Comparison of Platelet-Rich Plasma Therapy Versus Intralesional Triamcinolone Acetonide in the Treatment of Alopecia Areata: A Single-Blinded, Randomised Controlled Trial

Abstract Background and Aim: The management of alopecia areata is often challenging. Available treatment modalities include intralesional triamcinolone, topical steroids, and immunotherapy to name a few. The current study was designed to compare the efficacy, safety, and patient satisfaction of platelet-rich plasma (PRP) versus intralesional triamcinolone acetonide (IT) (10 mg/ml) given 3-weekly for 3 doses in the treatment of localised alopecia areata of the scalp. Method: This was a single-blind, randomised controlled study wherein 60 patients with localised alopecia areata of the scalp were enrolled. Thirty patients each received either IT or PRP therapy at 3 weekly intervals for 3 sessions at 0, 3, and 6 weeks, and follow-up was done at 9 and 18 weeks. The response was assessed using the mean severity of alopecia tool score (SALT) score, SALT score reduction, regrowth of fully pigmented hair, hair regrowth grade scale, complete regrowth, side effect profile, and patient satisfaction scale. Results: The mean SALT score in IT and PRP groups at baseline was 4.04 ± 2.19 and 3.92 ± 2.22, respectively. The mean SALT scores in IT and PRP groups decreased to 2.22 ± 1.74 and 1.46 ± 3.25, respectively ( P = 0.625) at 9 weeks follow-up. The percentage reduction in mean SALT score in IT and PRP groups was 54.86 ± 44.4 and 48.77 ± 56.5, respectively ( P = 0.976) at 9 weeks. The percentage of patients showing complete regrowth was higher in the IT group ( P = 0.292), while regrowth of fully pigmented hair was more frequent in PRP group ( P = 0.272), although both were not statistically significant. Pain and bleeding were more frequently reported in the PRP group. Atrophy and telangiectasia were exclusively seen in the IT group. The patient satisfaction score (PSS) was similar in both groups ( P = 0.691). Conclusion: Platelet-rich plasma therapy was as effective as intralesional triamcinolone acetonide (10 mg/ml) in treating patients of localised alopecia areata. Trial Registration: Clinical Trials Registry of India number CTRI/2023/01/048750 [Registered on: 04/01/2023]