Efficacy of Stromal Vascular Fraction Versus Topical Minoxidil in Treatment of Androgenetic Alopecia: A Simple Randomized Study

Abstract

Background: A hair loss form that affects both men and women is known as Androgenic alopecia (AGA). AGA results from a combination of hormonal imbalances and genetic predisposition. We aims to estimate the topical minoxidil versus stromal vascular fraction (SVF) efficiency in the AGA treatment. Adipocytes, smooth muscle cells, endothelial cells, blood cells, stem cells, and extracellular matrix are excluded from the SVF, which encompasses all cellular components of the adipose tissue. For both male and female patients with AGA, minoxidil topically is the first-line medication that has been revealed to be efficacious in a multitude of randomized double-blind and case-control studies.

Methods: This randomized study was performed on 70 Egyptian males and females cases, aged from 18 to 45 years old, with all androgenetic alopecia grades based on basic and specific classification. Two equal groups of patients were randomly assigned: Group A received SVF as single injection in the scalp frontal area under strict sterile conditions, with 0.1 ml/cm2 of SVF administered intradermally utilizing 30 G syringes. Group B was treated with minoxidil 5% topically twice daily for men and 2%minoxidil for women for a period of six months.

SVF preparation was done applying Coleman’s technique (2006) was utilized for fat grafting, First, Klein’s,(1996) The 6-month follow-up visit included a comprehensive evaluation. Digital and trichoscopic examinations of the scalp were conducted on all patients using the Dlite STR CA_USA.

Results: Regarding group (A), there was highly significant improvements at 6 months compared to baseline regarding hair shaft density, diameter and the T/V hair ratio (P <0.001).These findings highlight the SVF treatment efficacy in improving both objective hair parameters .Regarding group (B) there was highly significant improvements at 6 months compared to baseline regarding hair shaft density ,diameter and the T/V hair ratio (P <0.001).Regarding patient satisfaction , in patient satisfaction there was statistically significant difference (p = 0.011) between both groups .SVF may offer a more satisfactory treatment experience but there was insignificant improvement in hair shaft diameter, density, T/V hair ratio between both groups. Regarding improvement at six months, using SVF; A significant positive correlation was indicated between hair shaft diameter and hair shaft density (p = 0.023), the T/V ratio also correlates with Hair shaft diameter (p=0,009) and hair shaft density (p=0,013). using topical  minoxidil; hair shaft diameter shows a moderate positive correlation with hair shaft density (p=0,007), and the terminal to vellus hair ratio (T/V ratio) (p = 0.009). Hair shaft density also correlates with the T/V ratio (p =0.002). Additionally Gender does not significantly influence any outcomes in both groups, suggesting that SVF and topical minoxidil effects are consistent across genders.

Conclusion: The study shows that while both the SVF and Minoxidil treatments appear to beneficial over 6 months, there were insignificant differences between the two treatment groups regarding hair characteristics but SVF showed more satisfactory treatment experience, individual responses may vary.