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A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia

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Abstract

Owing to the inadequate response to and limitations of the approved medications for androgenetic alopecia, novel therapies are warranted to enhance outcomes. The objective of this paper is to ascertain the effectiveness of fractional carbon dioxide laser followed by platelet-rich plasma application on hair regrowth and to compare the two laser settings. Seven participants were enrolled in this half-head pilot study based on different laser pulse energy and density values (12 mJ, 800 spots/cm2 and 22 mJ, 400 spots/cm2). Ten treatment sessions were performed every 2 weeks with 12-week follow-up. The evaluation methods were based on hair density from standardized phototrichograms, global photographic assessment, and patient satisfaction. Significantly increased total and terminal hair densities were observed during treatment in both groups as compared with baselines. The mean total hair density has weekly increased significantly with high pulse energy (1.42 hair/cm2) as compared to low pulse energy (1.04 hair/cm2) throughout the study period (p = 0.023; 4.89 hair/cm2). Global photographs and patient satisfaction scores demonstrated improvement, but only the latter showed statistical significance (p = 0.029). The average pain intensity scores were not different between the groups (p = 0.760) all over the procedure. The adverse events were minor and well tolerated. This synergistic treatment remarkably leads to hair restoration and high patient satisfaction. The parameters of 22-mJ beam energy with 400 spots/cm2 density are appropriate and superior to 12-mJ beam energy with 800 spots/cm2. Albeit higher energy, no more pain is indicated in the high pulse energy group. Trial registration number (TRN): TCTR20180619004, Thai Clinical Trials Registry (TCTR) since 2018-05-15 13:39:48

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The Stata version 13.0 software (StataCorp., College Station, TX, USA)

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Funding

The study was supported by a grant from the Navamindradhiraj University Research Fund.

Author information

Authors and Affiliations

  1. Division of Dermatology, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Road, Dusit District, Bangkok, 10300, Thailand

    Sujirod Hanthavichai

  2. Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand

    Nutthinee Archavarungson & Thanwa Wongsuk

Authors
  1. Sujirod Hanthavichai
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  2. Nutthinee Archavarungson
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  3. Thanwa Wongsuk
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Contributions

All named authors meet the criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Conceptualization: Sujirod Hanthavichai; Methodology: Sujirod Hanthavichai, Nutthinee Archavarangson, Thanwa Wongsuk; Formal analysis and investigation: Sujirod Hanthavichai, Nutthinee Archavarangson, Thanwa Wongsuk; Writing - original draft preparation: Sujirod Hanthavichai; Writing - review and editing: Sujirod Hanthavichai; Funding acquisition: Sujirod Hanthavichai; Resources: Sujirod Hanthavichai; Supervision: Sujirod Hanthavichai

Corresponding author

Correspondence to Sujirod Hanthavichai.

Ethics declarations

Ethics approval

The study is in compliance with Ethical Standards. This study protocol was performed in line with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of the Faculty of Medicine Vajira Hospital, Navamindradhiraj University.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

Conflict of interest

The authors declare no competing interests.

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Summary

• Since the conventional treatments of androgenetic alopecia have inadequate response and limitations, alternative therapies are required to improve outcomes.

• Although platelet-rich plasma injection and nonablative fractional laser have been individually studied as therapeutic options for androgenetic alopecia, there is still lack of information about fractional laser therapy combined with platelet-rich plasma application.

• We hypothesized that fractional carbon dioxide laser followed by topical platelet-rich plasma can promote hair regeneration and patient satisfaction.

• This combination regimen considerably results in hair regrowth and high patient satisfaction, without any serious adverse event.

• High beam energy (22-mJ) and 400 spots/cm2 density are the suitable laser parameters.

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Hanthavichai, S., Archavarungson, N. & Wongsuk, T. A study to assess the efficacy of fractional carbon dioxide laser with topical platelet-rich plasma in the treatment of androgenetic alopecia. Lasers Med Sci 37, 2279–2286 (2022). https://doi.org/10.1007/s10103-021-03496-7

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  • DOI: https://doi.org/10.1007/s10103-021-03496-7

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