Efficacy of Platelet-Rich Plasma vs. Platelet-Rich Fibrin Matrix in Hair Transplantation: A Randomized Clinical Trial

Background: Androgenic alopecia (AGA) is a common condition affecting mental health and quality of life. Platelet-rich plasma (PRP) and platelet-rich fibrin matrix (PRFM) are emerging regenerative therapies with potential benefits in hair restoration.
Objective: This study aimed to compare the efficacy of PRP versus PRFM in enhancing outcomes of follicular unit extraction (FUE) in patients with AGA.
Patients and methods: This prospective, randomized clinical trial included 20 patients with grades 2–6 AGA and aged 20–50 years. This study was conducted at Cairo University and Shaalan Surgical Center from June 2017 to March 2018. Patients were randomly assigned into two groups: Group 1 received intradermal PRP injections, and group 2 received intradermal PRFM injections combined with FUE.
Results: Both treatment groups experienced notable improvements in hair density following the procedures. However, patients receiving PRFM showed a more substantial increase in hair density compared to those treated with PRP with statistical significance indicated by a p-value of 0.02. Additionally, the follicle survival rate was significantly higher in the PRFM group (p=0.03) suggesting better integration and growth of transplanted follicles. Patient satisfaction scores were also greater for the PRFM group with a p-value of 0.04 reflecting a more favorable aesthetic outcome. No adverse effects or complications were observed in either group throughout the study duration.
Conclusion: PRFM appeared to be more effective than PRP in promoting hair regeneration when combined with FUE, likely due to its fibrin scaffold facilitating sustained growth factor release. Larger studies are recommended to confirm these findings.