Platelet-rich Plasma in Central Centrifugal Cicatricial Alopecia (CCCA)

Commentary by Tejashri Venkatesh | MD Candidate 2025 | Chicago Medical School at Rosalind Franklin University

Platelet-rich plasma (PRP) is a preparation of concentrated platelets found in plasma obtained by centrifugation of blood (Figure I)1. It contains growth factors and proteins implicated in tissue repair and regeneration2,3. A patient’s own blood is drawn, platelets are concentrated and injected into the patient at indicated locations. PRP was first used as an antihemorrhagic agent in the 1980s4; its use has since evolved into applications such as wound healing, joint restoration, bone maturation and formation, and cosmetics. In recent years, it has emerged as a novel therapeutic for hair loss disorders.

Figure I1: Obtaining PRP from centrifugation of whole blood.

PRP has proven to be a safe and effective therapy for nonscarring androgenetic alopecia (AGA)5,6,7. Given its anti-inflammatory properties as well as its ability to remodel scar tissue3, it has been proposed as a potentially effective therapeutic for scarring alopecia by experts8, particularly for central centrifugal cicatricial alopecia (CCCA) with concomitant AGA9. Encouraging evidence comes from a few published case reports of patients with stabilized disease, who demonstrated significantly improved follicular density after 3 consecutive monthly treatments of PRP injections10,11. No adverse effects were reported with multiple sessions. However, a reduction in follicular density was noted 6 months after treatment, suggesting that frequent maintenance therapy may be required to upkeep the benefit achieved with initial treatment.

While the promise of PRP gives hope to both patients with recalcitrant scarring alopecia and dermatologists, a plethora of questions and limitations remain to be addressed. Larger studies and clinical trials are needed to generate more robust data on efficacy of PRP in scarring alopecia. Standardization of treatment preparation, dose, frequency, and evaluation is necessary. Significant cost is a barrier for many patients.


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