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. 2025 Jul 8.
doi: 10.1097/DSS.0000000000004755. Online ahead of print.

Platelet-Rich Plasma Treatment for Endocrine-Induced Alopecia and Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors: A Randomized, Controlled, Pilot Study

Anthony Rossi  1 , Alexander Pan  1   2 , Christian Menzer  1   3 , Leore Lavin  1   4 , Saud Aleissa  5 , Abdullah Aleisa  6 , Hesham Alshaikh  1 , George Dranitsaris  7 , Stephen Dusza  1 , Cindy Bravo  1 , Mario E Lacouture  8   9
Affiliations

Platelet-Rich Plasma Treatment for Endocrine-Induced Alopecia and Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors: A Randomized, Controlled, Pilot Study

Anthony Rossi et al. Dermatol Surg. .

Abstract

Background: Platelet-rich plasma (PRP) shows potential in treating androgenetic alopecia but lacks evidence for endocrine-induced alopecia (EIA) or persistent chemotherapy-induced alopecia (pCIA).

Objective: To evaluate safety and efficacy of PRP in breast cancer survivors with EIA or pCIA.

Methods: In this single-center, randomized, controlled trial, EIA and pCIA patients received PRP injections on one side of their scalp monthly for 3 months. Evaluations occurred at baseline and at week 12, followed by an optional cross-arm at week 24. The primary outcome was difference in global assessment scale (GAS) at week 12, assessed by a blinded investigator. Secondary outcomes included adverse events, hair-related quality of life, trichoscopic data, and circulating tumor cell (CTC) assay.

Results: Fifteen EIA and 12 pCIA patients enrolled. GAS improved from baseline to week 12 (+1.2 each, p < .001) but not statistically significant between treated and untreated sides ( p > .05). Hair density increased for both sides (+21 and +16 hairs/cm 2 , respectively, p < .05), without difference between the sides ( p > .05). Quality of life showed no improvement (41.1-39.4, p > .05). Adverse events included grade 1 to grade 3 scalp pain. Two of 12 CTC assays detected malignant cells in PRP, but no tumor seeding events were observed.

Conclusion: PRP may increase hair density in EIA and pCIA patients and showed no adverse cancer outcomes or tumor seeding. Results may be confounded by possible PRP diffusion in split-scalp study design.

Clinicaltrialsgov id: NCT04459650.

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References

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    1. Cash TF. The psychology of hair loss and its implications for patient care. Clin Dermatol 2001;19:161–6.
    1. Freites-Martinez A, Shapiro J, Chan D, Fornier M, et al. Endocrine therapy–induced alopecia in patients with breast cancer. JAMA Dermatol 2018;154:670–5.
    1. Freites-Martinez A, Shapiro J, van den Hurk C, Goldfarb S, et al. Hair disorders in cancer survivors. J Am Acad Dermatol 2019;80:1199–213.

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