Increased Incidence of Telogen Effluvium Following Platelet-Rich Plasma Therapy in Patients with Elevated TNF-Alpha Expression: A Prospective Cohort Study

August 2025 in “ Research Square (Research Square) ”

Shabnam Feshangchian-Atashbar, Ali Akbar Ghamari, Sahel Jafarnejad-Komachali, Mahsa Azhdari, Alireza Shoae‐Hassani

telogen effluvium platelet-rich plasma TNF-α androgen receptors 5α-reductase DHT 5α-Reductase I 5α-Reductase II androgenetic alopecia PRP tumor necrosis factor alpha dihydrotestosterone

Studysummary This study observed that among male patients who experienced telogen effluvium after platelet-rich plasma treatment for androgenic alopecia, there were elevated levels of TNF-α, androgen receptors, and altered 5α-reductase gene expression, suggesting these factors as potential contributors to this unintended outcome. Our plain-language summary of this paper — not a Tressless recommendation.

This study examines the increased incidence of telogen effluvium (TE) following platelet-rich plasma (PRP) therapy in patients with elevated TNF-α expression, focusing on 50 patients divided into two groups. Group 1, consisting of 30 patients with TE, showed significantly higher levels of TNF-α, androgen receptors, and altered 5α-reductase gene expression compared to Group 2, which had 20 patients without TE. Elevated DHT concentrations and increased expression of 5α-Reductase I and II were observed in Group 1, suggesting these factors contribute to hair loss. The study highlights the importance of considering cytokine levels in PRP treatments for androgenetic alopecia (AGA) and suggests that elevated TNF-α is a critical risk factor for developing TE post-PRP therapy. Limitations include a small sample size and lack of a placebo control group, affecting the generalizability of the results.

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