Non-transplant alopecia treatments grow in popularity

Three minimally invasive procedures are gaining traction for the management of alopecia. As research continues and evidence mounts, experts discussed three key strategies during Saturday’s “Emerging Non-transplant Procedures and Drug Delivery for the Management of Complex Alopecias” (U034).

From left to right: Nicole Elaine Rogers, MD, Neil S. Sadick, MD, Ana Lucia Ariano Junqueira, MD, and Maria K. Hordinsky, MD, share minimally invasive procedures for the management of alopecia.

1. Platelet-rich plasma (PRP)

PRP is the autologous high concentration of platelets in a small volume of plasma. It’s performed in a 10-minute process that’s comprised of five steps: Collect the blood, centrifuge it, remove platelet-poor plasma (PPP), re-suspend and collect PRP, and inject.

PRP treats hair loss by promoting vascularization and angiogenesis, triggering anagen entry, extending anagen duration, reducing inflammation and oxidative stress, and triggering hair stem cell regeneration. Neil S. Sadick, MD, clinical professor of dermatology at Weill Cornell Medical College in New York, said the first sign that the treatment is working is that the patient will experience decreased shedding. If the patient hasn’t experienced hair growth by the five- to six-month mark, Dr. Sadick will discuss ending treatment.

See related PRP story in Dermatology World
Platelet-rich plasma

2. Microneedling

Microneedling is the practice of wounding the skin to mimic embryonic follicle development and to express nascent follicles. By introducing microscopic punctures to the skin, the follicle infundibulum is dilated, and the patient will experience improved transepidermal and transfollicular delivery of hair growth agents.

Nicole Elaine Rogers, MD, a dermatologist with East Jefferson General Hospital in Metairie, Louisiana, said there is evidence that the process of wounding the skin alone can enhance hair growth. “Alone, it is probably not superior to existing alopecia therapies,” she said. But in combination, she believes it is probably superior.

See related story in Dermatology World on microneedling:
The many uses of microneedling

3. Laser-assisted drug delivery

In addition to microneedling, transdermal drug delivery treatments can include fractionated lasers. These create small channels through the stratum corneum to the dermis and can include either ablative lasers or non-ablative lasers.

Sisters Ana Carina Junqueira Bertin, MD, and Ana Lucia Ariano Junqueira, MD, from Clinic 462 in São Paulo, Brazil, use fractional non-ablative lasers in their practice. These act as a wounding source, increase blood flow, impact cytokine expression, induce growth factor changes, and enhance penetration of topical agents.