PRP therapy shows some promise for alopecia areata, but it is not a first-line treatment. Corticosteroid injections remain the standard approach for this autoimmune condition that causes round patches of hair loss in about 2% of the population. PRP may help as an add-on therapy when standard treatments fall short.
This article is for informational purposes only and does not constitute medical advice.
Understanding Alopecia Areata and Why Treatment Differs
Alopecia areata is fundamentally different from androgenetic alopecia (pattern hair loss). In alopecia areata, the immune system mistakenly attacks hair follicles, causing them to shrink and stop producing visible hair. The follicles are not destroyed, which is why spontaneous regrowth can occur, but the autoimmune process must be addressed for sustained recovery.
Why Standard PRP Logic Does Not Fully Apply
PRP works by concentrating growth factors from the patient's own blood and injecting them into the scalp. For androgenetic alopecia, this directly targets the problem of follicle miniaturization caused by DHT. For alopecia areata, the underlying cause is immune-mediated inflammation, and growth factors alone do not suppress the immune attack on follicles.
This distinction matters because it explains why PRP results for alopecia areata are less consistent than for pattern hair loss. The growth factors in PRP may help stimulate regrowth in follicles where the immune attack has subsided, but they do not address the root autoimmune mechanism.
The Potential Role of PRP's Anti-Inflammatory Properties
PRP does contain anti-inflammatory cytokines and growth factors that may modulate the local immune environment around follicles. Some researchers theorize that these properties contribute to the benefit seen in small studies. Specifically, PRP may reduce perifollicular inflammation, promote angiogenesis around dormant follicles, and create a more favorable environment for hair cycling to resume.
Clinical Evidence for PRP in Alopecia Areata
What the Studies Show
The evidence base for PRP in alopecia areata is smaller and less robust than for androgenetic alopecia. Several small studies have reported positive outcomes. A 2020 systematic review found that PRP produced significant improvement in hair regrowth in most included studies, but the authors noted significant limitations including small sample sizes, variable PRP preparation methods, and short follow-up periods.
Key findings from individual studies include improvement in hair regrowth compared to placebo in patches treated with PRP, better outcomes when PRP is combined with intralesional corticosteroid injections compared to corticosteroids alone, and response rates that vary widely from 30% to 70% depending on the study design and patient population.
Limitations You Should Know
The quality of evidence is moderate at best. Most studies involve fewer than 50 patients, follow-up periods are typically 6 months or less, and there is no standardized PRP preparation protocol. The unpredictable nature of alopecia areata, which can spontaneously remit, makes it difficult to determine how much improvement is attributable to PRP versus natural disease fluctuation.
No large randomized controlled trial has established PRP as a reliable standalone treatment for alopecia areata.
Treatment Protocol for Alopecia Areata
Session Details
When PRP is used for alopecia areata, the protocol is similar to its use for pattern hair loss. A typical session involves drawing 20 to 60ml of blood, processing it in a centrifuge, and injecting the concentrated platelet solution into and around the affected patches.
Most protocols call for 3 to 4 sessions spaced 4 to 6 weeks apart. Each session takes 30 to 60 minutes. Injections are concentrated in and around active patches rather than distributed across the entire scalp as with androgenetic alopecia.
Combining PRP With First-Line Treatments
PRP for alopecia areata is most effective when used alongside standard treatments rather than as a replacement. Typical combinations include PRP with intralesional corticosteroid injections (the most studied combination), PRP with topical minoxidil to stimulate regrowth in stabilized patches, and PRP as an adjunct to systemic immunotherapy for more extensive disease.
The combination of PRP with corticosteroid injections has the most supporting evidence. Some studies suggest this combination produces faster and more complete regrowth than corticosteroids alone. For a full overview of standard treatments, see our guide to alopecia areata treatments ranked.
Cost and Practical Considerations
Pricing
PRP sessions for alopecia areata typically cost $500 to $2,000 per session. The range depends on the provider's experience, geographic location, and the specific centrifuge system used.
| Component | Cost Range |
|---|---|
| Single PRP session | $500 to $2,000 |
| Initial series (3 to 4 sessions) | $1,500 to $8,000 |
| Maintenance sessions (if needed) | $500 to $2,000 per session |
Insurance coverage for PRP in alopecia areata is extremely rare because the treatment is considered investigational for this indication. Patients should expect to pay out of pocket.
When PRP Might Be Worth Considering
PRP may be a reasonable option for alopecia areata patients who have not responded adequately to corticosteroid injections alone, cannot tolerate corticosteroid side effects such as skin atrophy, want to try an adjunctive therapy with a low side-effect profile, or have limited patchy disease (not extensive alopecia totalis or universalis).
PRP is less likely to help patients with longstanding total scalp hair loss or alopecia universalis, where the immune process is widespread and more aggressive. For more on the mechanics of PRP and how the therapy works, see our PRP therapy guide.
Who Should Avoid PRP for Alopecia Areata
PRP is not appropriate for all alopecia areata patients. It is not recommended as a first-line standalone treatment when corticosteroids have not been tried, for patients with blood disorders or platelet dysfunction, during active widespread disease flares where the immune process is highly active, or as a replacement for FDA-approved treatments like baricitinib in severe cases.
Setting Realistic Expectations
Patients considering PRP for alopecia areata should understand that results are less predictable than for androgenetic alopecia. Some patients experience significant regrowth while others see little benefit. The autoimmune nature of the condition means that even successful regrowth can be followed by new episodes of hair loss if the immune system becomes active again.
A dermatologist experienced with alopecia areata should guide treatment decisions and help determine whether PRP is appropriate for your specific situation.
Side Effects
PRP has a favorable safety profile because it uses the patient's own blood. Common side effects include temporary soreness at injection sites, mild swelling lasting 24 to 48 hours, and occasional bruising. Serious complications are rare.
The main risk is financial rather than physical. Spending $1,500 to $8,000 on a treatment with inconsistent evidence is a significant investment, especially when first-line treatments with stronger evidence exist.
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