Comparison of Microneedling with Platelet Rich Plasma vs Minoxidil (5%)+Finasteride (0.1%) Topical Therapy in Androgenetic Alopecia: A Randomised Clinical Study

Introduction: Androgenetic Alopecia (AGA) is a progressive loss of hair in a patterned distribution for which treatment selection is limited. Long-term efficacy, safety and cost leads to low compliance rate. Among various treatment modalities (medical and surgical) available, microneedling and Platelet Rich Plasma (PRP) are emerging as a newer, useful and safe non surgical treatment regime.

Aim: To evaluate the effectiveness and safety of microneedling with PRP versus minoxidil (5%) + finasteride (0.1%) topical therapy in AGA.

Materials and Methods: This randomised clinical trial was done at Department of Dermatology, Venereology and Leprology (DVL), Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India, from November 2021 to November 2022. Total of 60 adult males clinically diagnosed with AGA were enrolled and randomised into group 1 and group 2. Subjects in group 1 were treated with microneedling+PRP and group 2 were advised minoxidil+finasteride topical therapy. Microneedling alongwith intradermal injection of autologous PRP was done every month for four consecutive months in group 1 (n=30) while 1 mL of minoxidil (5%)+finasteride (0.1%) lotion was advised to be applied over dry scalp twice daily for four months in group 2 (n=30) patients. Both groups were followed-up for next two months. Hair density was assessed by Hamilton Norwood Scale using photographic and dermoscopic images and patients self-assessment scores. Data assessment was done by Chi-square test. Statistical Package for the Social Sciences (SPSS) version 26.0 was used to analyse data and p-value for significance was established at <0.05.

Results: Patients in group 1 with mean age 27.9±4.15 years showed almost similar increase in hair density compared to group 2 with mean age 25.8±3.94 years, as assessed by patient assessment score, photography, dermoscopy, Hamilton Norwood scale at six months of study (p-value >0.05), however onset of action was quicker in group 1. Investigator assessment on improvement in hair density using Hamilton Norwood Scale at three months (p-value=0.920) and six months (p-value=0.995) showed that microneedling+PRP therapy is as effective as minoxidil+finasteride lotion since the difference between results of both groups was not statistically significant.

Conclusion: Microneedling and PRP although safe, effective and promising treatment modality in AGA is comparable to minoxidil+finasteride topical therapy.