)70195-7 PMid:10025752 DOI: https://doi.org/10.1016/S0190-9622(99)70195-7

Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, et al. Alopecia areata investigational assessment guidelines, Part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440-7. http://doi.org/10.1016/j.jaad.2003.09.032 PMid:15337988 DOI: https://doi.org/10.1016/j.jaad.2003.09.032

Lee BS, Chan JY, Monselise A, Lee BS, Chan JY, Monselise A, et al. Assessment of hair density and caliber in Caucasian and Asian female subjects with female pattern hair loss by using the folliscope. J Am Acad Dermatol. 2012;66(1):166-7. http://doi.org/10.1016/j.jaad.2011.04.023 PMid:22177643 DOI: https://doi.org/10.1016/j.jaad.2011.04.023

D’Ovidio R, Roberto M. Limited effectiveness of platelet-richplasma treatment on chronic severe alopecia areata. Hair Ther Transplnt. 2014;4(1):118-22. DOI: https://doi.org/10.4172/2167-0951.1000116

Li ZJ, Choi HI, Choi DK, Sohn KC, Im M, Seo YJ, et al. Autologous platelet-rich plasma: A potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012;38(7 Pt 1):1040-6. http://doi.org/10.1111/j.1524-4725.2012.02394.x PMid:22455565 DOI: https://doi.org/10.1111/j.1524-4725.2012.02394.x

Yamazaki M, Miura Y, Tsuboi R, Ogawa H. Linear polarized infrared mirradiation using super lizar is an effective treatment for multipletype alopecia areata. Int J Dermatol. 2003;42(9):738-40. http://doi.org/10.1046/j.1365-4362.2003.01968.x PMid:12956694 DOI: https://doi.org/10.1046/j.1365-4362.2003.01968.x

Waiz M, Saleh AZ, Hayani R, Jubory SO. Use of the pulsed infrared diode laser (904 nm) in the treatment of alopecia areata. J Cosmet Laser Ther. 2006;8(1):27-30. http://doi.org/10.1080/14764170600607368 PMid:16581682 DOI: https://doi.org/10.1080/14764170600607368

Abdelhalim NM. Efficacy of low level laser therapy in the treatment of alopecia areata. Int J Physiother Res. 2014;2(2):460-5.

Han L, Liu B, Chen X, Chen XY, Chen HY, Deng WJ, et al. Activation of Wnt/B-catenin signaling is involved in hair growth-promoting effect of 655-nm red light and LED in vitro culture model. Lasers Med Sci. 2018;33(3):637-45. http://doi.org/10.1007/s10103-018-2455-3 PMid:29468283 DOI: https://doi.org/10.1007/s10103-018-2455-3

King LE, Silva KA, Kennedy VE, Sundberg JP. Lack of response to laser comb in spontaneous and graft-induced alopecia areata in C3H/HeJ mice. J Invest Dermatol. 2014;134(1):264-6. http://doi.org/10.1038/jid.2013.252 PMid:23752043 DOI: https://doi.org/10.1038/jid.2013.252




How to Cite

Tawfik AA, Mostafa I, Soliman M, Soliman M, Abdallah N. Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study. Open Access Maced J Med Sci [Internet]. 2022 Jan. 2 [cited 2023 Mar. 24];10(B):420-7. Available from: https://oamjms.eu/index.php/mjms/article/view/7428

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