Comparative Evaluation of Buffy Coat-Derived and Apheresis Platelet-Rich Plasma in the Treatment of Androgenetic Alopecia: Laboratory and Clinical Insights.

BACKGROUND

Androgenetic alopecia (AGA) is the most common type of hair loss, and platelet-rich plasma (PRP) has emerged as a promising therapy. However, preparation methods may influence clinical outcomes.

OBJECTIVE

To compare buffy coat and apheresis PRP in terms of laboratory characteristics and treatment efficacy in AGA, and to identify predictors of response.

METHODS

A retrospective analysis was conducted on 747 PRP preparations (514 buffy coat, 233 apheresis) and 163 AGA patients who were eligible for final analysis after screening (87 buffy coat, 76 apheresis). Laboratory indices and PRP parameters were assessed. Clinical efficacy was evaluated by trichoscopy and patient-reported outcomes. Logistic regression was used to determine independent predictors.

RESULTS

Apheresis PRP required greater blood volumes and yielded higher platelet concentration (1242×109/L vs 1079×109/L, P<0.001), total platelet counts, and purity, while buffy coat achieved higher recovery rates. Both methods significantly improved hair density, shaft diameter, and follicular parameters, with no significant differences between groups. Patient-reported improvement was higher in the buffy coat group (51.7% vs 46.1%). Logistic regression identified preparation method (buffy coat: OR=3.41, 95% CI: 1.21-9.65, P=0.021) and treatment frequency (OR=2.01 per session, 95% CI: 1.32-3.07, P=0.001) as independent predictors of response. Sex and platelet concentration showed no significant associations.

CONCLUSION

Both buffy coat and apheresis PRP are effective for AGA. Buffy coat PRP was associated with greater subjective improvement despite lower platelet counts, suggesting that platelet number alone does not determine efficacy. Repeated treatments significantly enhance outcomes, highlighting the importance of treatment frequency in PRP therapy.