Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : March | Volume : 17 | Issue : 3 | Page : WC01 - WC05 Full Version

Comparison of Microneedling with Platelet Rich Plasma vs Minoxidil (5%)+Finasteride (0.1%) Topical Therapy in Androgenetic Alopecia: A Randomised Clinical Study

Published: March 1, 2023 | DOI:
Arphool Khan, Deepika Agarwal, Ankur Talwar

1. Junior Resident, Department of Dermatolgy, Venereology and Leprosy, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India. 2. Assistant Professor, Department of Dermatolgy, Venereology and Leprosy, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India. 3. Professor, Department of Dermatolgy, Venereology and Leprosy, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India.

Correspondence Address :
Deepika Agarwal,
202, Scotia, Omaxe Heights, Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India.


Introduction: Androgenetic Alopecia (AGA) is a progressive loss of hair in a patterned distribution for which treatment selection is limited. Long-term efficacy, safety, cost leads to low compliance rate. Among various treatment modalities (medical and surgical) available, microneedling and Platelet Rich Plasma (PRP) are emerging as a newer, useful and safe non surgical treatment regime.

Aim: To evaluate the effectiveness and safety of microneedling with PRP versus minoxidil (5%) + finasteride (0.1%) topical therapy in AGA.

Materials and Methods: This randomised controlled trial was done at Department of Dermatology, Venereology and Leprology (DVL), Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India, from November 2021 to November 2022. Total of 60 adult males clinically diagnosed with AGA were enrolled and randomised into group 1 and group 2. Subjects in group 1 were treated with microneedling+PRP and group 2 were advised minoxidil+finasteride topical therapy. Microneedling alongwith intradermal injection of autologous PRP was done every month for four consecutive months in group 1 (n=30) while 1 mL of minoxidil (5%)+finasteride (0.1%) lotion was advised to be applied over dry scalp twice daily for four months in group 2 (n=30) patients. Both groups were followed for next two months. Hair density was assessed by Hamilton Norwood Scale using photographic and dermoscopic images and patient’s self-assessment scores. Data assessment was done by Chi-square test. Statistical Package for the Social Sciences (SPSS) version 26.0 was used to analyse data and p-value for significance was established at <0.05.

Results: Patients in group 1 with mean age 27.9±4.15 years showed almost similar increase in hair density compared to group 2 with mean age 25.8±3.94 years, as assessed by patient assessment score, photography, dermoscopy, Hamilton Norwood scale at six months of study (p-value >0.05), however onset of action was quicker in group 1. Investigator assessment on improvement in hair density using Hamilton Norwood Scale at three months (p-value=0.920) and six months (p-value=0.995) showed that microneedling+PRP therapy is as effective as minoxidil+finasteride lotion since the difference between results of both groups was not statistically significant.

Conclusion: Microneedling and PRP although safe, effective and promising treatment modality in AGA is comparable to minoxidil+finasteride topical therapy.


Autologous, Density, Dermoscopic, Hair

The AGA is an hereditary, male hormone-dependent hair disorder manifesting as thinning of scalp hairs in a patterned distribution (1). While drug and non drug interventions such as low level light therapy, microneedling, PRP manages to improve density of hair, management of AGA should be aimed to stop the progressive nature of disease (2). AGA affects social and psychological well-being of young patients, usually beginning at the age of 20 years and affecting 50% of males by 50 years of age (3). Medical and surgical treatments available include minoxidil, finasteride, dutasteride, oral biotin, low level light therapy and hair transplantation surgery (4). Among them, only topical minoxidil and oral finasteride are the only Food and Drug Administration (FDA) approved treatment (4). These conventional modalities may not always be effective, slower in response, expensive, require long-term compliance and may be associated with unacceptable adverse effects (5),(6).

Microneedling first described by Orentreich in 1995 is a minimally invasive procedure, which creates percutaneous wounds thereby releasing various growth factors such as platelet-derived growth factor and vascular endothelial growth factor which aids in healing, improvise angiogenesis and arrest or partially alter the fibrotic changes (7). Previous research has demonstrated that microneedling potentiates therapeutic effects in hair loss disorders by promoting anagen-initiating Wnt/β-catenin signaling pathway and improvising hair stem cell proliferation present in dermal papillae (8),(9). PRP is an autologous concentrate of plasma and a rich source of various growth factors which enhances blood circulation to dermal papilla thereby preventing hair shedding and improving hair density in AGA (10). There is always a need for new, adjuvant and promising treatment in AGA which gives early patient satisfaction with fewer side effects.

Few studies done in past have evaluated the efficacy of microneedling with PRP for hair restoration (11),(12) and safety of PRP versus topical minoxidil+finasteride (13). Although microneedling, PRP, topical minoxidil+finasteride have been individually studied in management of AGA, there is no published literature comparing efficacy of microneedling with PRP versus minoxidil+finasteride topical therapy. Hence, the present study was undertaken. Thus, the study aimed to analyse the effectiveness and safety of microneedling with PRP versus minoxidil (5%)+finasteride (0.1%) topical therapy in AGA.

Material and Methods

This hospital-based, prospective, randomised, single-blinded clinical trial was conducted over a period of one year from November 2021 to November 2022 on 60 male patients clinically diagnosed with AGA attending DVL Outpatient Department (OPD), Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh, India. After approval of Institutional Ethical Committee study was started (IEC Number HIMS/IRB/2021-22/5177).

Inclusion criteria: All male patients aged 18-40 years presenting with patterned baldness grade 2-4, as per Hamilton Norwood scale (14) willing and consenting to participate in the study were enrolled.

Exclusion criteria: Patients with alopecia other than AGA, application of topical lotions like minoxidil, finasteride or any other with antiandrogenic properties during the last six months, uncontrolled systemic disorders like hypertension and diabetes, any history of bleeding diathesis, patients having erythema or swelling over the scalp, previous history of malignancy or any immunocompromised states were excluded.

Sample size calculation:

n=(Z1-α/2+Z1-β)2 {p1(1-p1)+p2(1-p2)}/ (p1-p2)2

Z1-α/2=1.96 at α=5%=0.05
Z1-β=0.84 at 80% of power
p1=88.2%=0.882 (15)
p2=47.4%=0.474 (15)

n=(1.96+0.84)2 [0.882 (1-0.882)+0.474 (1-0.474)]/ (0.882-0.474)2

n=22.28+4.456 (considering 20% dropout)
n=30 per group (after round-off)
So, total sample size is 60 patients.


A detailed medical history was taken for each patient which included duration of hair fall, history of any drugs intake, family history, history of any systemic disorder to exclude other causes of diffuse loss of hair. Smoking history was elicited since it can aggravate AGA. A thorough clinical examination was done and AGA was diagnosed. AGA grading as per the Hamilton Norwood scale, baseline clinical photography and dermoscopy (DermLite DL 4) was done in all patients.

Simple randomisation was done by odd and even number and enrolled patients were allotted in two different groups.

Group 1 (n=30): Participants were treated every month with intradermal injection of autologous PRP with microneedling for four months.

Group 2 (n=30): Participants were advised to apply 1 mL of minoxidil (5%)+finasteride (0.1%) lotion over scalp twice daily 12 hours apart for four months. Both groups were followed-up for next two months.

Group 1

The study participants in group 1 were investigated with complete blood picture, hepatic function tests, kidney function tests, thyroid profile, random blood sugar, bleeding time, clotting time, International normalised ratio, hepatitis B, hepatitis C, Enzyme-Linked Immunosorbent Assay for HIV I and II, Rapid Plasma Reagin test in dilution.

PRP preparation: PRP was prepared as per the method described by Singh SK et al., (15). Under aseptic precautions 18 mL of whole blood was obtained from the median cubital vein and mixed with 2 mL of 3.8% sodium citrate solution into an autoclaved Falcon tube. Centrifugation machine (Remi model R-8C) was used and 1st spin was done at 1500 revolutions per minute for 10 minutes. It separated the blood components into the following three layers, from bottom to top, containing red blood cell layer followed by PRP layer “buffy coat” and finally topmost acellular plasma layer, Platelet-Poor Plasma (PPP). Finnpipette was used to collect buffy coat with plasma into another Falcon tube and the collected plasma was spinned again at 3500 revolutions per minute for 10 minutes for 2nd spin. This procedure 2separated the platelets (PRP) at the bottom of the tube. The PPP which got collected at the upper two-third was discarded, and the remaining PRP (lower one-third) was filled in 1 mL Beckton Dickinson syringe which contained calcium gluconate mL (one part calcium gluconate 10% and nine parts of PRP) as an activator. At the end of the procedure, around 3-3.5 mL of PRP having platelet concentration of 3-4 folds higher when compared with whole blood was obtained. About 1 mL of PRP was processed to determine platelet concentrate by Mindray, auto haematology analyser, model: BC-5150 in the first ten participants for standardisation of procedure.

Microneedling+PRP application: Anaesthetic cream, EMLA (eutectic mixture of 2.5% lignocaine+2.5% prilocaine) was applied topically over the treated area of scalp (frontal, parietal and occipital) one hour prior to the procedure. A 70% alcohol was used to disinfect the treated area. A ring block was given at forehead by insulin syringe containing lignocaine hydrochloride 2%. Microneedling with dermapen (model no MYMM-17) at depth of 1.5 mm was done in vertical, horizontal, diagonal directions from frontal to occipital area 6-8 times until mild erythema was obtained. This activation was followed by intradermal injections of PRP 0.05 mL/cm2 from deeper to superficial layer in receding direction. Remaining PRP was massaged over the treated area to permeate through the epidermis by primary investigator. Similar sessions were done every month for four months.

Group 2

Group 2 patients were advised to apply 1 mL minoxidil (5%)+finasteride (0.1%) lotion twice daily over scalp, 12 hours apart for four months.

Vital signs and adverse events such as instant pain/discomfort, headache, swelling, increase in facial hairs, any allergic reactions observed by the subjects or noticed by the primary investigator were evaluated on follow-up visits in both groups.


The study participants were selected, enrolled and assessed by the parameters adopted by similar study done by Singh SK et al., (15). Both the groups were assessed on socio-demographic factors which included age, duration of hair fall, family history, smoking and grade of alopecia. Hair regrowth was assessed at 3 months intervals by primary investigator on Hamilton Norwood scale by clinical photography and dermoscopy. Photographic images were taken keeping placement, angulation, illumination, magnification fixed using SONY DSC TX -55 camera from frontal, occipital and lateral views of both sides.

Improvement in hair density was assessed by taking dermoscopic pictures at 1cm2 area from fixed site which was 10 cm above and 3 cm front measured from the upper end of right tragus. Area was fixed with stamp of 1×1 cm. Dermoscopic and photographic images were taken by independent observer.

Patients assessed their scalp hairs at 2nd month, 3rd month, 4th month and 6th month of follow-up (total 6 months of study) on hair growth assessment scale of 0-4 which signify the following:

• A0: No improvement
• A1: 1%-25% improvement
• A2: 26%-50% improvement
• A3: 51%-75% improvement
• A4: 76%-100% improvement

The flow chart of study is depicted in (Table/Fig 1).

Statistical Analysis

Data presentation was done using mean, standard deviation and percentage. Both groups comparison was done using Chi-square and Fisher’s-exact tests for qualitative variables and unpaired t-test for quantitative variables. Level of significance was established at p-value <0.05. Analysis of data was done by SPSS version 26.0 and advanced Excel.


The study population had mean age of 26.85±4.15 years. Positive family history in group 1 and 2 were seen in 18 (60%) and 11 (36.7%) participants respectively. Smoking history was present in 15 (50%) and 17 (56.7%) participants in group 1 and group 2. The most frequent baldness was grade 2 present in 32 (53.3%) patients followed by grade 3 present in 18 (30%) patients. Both groups were almost comparable in terms of clinicodemographic profile except for duration of hair fall as summarised in (Table/Fig 2). group 1 patients had longer duration of hair fall.

Effect of intervention was studied in both groups by patient self-assessment score as shown in (Table/Fig 3). The groups were comparable in terms of patient self-assessment score at 2nd month, 3rd month, 4th month and 6th month, respectively and difference was not statistically significant (p-value >0.05) however, patients in group 1 had attained early improvement in hair density.

Investigator assessment of hair density by Hamilton Norwood scale using clinical photographs and dermoscopic images is depicted in (Table/Fig 4),(Table/Fig 5).

It was observed that both treatment modalities were similarly effective in improving hair density on Hamilton Norwood scale at 3rd and 6th month, respectively and the difference between results of both groups was not statistically significant as shown in (Table/Fig 6).

Overall hair density as analysed by improvement in alopecia grading on Hamilton Norwood scale following 0-3 months and 0-6 months (intragroup analysis) increased significantly in both groups which showed that microneedling and PRP was similarly effective in improving hair density as compared with minoxidil+finasteride topical therapy. A significant increase in hair density after completion of treatment course was demonstrated in group 1 and group 2 with p-value=0.000002 and p-value=0.00002, respectively as depicted in (Table/Fig 7).

Various adverse effects were noted during the study period (Table/Fig 8). In group 1, 4 (13.3%) patients had instant pain/discomfort on day of procedure which was relieved by ice compression and paracetamol 500 mg. Out of them, 2 (6.7%) patients had swelling, and 1 (3.3%) patient had headache who refused to continue the study. In group 2, 2(6.7%) patients had instant pain/discomfort and 4 (13.3%) patients had increase in facial hairs which required reassurance. Among them, 2 (6.7%) patients had swelling, 2 (6.7%) patients had headache and 1 (3.3%) developed allergic reaction to minoxidil.


The AGA, the most common type of patterned baldness has a high prevalence rate among youth which may adversely affect their Quality of Life (QoL), since hair is an important aspect of one’s personality (16).

In the present era, microneedling and PRP is gaining popularity among dermatologists and patients however, there is general lack of controlled trials and no specific criteria have yet been established in regard to total numbers and the interval between sessions required to attain hair regrowth. Overall in the past 5 years, there are few publications favouring microneedling and PRP and this treatment is worth exploring (11),(12),(17).

Hair density was evaluated in the present study by primary investigator at three months intervals since it takes 90-100 days for new hair growth to become evident over scalp (18). This methodology was similarly adopted by Schiavone G et al., (19). In the present study, both treatments were well tolerated and equally effective in attaining hair regrowth but results in microneedling and PRP group was attained early. In similar study done by, Yepuri V et al., in 2021, PRP with microneedling was found to be effective treatment which augments the effect of conventional treatment (12). Jha AK et al., studied, 93 AGA patients which were randomised into three groups A (31 patients treated with minoxidil 5% lotion twice daily), B (31 patients advised twice a day application of minoxidil 5% topically and PRP), C (31 patients given minoxidil 5% topically twice a day along with PRP and microneedling). Effect of intervention was studied by baseline and post-treatment photographic and dermoscopic images, hair pull test, patient’s self-satisfaction score on Likert scale. Final observation post-treatment showed that hair pull test became negative in 27 (87.1%, p<0.01), 20 (64.5%, p<0.05) and 15 (48.4%) participants in groups C, B, A, respectively. Hair regrowth as analysed by photographic and dermoscopic images showed better outcome in group C (26/31) participants than group B (17/31) and group A (10/31) participants. The patient’s self-satisfaction score evaluated on Likert scale showed higher score in group C (24/31) and hence, the study concluded that PRP in adjuvant with microneedling was more effective than PRP or minoxidil monotherapy in AGA (17).

Shah et al., in 2017 evaluated 50 AGA patients aged 18-50 years with Hamilton Norwood scale (3-5) who were grouped into group A and B; group A (25 patients received minoxidil 5% topically and group B (25 patients treated with minoxidil 5% lotion, PRP and microneedling). At the end of study period of 6 months group B participants had significant improvement in both patient and investigator’s assessment than group A with p-value <0.05, thereby concluding that microneedling and PRP was safer, efficacious and encouraging modality of treatment in AGA (11).

Sharma HK et al., studied 60 AGA patients which were divided into-group A participants were treated with PRP therapy and group B were advised topical application of minoxidil plus finasteride therapy. Assessment was done by photography, standardised hair growth questionnaire and patient satisfaction score. The final assessment after 12 months of study period showed that PRP group had better result on investigator satisfaction scale score (p-value <0.001) and hence concluded that PRP acts as an adjunctive therapy in AGA (13).

Rai PB et al., found that topical minoxidil and finasteride had significantly improved the QoL and the assessment was done according to the male AGA QoL questionnaire (20).

To the best of our knowledge, no literature has been published comparing microneedling and PRP versus minoxidil+finasteride. The study concluded that microneedling and PRP although comparable with minoxidil+finasteride regime yielded early onset of action on patient and investigator assessment scale and should be offered to patients along with existing treatment modalities for faster hair regrowth and better patient compliance.


The limitations were small sample size and follow-up of patients for six months only. The duration of hairfall was not comparable between groups also limits the study. The study participants included only male gender hence results cannot be generalised to the entire population.


Both forms of therapies are equally effective in improving hair density in AGA. However, microneedling and PRP therapy had early improvement in hair regrowth and hence had a slight edge over minoxidil+finasteride lotion. This may require reconfirmation in future with more studies including larger sample size, done on more varied population and for longer period of time before it is used extensively.


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Kaufman KD, Rotonda J, Shah AK, Meehan AG. Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss). Eur J Dermatol. 2008;18(4):400-06.
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Sharma A, Surve R, Dhurat R, Sinclair R, Tan T, Zou Y, et al. microneedling improves minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. J Biol Regul Homeost Agents. 2020;34(2):659-61.
Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, Kang H. Repeated microneedle stimulation induces enhanced hair growth in a murine model. Ann Dermatol. 2016;28(5):586-92. [crossref] [PubMed]
Arshdeep, Kumaran MS. Platelet rich plasma in dermatology: Boon or a bane? Indian J Dermatol Venereol Leprol. 2014;80(1):05 14. [crossref] [PubMed]
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Sharma HK, Chauhan PS, Mehta KS, Mahajan V, Chandel M, Verma Y, et al. A study to compare the efficacy and safety of platelet rich plasma and topical minoxidil fortified with finasteride in the treatment of androgenic alopecia in male patients. IP Indian J Clin Exp Dermatol. 2022;8(2):91-96. [crossref]
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DOI and Others

DOI: 10.7860/JCDR/2023/62102.17569

Date of Submission: Dec 08, 2022
Date of Peer Review: Dec 29, 2022
Date of Acceptance: Jan 30, 2023
Date of Publishing: Mar 01, 2023

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

• Plagiarism X-checker: Dec 10, 2022
• Manual Googling: Jan 19, 2023
• iThenticate Software: Jan 28, 2023 (24%)

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