Evaluation of Efficacy of Platelet rich Plasma on Androgenetic Alopecia: A Multimodal Assessment Using Trichoscopy, Histopathology, and CD34 Immunohistochemical Assay

Background: Androgenetic alopecia (AGA) significantly impacts patients’ psychological well-being, with conventional treatments showing limited efficacy and potential adverse effects. Platelet-rich plasma (PRP) therapy, utilizing growth factors (GFs) including vascular endothelial GF, platelet-derived GF, and transforming GF-β, represents a promising regenerative approach. This study evaluated PRP efficacy in AGA management through a comprehensive multimodal assessment. Materials and Methods: This prospective controlled study enrolled 35 AGA patients using split-scalp methodology. PRP was administered to one scalp hemisphere with placebo injections to the contralateral side as within-subject controls. Assessments included trichoscopic evaluation of hair density and diameter, histopathological analysis of follicular morphology and perifollicular inflammation, and CD34 immunohistochemical staining for neovascularization and stem cell activation. Results: Twenty-six patients (74.3%) demonstrated statistically significant improvement on PRP-treated hemispheres, with substantial increases in hair density and diameter. Histopathological examination revealed reduced perifollicular inflammation and increased follicular dimensions. Enhanced CD34 immunoexpression indicated improved microvascular networks and stem cell activation. Nine patients (25.7%) showed no differential response, highlighting individual variability in treatment responsiveness. Conclusion: This multimodal investigation provides robust evidence supporting PRP efficacy in AGA management, demonstrating superior outcomes versus placebo across trichoscopic, histomorphological, and immunohistochemical parameters. PRP represents a safe, regenerative alternative to conventional pharmacological approaches. However, heterogeneous treatment responses and limited follow-up duration necessitate protocol standardization and extended multicenter trials to optimize therapeutic strategies and identify predictive factors for treatment success.