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Regenerative medicine in the treatment of specific dermatologic disorders: a systematic review of randomized controlled clinical trials

Stem Cell Research & Therapy volume 15, Article number: 176 (2024) Cite this article

Abstract

Aims and objectives

The aim of this study is to systematically review randomized controlled clinical trials (RCTs) studying various types of regenerative medicine methods (such as platelet-rich plasma, stromal vascular fraction, cell therapy, conditioned media, etc.) in treating specific dermatologic diseases. Rejuvenation, scarring, wound healing, and other secondary conditions of skin damage were not investigated in this study.

Method

Major databases, including PubMed, Scopus, and Web of Science, were meticulously searched for RCTs up to January 2024, focusing on regenerative medicine interventions for specific dermatologic disorders (such as androgenetic alopecia, vitiligo, alopecia areata, etc.). Key data extracted encompassed participant characteristics and sample sizes, types of regenerative therapy, treatment efficacy, and adverse events.

Results

In this systematic review, 64 studies involving a total of 2888 patients were examined. Women constituted 44.8% of the study population, while men made up 55.2% of the participants, with an average age of 27.64 years. The most frequently studied skin diseases were androgenetic alopecia (AGA) (45.3%) and vitiligo (31.2%). The most common regenerative methods investigated for these diseases were PRP and the transplantation of autologous epidermal melanocyte/keratinocyte cells, respectively. Studies reported up to 68.4% improvement in AGA and up to 71% improvement in vitiligo. Other diseases included in the review were alopecia areata, melasma, lichen sclerosus et atrophicus (LSA), inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and dystrophic epidermolysis bullosa. Regenerative medicine was found to be an effective treatment option in all of these studies, along with other methods. The regenerative medicine techniques investigated in this study comprised the transplantation of autologous epidermal melanocyte/keratinocyte cells, isolated melanocyte transplantation, cell transplantation from hair follicle origins, melanocyte–keratinocyte suspension in PRP, conditioned media injection, a combination of PRP and basic fibroblast growth factor, intravenous injection of mesenchymal stem cells, concentrated growth factor, stromal vascular fraction (SVF), a combination of PRP and SVF, and preserving hair grafts in PRP.

Conclusion

Regenerative medicine holds promise as a treatment for specific dermatologic disorders. To validate our findings, it is recommended to conduct numerous clinical trials focusing on various skin conditions. In our study, we did not explore secondary skin lesions like scars or ulcers. Therefore, assessing the effectiveness of this treatment method for addressing these conditions would necessitate a separate study.

What is already known about this topic?

  • Regenerative medicine is an effective treatment method for managing inflammatory and degenerative diseases, including inflammatory skin diseases.

  • Regenerative medicine methods encompass therapeutic approaches such as PRP injection, SVF injection, use of conditioned medium, autologous melanocyte and keratinocyte cell transplantation, exosomes, utilization of mesenchymal stem cells, and a combination of the aforementioned methods.

  • So far, most studies on the role of regenerative medicine in dermatology have focused on rejuvenation, scar healing, and wound healing. However, there has been no systematic review of specific skin diseases.

What does this study add?

  • To date, clinical trial studies in the field of regenerative medicine for the treatment of specific dermatologic diseases such as androgenetic alopecia (AGA), vitiligo, alopecia areata, melasma, lichen sclerosus et atrophicus (LSA), inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and dystrophic epidermolysis bullosa have been conducted.

  • In relation to AGA, 86.2% of the studies have shown the effectiveness of various regenerative medicine methods in treating the disease. This rate is 100% for vitiligo, 83.3% for alopecia areata, 100% for melasma, 50% for LSA, 100% for acne vulgaris, 100% for chronic telogen effluvium, 100% for erosive oral lichen planus, and 100% for dystrophic epidermolysis bullosa.

  • The most common diseases associated with the use of regenerative medicine in their treatment include androgenetic alopecia and vitiligo. The most common methods in AGA include PRP, Conditioned Media, and a Combination of PRP and Basic Fibroblast Growth Factor (bFGF), respectively. Regenerative medicine has been effective in treating AGA up to 68.4% in studies.

  • In the case of vitiligo, the most common methods are Transplantation of autologous epidermal melanocyte/keratinocyte cells, isolated melanocyte transplantation, and Cell transplantation from hair follicle origins, with the treatment showing effectiveness up to 71% in studies for this disease.

Introduction

Regenerative medicine is a crucial field of medicine known for its effectiveness in treating numerous inflammatory and degenerative diseases. This treatment approach encompasses various methods such as platelet-rich plasma (PRP), stromal vascular fraction (SVF), conditioned media, and the transplantation of autologous epidermal melanocyte/keratinocyte cells [1,2,3].

These methods, through multiple pathways, ultimately lead to a singular result, which is the reversal of the inflammatory and degeneration processes by releasing cell factors and cytokines as well as promoting the proliferation of stem cells. For instance, the PRP injection method aims to release factors from concentrated platelets, whereas in the SVF injection, stem cells and factors derived from adipocyte cells stimulate cell regeneration [4, 5].

These treatments have been extensively investigated for a wide range of skin diseases, which can be categorized into two main groups: primary skin diseases, including androgenetic alopecia [6, 7], vitiligo [8, 9], alopecia areata [10], telogen effluvium [11], melasma [12], acne vulgaris [13], lichen sclerosus et atrophicus (LSA) [14], erosive oral lichen planus [15, 16], and dystrophic epidermolysis bullosa [17]; and skin conditions secondary to damage such as acne scars, hypertrophic scars from burns, erosions, and ulcers [18].

In our study, we conducted a systematic review of all regenerative medicine treatment methods for primary skin diseases. Specifically, we focused on randomized controlled clinical trials to assess recovery rates, side effects, and intervention protocols. We meticulously analyzed each treatment method to provide a comprehensive summary of their efficacy in managing various skin conditions.

Method and materials

Search strategy and databases

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A meticulous literature review was performed to identify relevant keywords for different types of regenerative medicine, including fat transfer, stem cell therapy, SVF, PRP, platelet-poor plasma, and melanocyte–keratinocyte transplantation, among others. The dermatological conditions encompassed Lichen Planopilaris, Frontal Fibrosing Alopecia, Androgenetic Alopecia, other forms of Alopecia (Areata, Telogen Effluvium, Anagen Effluvium), Cicatricial and Non-Cicatricial Alopecia, Discoid Lupus Erythematosus, Psoriasis, Hidradenitis Suppurativa, Morphea, LSA, and also a broader category of dermatological diseases including Granulomatous Disease, Vasculitis, Inflammatory Skin and Cutaneous Diseases, Pyoderma Gangrenosum, Inflammatory Dermatoses, Genodermatoses, Adverse Drug Reactions, Toxic Epidermal Necrolysis, Stevens-Johnson Syndrome, Papulosquamous Disorders, Vitiligo, Pigmentary Disorders, Immunobullous Diseases (Pemphigus Vulgaris, Bullous Pemphigoid), Epidermolysis Bullosa, melanocytic and non-melanocytic Skin Cancers (Basal Cell Carcinoma, Squamous Cell Carcinoma), Ulcerative, Anogenital, and Nail Disorders, Collagen Vascular Disease, Acne, and Melasma. To refine the specificity of retrieved studies, keywords pertaining to randomized clinical trials were also integrated. Furthermore, a meticulous examination of the references within selected articles was conducted to encompass all relevant research. The search spanned studies published up to January 3, 2024. The detailed syntaxes utilized across different databases are delineated in Table 1.

Table 1 Search syntax across databases
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Inclusion and exclusion criteria

The inclusion criteria were specifically designed to include RCTs that investigate the effectiveness of regenerative medicine interventions for treating dermatological disorders. The exclusion criteria targeted studies that deviated from the RCT design, such as non-randomized trials, review articles, studies focusing on secondary skin lesions (e.g., scars, ulcers), and interventions not categorized under regenerative medicine (e.g., topical treatments, traditional pharmacotherapy). Additionally, non-human research (including animal models and in vitro studies), experimental studies, and trials lacking definitive outcome measures were excluded. Articles not written in English or those without accessible full texts were also omitted.

Study selection and data extraction

Two evaluators [A.J. and H.K] reviewed the titles and abstracts of identified records based on the predefined inclusion criteria. They assessed each study for various attributes, including the study design, the dermatological condition being assessed, the type of regenerative therapy, the treatment regimen, observed improvements, and reported adverse events. Details such as average age, gender distribution, and the number of participants were also collected from these studies. To facilitate the article screening and data extraction processes, EndNote® X8 and Google Sheets™ were employed. This screening and data compilation were carried out independently by two investigators, with any discrepancies being adjudicated by consulting a senior researcher [A.G.].

Result

In our initial search, we obtained 458 articles. Based on the inclusion and exclusion criteria, we selected 65 articles to extract the final data. The screening steps are shown in the PRISMA chart (Fig. 1). The data extracted from the selected studies are presented in Table 2.

Fig. 1
figure 1

PRISMA chart of studied articles

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Table 2 Characteristics of included studies
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In a total of 64 studies, 2888 patients with dermatologic diseases were examined. Among them, 1086 were women (44.8%) and 1339 were men (55.2%). However, in 12 studies (18.2% of the studies involving 463 patients), the separation of gender was not conducted.

Out of the 64 studies, the average age of the participants was reported in 49 studies, with the average age of the patients being 27.46 years. All 64 studies were randomized controlled trials (RCTs). Among the 64 studies, 29 studies (45.3%) focused on androgenetic alopecia (AGA), 20 studies (31.2%) on vitiligo, 6 studies (9.3%) on alopecia areata, 3 studies (4.7%) on melasma, 2 studies (3.1%) on lichen sclerosis et atrophicus (LSA), and 1 study (each) on inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and dystrophic epidermolysis bullosa.

Among the 64 studies conducted, there were a total of 149 intervention groups, with 102 groups treated using regenerative medicine methods. The following information provides the number and percentage of utilization for each regenerative medicine method:

  • Platelet-rich plasma (PRP) injection in 57 groups (55.9%).

  • Transplantation of autologous epidermal melanocyte/keratinocyte cells in 19 groups (18.6%).

  • Isolated melanocyte transplantation in 6 groups (5.9%).

  • Cell transplantation with hair follicle origin in 5 groups (5%).

  • Melanocyte–keratinocyte suspension in PRP in 2 groups (1.9%).

  • Conditioned media injection in 2 groups (1.9%).

  • Combination of PRP and Basic fibroblast growth factor (bFGF) in 2 groups (1.9%).

  • Intra venous injection of mesenchymal stem cells in 2 groups (1.9%).

  • Concentrated growth factor (CGF) in 1 group (1%).

  • Stromal vascular fraction (SVF) in 1 group (1%).

  • Combination of PRP and SVF in 1 group (1%).

  • Preserving hair grafts in PRP in 1 group (1%).

  • Topical use of umbilical cord as a source of mesenchymal stem cells in 1 group (1%).

  • Adipose-derived stem cell constituents extract in 1 group (1%).

  • Combined cell transplantation with epidermal and hair follicle origin in 1 group (1%).

Adverse events were reported in 29 studies (45.3%), with the most common side effect being pain during the procedure. All side effects mentioned in the studies were mild, and no serious or life-threatening side effects were reported.

Androgenetic alopecia (AGA)

Of the 2888 patients included in the study, 1190 patients (41.2%) were diagnosed with AGA and received interventions. The most commonly used regenerative medicine method in this group was PRP, which was utilized in 36 intervention groups (from 23 studies). Among 23 studies, significant effectiveness of PRP compared to the control group has been proven in 19 studies, with no significant difference reported in the remaining 4 studies.

Additionally, the combination of PRP and Basic Fibroblast Growth Factor (bFGF), as well as Conditioned Media, were used in two intervention groups each (2 studies on conditioned media and one study on the combination of PRP and bFGF). Concentrated Growth Factor (CGF), Adipose-Derived Stem Cell constituents’ extract, and preserving hair grafts in PRP were each studied in one group and one study.

PRP

In several studies, the effectiveness of PRP in treating AGA has been reported. Monthly intradermal injections of PRP for three months, on average, resulted in an increase of 33.6 hairs in the treated area, while the placebo area experienced a decrease of 3.2 hairs. The PRP-treated group showed a significant difference in hair density compared to the placebo group, with an increase of 45.9 hairs per square centimeter versus a decrease of 3.8 hairs per square centimeter. Moreover, the density of terminal hairs increased by 40.1 hairs per square centimeter in the PRP-treated group, which was significantly different from the control group. However, there was no significant difference in the density of vellus hairs compared to the placebo group [2].

In another similar study, PRP injections at one-month intervals for three months improved average hair density by 71.1 hairs per square centimeter in the PRP-injected area, while the placebo group experienced a decrease of 26.7 hairs per square centimeter. By the end of the eighth week, the PRP-treated group showed a density improvement of 105.9 hairs per square centimeter, contrasting with a reduction of 52.4 hairs per square centimeter in the placebo group. This difference remained significant between the two groups [5].

In another study, the effectiveness of three monthly PRP injections was compared to a placebo. The results confirmed a significant improvement in anagen hair (67.6 ± 13.1), telogen hair (32.4 ± 13.1), and hair density (179.9 ± 62.7). Additionally, there was an improvement in the density of terminal hair, which was found to be 165.8 ± 56.8 [19]. Treatment with PRP for four sessions at three-week intervals led to a significant improvement in hair density during weeks 12 and 24 following the treatment. It is noteworthy to mention that in the placebo group, a significant difference in hair density compared to the intervention was only observed during week 24 [20].

In a study where patients underwent five sessions of PRP treatment within eight weeks and were evaluated eight weeks after the last treatment session, the intervention group showed an average hair density increase of 12.76%, while the placebo group reported a hair density increase of only 0.99%. This significant difference between the two groups indicates the effectiveness of the intervention. However, it is worth noting that hair caliber decreased in both groups [21]. Additionally, in other studies, significant effectiveness of PRP has been demonstrated compared to control groups and standard treatments [22,23,24,25,26,27,28,29,30,31,32,33,34,35] (Table 2).

However, it is important to note that in several studies, no significant response has been reported after PRP treatment. For example, PRP injection twice with a one-month interval did not cause significant differences compared to the placebo group [36]. Similarly, injections with intervals of one month for three sessions led to improvement in hair density, but did not show a significant difference compared to the placebo group [37]. These results have been repeated in other studies where PRP injection, while controlling hair loss and increasing hair thickness and regrowth in some patients, did not cause a significant difference compared to the placebo group [38].

Another similar study, in which patients underwent five sessions of PRP with a 4–6 week interval and were evaluated one month and six months later, showed no significant difference in the number of hairs, hair diameter, and patient satisfaction between the intervention and control groups [39].

Combination of PRP and basic fibroblast growth factor (bFGF)

In the single study examining the use of both PRP and basic fibroblast growth factor (bFGF) in treating AGA, the findings demonstrated a notable enhancement in the group that received this combination alongside 5% topical minoxidil, in contrast to the group that only received the PRP and bFGF combination. Moreover, there was a significant improvement seen in the group treated with the PRP and bFGF combination compared to the group solely using 5% topical minoxidil. The average increase in hair count was approximately 31.28 hairs in the PRP group, 11.32 hairs in the minoxidil group, and 41.96 hairs in the combined therapy group (p < 0.05) [40].

Conditioned media

In both studies investigating the use of adipose-derived mesenchymal stem cell-conditioned medium in AGA treatment, a significant improvement has been demonstrated compared to the control group in terms of the percentage increase in Hair Count (184.9%), Hair Density (185.0%), Terminal rate (43.4%), Mean thickness (50.0%), and Total follicular units (104.3%). The studies also showed the highest decline in Vellus rate (− 56.0%) [6, 41].

Adipose-derived stem cell constituents’ extract

In the only study investigating the effectiveness of adipose-derived stem cell constituents extract (ADSC-CE) in the treatment of AGA, a significant improvement in hair count, hair density in the 8th week of treatment, and hair diameter in the 16th week was reported compared to the control group. A 19.2% increase in hair count and a 21% increase in hair density, contrasting with the control group, were observed [42].

Concentrated growth factor (CGF)

In the only study investigating the effectiveness of concentrated growth factor (CGF) in the treatment of AGA, the results showed a significant improvement in hair density, the ratio of terminal hairs to vellus, and the amount of hair growth compared to the control group. Furthermore, the satisfaction level of patients in the group receiving the combination of minoxidil and CGF was reported as 75% [43].

Preserving hair grafts in PRP

In the only study investigating the preservation of hair grafts using PRP to enhance hair transplantation results, the findings showed a substantial increase in hair density within the PRP group compared to the control group over a 6-month period. All patients demonstrated over 75% hair growth [44].

Vitiligo

Out of the 2888 patients included in the study, 1087 patients (37.6%) were diagnosed with vitiligo and underwent interventions. The most commonly used regenerative medicine method in this group was the transplantation of autologous epidermal melanocyte/keratinocyte cells, which was employed in 19 intervention groups from 13 studies. In all 13 studies investigating the transplantation of autologous epidermal melanocyte/keratinocyte cells, a significant improvement in clinical response was reported.

Subsequently, PRP was utilized in 8 intervention groups across 4 studies. Isolated melanocyte transplantation was employed in 6 intervention groups across two studies. Cell transplantation originating from hair follicles was utilized in 5 intervention groups across 3 studies (including 2 joint studies with the transplantation of autologous epidermal melanocyte/keratinocyte cells). Melanocyte–keratinocyte suspension in PRP was employed in 2 intervention groups across 2 studies (both studies were conducted in conjunction with the transplantation of autologous epidermal melanocyte/keratinocyte cells). Lastly, combined cell transplantation with both epidermal and hair follicle origins was utilized in a single intervention group in a study (a joint study with the transplantation of autologous epidermal melanocyte/keratinocyte cells).

Transplantation of autologous epidermal melanocyte/keratinocyte cells

In a study comparing cell transplantation from grafts with a size of 1/3 of the recipient area, with a cell count of 231.60 ± 27.03 melanocytes per square millimeter, to grafts with a size of 1/5 of the recipient area, with a cell count of 154.90 ± 27.65, the amount of repigmentation and color match in the first group were significantly better than in the second group. However, the time of the onset of repigmentation was not significantly different between the two groups [3].

In a study comparing two methods of suspending autologous epidermal melanocyte/keratinocyte cells and grafting through suction blister, both groups demonstrated significant improvement. However, the transplantation through suspension showed a more remarkable improvement compared to the suction blister group (p = 0.002). An excellent response was observed in 71% of lesions in the epidermal melanocyte/keratinocyte group, while only 27% of the lesions in the suction blister group exhibited such a response [8].

Regarding the preparation of the recipient site of autologous epidermal melanocyte/keratinocyte cells, site preparation with Erbium YAG laser has resulted in 54.7% repigmentation, while preparation with motorized dermabrasion has led to 48.8% repigmentation; both methods show significant improvement. However, no significant difference was observed between the two groups [45].

Also, in the comparison of the preparation of the receptor site between fractional CO2 and full surface CO2 methods, excellent repigmentation was observed in 40% and 35% of patients, respectively. Despite the significant improvement in both groups, no significant difference has been noted between the two groups [46]. Furthermore, in the comparison of the two methods of dermabrasion and microneedling at the transplant site, both methods have shown effectiveness. However, dermabrasion has demonstrated significant improvement compared to microneedling [47].

The results of other investigated studies have also confirmed the significant effectiveness of transplantation of autologous epidermal melanocyte/keratinocyte cells compared to the control group and those receiving standard treatment [48,49,50,51,52,53,54,55] (Table 2).

PRP

In all four studies investigating the effectiveness of PRP in treating vitiligo, significant improvement has been observed. In one study, the combination of excimer laser and PRP resulted in a significant improvement compared to each method alone. Additionally, in this study, excimer laser was significantly more effective than PRP in healing lesions [56]. In another similar study, the combination of excimer laser and PRP was significantly more effective than excimer laser alone [57].

In a study comparing PRP, fractional CO2 laser, the combination of these two methods, the combination of fractional CO2 laser and UVB, and the combination of PRP, fractional CO2 laser, and UVB in the treatment of vitiligo, the results showed a significant difference in the rate of recovery in all aforementioned groups compared to the control group. However, there was no significant difference between the intervention groups [58].

In a study comparing fractional CO2 laser and PRP, the combination of the two, and the combination of fractional CO2 laser and UVB in the treatment of vitiligo, the results demonstrated the superiority of the combination of fractional CO2 laser and PRP, followed by the combination of fractional CO2 laser and UVB, and finally fractional CO2 laser and PRP individually. These differences were found to be significant [59].

Isolated melanocyte transplantation

In both studies investigating isolated melanocyte transplantation for the treatment of vitiligo, significant improvements were observed in the lesions.

In one study, melanocyte suspension in the individual’s own serum was compared with melanocyte suspension in normal saline for the treatment of vitiligo. The results showed a significant improvement in both methods, with the first group showing a significantly greater improvement than the second group [60].

In another study evaluating melanocyte transplantation for the treatment of vitiligo, patients were divided into four groups. The first group received melanocyte transplantation and underwent 20 sessions of UVB before transplantation. The second group underwent transplantation and received 30 sessions of UVB after transplantation. The third group received 20 sessions of UVB before transplantation and 30 sessions of UVB after transplantation. The fourth group only underwent transplantation.

The results demonstrated a significant improvement in groups 1 to 3 compared to group 4. Additionally, there was a significant improvement in group 3 compared to groups 1 and 2. However, there was no significant difference in the amount of improvement between groups 1 and 2 [61].

Cell transplantation originating from hair follicles

In all three studies investigating the effectiveness of cell transplantation with hair follicle origin for the treatment of vitiligo, significant improvement has been observed in the lesions.

In a study examining three methods for cell transplantation with hair follicle origin in vitiligo treatment—using trypsin and collagenase, using trypsin alone, and using dermabrasion alone—the results showed a significant improvement in the first method compared to the third method. However, no significant difference was observed between the first and second methods, as well as between the second and third methods [62].

In two studies comparing cell transplantation with hair follicle origin and autologous epidermal melanocyte/keratinocyte cell transplantation for improving vitiligo lesions, both methods resulted in significant improvement. However, there was no significant difference in the degree of improvement between the two methods [53, 54].

Melanocyte–keratinocyte suspension in PRP

In two studies comparing the transplantation methods of Melanocyte–keratinocyte suspension in PRP and the usual melanocyte/keratinocyte suspension, both methods demonstrated significant improvement. In one study, there was a significant improvement reported in the Melanocyte–keratinocyte suspension in PRP method compared to the usual melanocyte/keratinocyte suspension [50], while the second study reported no significant difference between the two groups [51].

Combined cell transplantation with both epidermal and hair follicle origins

In a study comparing the combination of two methods—transplantation of autologous epidermal melanocyte/keratinocyte cells and cell transplantation with hair follicle origin—with transplantation of autologous epidermal melanocyte/keratinocyte cells alone, the results showed a significant increase in repigmentation amount, speed, and color match in the first group compared to the second group [52].

Alopecia areata

Out of the 2888 patients included in the study, 332 patients (15.9%) were diagnosed with alopecia areata and received interventions. The most commonly utilized regenerative medicine method in this group was PRP, which was used in all seven intervention groups across six studies.

Out of the six studies examining PRP in the treatment of alopecia areata, five studies reported a significant improvement with it, while one study indicated no significant difference in the amount of improvement compared to the control group.

PRP

In three studies comparing PRP and triamcinolone acetonide injection for healing lesions, both methods showed significant improvement. However, in two studies, triamcinolone demonstrated greater improvement compared to PRP [63, 64], while in one study, PRP showed significant improvement compared to triamcinolone [65].

In a study comparing three methods of PRP, including PRP injection, the combination of fractional CO2 laser and PRP, and the combination of PRP and microneedling for lesion healing, all three methods demonstrated significant improvement, without any notable differences among them [66].

Furthermore, in a study comparing PRP and topical minoxidil 5% for the treatment of alopecia areata, both groups exhibited significant improvement, with PRP showing a significantly faster response in the beginning of hair regrowth [67].

Also, in a study that compared 3 sessions of PRP injections with a one-month interval to normal saline injections for the treatment of alopecia areata, the results showed a decrease in the severity of the disease by 9.05% in the PRP group and 4.99% in the normal saline group. There was no significant difference [10].

Melasma

Out of the 2888 patients included in the study, 90 patients (3.1%) were diagnosed with melasma and received interventions. The most commonly utilized regenerative medicine method in this group was PRP, which was used in two intervention groups across two studies. Additionally, the topical use of umbilical cord as a source of mesenchymal stem cells has been evaluated in an intervention group through a study.

PRP

In both studies investigating the effectiveness of PRP in improving melasma, the results showed a significant difference in the improvement rate compared to the control group. In the first study, the changes in the mean melanin level and mean mMASI score in the group receiving PRP for 4 sessions with a 2-week interval were significantly higher than those in the group receiving normal saline [68]. In the second study, the results indicated a good response in 53.3% of patients receiving the combination of hydroquinone and PRP compared to 27% of patients receiving hydroquinone alone, and this difference was statistically significant [12].

Topical use of umbilical cord as a source of mesenchymal stem cells

In the only study that used umbilical cord as a skin mask rich in mesenchymal stem cells, the results demonstrated a significant improvement compared to the control group. The MASI score showed a decrease of 4.23 points in the intervention group and a decrease of 0.16 points in the control group, and this difference was statistically significant [69].

Lichen sclerosis et atrophicus (LSA)

Of the 2888 patients participating in the study, 69 patients (2.4%) were diagnosed with LSA and received interventions. Among the studies, PRP was investigated as an intervention in one study, and PRP and SVF were investigated as interventions in another study.

PRP

The only study examining PRP in the treatment of LSA found no significant improvement in the intervention group compared to the control group. The changes in the clinical scoring system for vulvar lichen sclerosus (CSS) in the group receiving PRP were -7.74, while in the placebo group they were -9.44. These changes were not significant between the two groups [14].

SVF

In a study comparing the combination of SVF and PRP to SVF alone, both methods were found to be significantly effective in healing lesions, but no significant difference was observed between the two groups [70].

Inflammatory acne vulgaris

Out of the 2888 patients included in the study, 30 patients (1%) were diagnosed with inflammatory acne and received interventions. The only modality investigated in this group was PRP injection.

PRP

The only study conducted on regenerative medicine in the treatment of inflammatory acne focused on comparing PRP and Long Pulsed Nd YAG Laser. The results showed significant effectiveness of both methods in reducing active acne lesions. However, no significant difference was observed in the healing of lesions between the two groups. In the group treated with PRP, a 58.77% reduction in the number of inflammatory acne lesions was seen [13].

Chronic telogen effluvium

Out of the 2888 patients included in the study, 30 patients (1%) were diagnosed with chronic telogen effluvium and received interventions. The only modality investigated in this group was PRP injection.

PRP

The only study conducted on regenerative medicine in the treatment of chronic telogen effluvium focused on comparing two methods of PRP (platelet-rich plasma) preparation. The first method involved preparing PRP using a centrifuge at 3500 rpm for 10 min, while the second method utilized a centrifuge at 1000 rpm for 10 min.

The results demonstrated the significant effectiveness of both methods in controlling hair loss, increasing hair density and thickness, as well as improving patient satisfaction. However, no significant difference was observed between the two groups [11].

Erosive oral lichen planus

Out of the 2888 patients included in the study, 20 patients (0.7%) were diagnosed with erosive oral lichen planus and received interventions. The only modality investigated in this group was PRP injection.

PRP

The only study conducted to investigate regenerative medicine in the treatment of erosive oral lichen planus focused on comparing PRP and triamcinolone injection. The results indicated the significant effectiveness of both methods in healing the lesions, and no significant difference was observed between the two groups [15].

Dystrophic epidermolysis bullosa

Out of the 2888 patients included in the study, 14 patients (0.5%) were diagnosed with dystrophic epidermolysis bullosa and received interventions. The only modality investigated in this group was intravenous injection of mesenchymal stem cells.

Intra venous injection of mesenchymal stem cells

The only study conducted to investigate regenerative medicine in the treatment of dystrophic epidermolysis bullosa focused on comparing intravenous injection of mesenchymal stem cells with a combination of intravenous injection of mesenchymal stem cells and cyclosporine suspension. The results indicated the significant effectiveness of both methods in decreasing the number of new blisters and promoting the healing rate of new blisters, with no significant difference observed between the two groups [17].

Discussion

Regenerative medicine has emerged as a promising field in dermatology, offering innovative therapeutic approaches for various skin conditions. One of the key techniques utilized in regenerative medicine is platelet-rich plasma (PRP) injections, which have shown positive results in the treatment of conditions such as hair loss, pigment disorders, and inflammatory skin conditions. One potential way PRP aids in healing inflammatory skin lesions is by releasing a variety of growth factors, such as platelet-derived growth factor (PDGF) and TGF-β, from alpha platelet granules. This increase in TGF-β levels can then trigger negative feedback within the signaling pathways involved in inflammation [1].

In the realm of hair loss, particularly androgenetic alopecia (AGA), PRP injections have been extensively studied [5, 20, 22]. Research suggests that PRP injections, especially when administered using the double spin method, can lead to increased hair growth and density, particularly of terminal hairs [25]. Additionally, combining PRP with growth factors such as basic fibroblast growth factor or Concentrated Growth Factor (CGF) has shown enhanced efficacy in promoting hair regrowth [40, 43].

For pigmentary disorders like vitiligo, regenerative methods such as autologous epidermal melanocyte/keratinocyte cell transplantation have shown promising results [48,49,50,51,52,53,54,55]. Studies indicate that transplantation of these cells can effectively repigment the affected areas, with techniques like Erbium YAG laser or motorized dermabrasion enhancing the outcomes [45]. Moreover, the combination of different regenerative methods, such as melanocyte transplantation and hair follicle origin transplantation, has demonstrated significant improvements in repigmentation outcomes [52].

In other dermatologic conditions like melasma, regenerative approaches using PRP have yielded positive results. Studies have shown that PRP treatments can lead to significant improvements in skin pigmentation compared to traditional treatments like hydroquinone [12, 68]. Furthermore, the use of alternative sources of mesenchymal stem cells, such as umbilical cord-derived cells, has shown promising effects in treating melasma [69].

Notably, regenerative techniques like adipose-derived stem cell treatments and PRP injections have also shown potential benefits in addressing skin disorders like lichen sclerosis et atrophicus (LSA), inflammatory acne vulgaris, chronic telogen effluvium, erosive oral lichen planus, and alopecia areata. Studies have demonstrated the effectiveness of these methods in controlling symptoms, promoting hair growth, and improving patient satisfaction [11, 13, 14, 17, 67, 70].

Overall, regenerative medicine presents a wide array of therapeutic options for dermatologic conditions, with ongoing research focusing on optimizing treatment protocols and enhancing patient outcomes in the field of dermatology.

Conclusion

Regenerative medicine, as a new branch of medical science, plays an effective role in treating degenerative skin diseases. While this treatment is effective, it has not been associated with serious side effects for patients. Our conclusion in this systematic review study was limited to primary skin diseases, and secondary conditions such as burn scars, acne scars, diabetic wounds, etc., were not investigated. One limitation of our study was the limited access to the complete texts of certain articles. Additionally, our focus was solely on RCTs in this research, and we excluded both case reports and case series from our analysis. It is recommended to conduct more clinical trial studies to explore further the role of regenerative medicine in treating skin diseases.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Jafarzadeh A, PourMohammad A, Goodarzi A. A systematic review of the efficacy, safety and satisfaction of regenerative medicine treatments, including platelet-rich plasma, stromal vascular fraction and stem cell-conditioned medium for hypertrophic scars and keloids. Int Wound J. 2024;21(4):e14557. https://doi.org/10.1111/iwj.14557.

    Article  PubMed  Google Scholar 

  2. Gentile P, Garcovich S, Bielli A, Scioli MG, Orlandi A, Cervelli V. The effect of platelet-rich plasma in hair regrowth: a randomized placebo-controlled trial. Stem Cells Transl Med. 2015;4(11):1317–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Tegta GR, Parsad D, Majumdar S, Kumar B. Efficacy of autologous transplantation of noncultured epidermal suspension in two different dilutions in the treatment of vitiligo. Int J Dermatol. 2006;45(2):106–10.

    Article  PubMed  Google Scholar 

  4. Roohaninasab M, Khodadad F, Sadeghzadeh-Bazargan A, Atefi N, Zare S, Jafarzadeh A, et al. Efficacy of fractional CO(2) laser in combination with stromal vascular fraction (SVF) compared with fractional CO(2) laser alone in the treatment of burn scars: a randomized controlled clinical trial. Stem Cell Res Ther. 2023;14(1):269.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Dubin DP, Lin MJ, Leight HM, Farberg AS, Torbeck RL, Burton WB, et al. The effect of platelet-rich plasma on female androgenetic alopecia: a randomized controlled trial. J Am Acad Dermatol. 2020;83(5):1294–7.

    Article  CAS  PubMed  Google Scholar 

  6. Lee YI, Kim J, Kim J, Park S, Lee JH. The effect of conditioned media from human adipocyte-derived mesenchymal stem cells on androgenetic alopecia after nonablative fractional laser treatment. Dermatol Surg. 2020;46(12):1698–704.

    Article  CAS  PubMed  Google Scholar 

  7. Sadeghzadeh Bazargan A, Tavana Z, Dehghani A, Jafarzadeh A, Tabavar A, Alavi Rad E, et al. The efficacy of the combination of topical minoxidil and oral spironolactone compared with the combination of topical minoxidil and oral finasteride in women with androgenic alopecia, female and male hair loss patterns: a blinded randomized clinical trial. J Cosmet Dermatol. 2024;23(2):543–51.

    Article  PubMed  Google Scholar 

  8. Budania A, Parsad D, Kanwar A, Dogra S. Comparison between autologous noncultured epidermal cell suspension and suction blister epidermal grafting in stable vitiligo: a randomized study. Br J Dermatol. 2012;167(6):1295–301.

    Article  CAS  PubMed  Google Scholar 

  9. Jafarzadeh A, Pour Mohammad A, Khosravi M, Amiri S, Rasouli A, Keramati H, et al. A systematic review of case series and clinical trials investigating systemic oral or injectable therapies for the treatment of vitiligo. Skin Res Technol. 2024;30(3):e13642.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gupta V, Parihar AS, Sharma VK, Jain S, Singh V, Khanna N. Evaluation of platelet-rich plasma on hair regrowth and lesional T-cell cytokine expression in alopecia areata: a randomized observer-blinded, placebo-controlled, split-head pilot study. J Am Acad Dermatol. 2021;84(5):1321–8.

    Article  CAS  PubMed  Google Scholar 

  11. El-Dawla RE, Abdelhaleem M, Abdelhamed A. Evaluation of the safety and efficacy of platelet-rich plasma in the treatment of female patients with chronic telogen effluvium: a randomised, controlled, double-blind, pilot clinical trial. Indian J Dermatol Venereol Leprol. 2023;89(2):195–203.

    Article  PubMed  Google Scholar 

  12. Bikash C, Sarkar R, Relhan V, Singh S. Role of platelet-rich plasma therapy as an adjuvant in treatment of melasma. Dermatol Surg. 2022;48(4):429–34.

    Article  CAS  PubMed  Google Scholar 

  13. Moftah NH, Mansour AM, Ibrahim SMA. Clinical evaluation of efficacy of intralesional platelet-rich plasma injection versus 1064 nm long-pulsed Neodymium: YAG laser in the treatment of inflammatory acne vulgaris in adolescent and post-adolescent patients: a prospective randomized split-face comparative study. Lasers Med Sci. 2022;37(5):2471–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Goldstein AT, Mitchell L, Govind V, Heller D. A randomized double-blind placebo-controlled trial of autologous platelet-rich plasma intradermal injections for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol. 2019;80(6):1788–9.

    Article  PubMed  Google Scholar 

  15. Hijazi A, Ahmed W, Gaafar S. Efficacy of intralesional injections of platelet-rich plasma in patients with oral lichen planus: a pilot randomized clinical trial. Clin Exp Dent Res. 2022;8(3):707–14.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bazargan AS, Jafarzadeh A, Nobari NN. Successful treatment of resistant plantar ulcerative lichen planus with tofacitinib: a case report and comprehensive review of the literature. Clin Case Rep. 2023;11(10):e8066.

    Article  PubMed  PubMed Central  Google Scholar 

  17. El-Darouti M, Fawzy M, Amin I, Abdel Hay R, Hegazy R, Gabr H, et al. Treatment of dystrophic epidermolysis bullosa with bone marrow non-hematopoeitic stem cells: a randomized controlled trial. Dermatol Ther. 2016;29(2):96–100.

    Article  PubMed  Google Scholar 

  18. Kivi MK, Jafarzadeh A, Hosseini-Baharanchi FS, Salehi S, Goodarzi A. The efficacy, satisfaction, and safety of carbon dioxide (CO2) fractional laser in combination with pulsed dye laser (PDL) versus each one alone in the treatment of hypertrophic burn scars: a single-blinded randomized controlled trial. Lasers Med Sci. 2024;39(1):69.

    Article  PubMed  Google Scholar 

  19. Alves R, Grimalt R. Randomized placebo-controlled, double-blind, half-head study to assess the efficacy of platelet-rich plasma on the treatment of androgenetic alopecia. Dermatol Surg. 2016;42(4):491–7.

    Article  CAS  PubMed  Google Scholar 

  20. Chuah SY, Tan CH, Wang ECE, Tan KT, Chan RKW, Zhao X, et al. Efficacy of platelet-rich plasma in Asians with androgenetic alopecia: a randomized controlled trial. Indian J Dermatol Venereol Leprol. 2023;89(1):135–8.

    Article  PubMed  Google Scholar 

  21. Siah TW, Guo H, Chu T, Santos L, Nakamura H, Leung G, et al. Growth factor concentrations in platelet-rich plasma for androgenetic alopecia: an intra-subject, randomized, blinded, placebo-controlled, pilot study. Exp Dermatol. 2020;29(3):334–40.

    Article  CAS  PubMed  Google Scholar 

  22. Rodrigues BL, Montalvão SA, Cancela RB, Silva FA, Urban A, Huber SC, et al. Treatment of male pattern alopecia with platelet-rich plasma: a double-blind controlled study with analysis of platelet number and growth factor levels. J Am Acad Dermatol. 2019;80(3):694–700.

    Article  CAS  PubMed  Google Scholar 

  23. Tawfik AA, Osman MAR. The effect of autologous activated platelet-rich plasma injection on female pattern hair loss: a randomized placebo-controlled study. J Cosmet Dermatol. 2018;17(1):47–53.

    Article  PubMed  Google Scholar 

  24. Dicle Ö, Bilgic Temel A, Gülkesen KH. Platelet-rich plasma injections in the treatment of male androgenetic alopecia: a randomized placebo-controlled crossover study. J Cosmet Dermatol. 2020;19(5):1071–7.

    Article  PubMed  Google Scholar 

  25. Legiawati L, Yusharyahya SN, Bernadette I, Novianto E, Priyanto MH, Gliselda KC, Iriyanty S, Mutiara R. Comparing single-spin versus double-spin platelet-rich plasma (PRP) centrifugation methods on thrombocyte count and clinical improvement of androgenetic alopecia: a preliminary, randomized, double-blind clinical trial. J Clin Aesthet Dermatol. 2023;16(12):39–44.

    PubMed  PubMed Central  Google Scholar 

  26. Ozcan KN, Sener S, Altunisik N, Turkmen D. Platelet rich plasma application by dermapen microneedling and intradermal point-by-point injection methods, and their comparison with clinical findings and trichoscan in patients with androgenetic alopecia. Dermatol Ther. 2022;35(1):e15182. https://doi.org/10.1111/dth.15182.

    Article  CAS  PubMed  Google Scholar 

  27. Ramadan WM, Hassan AM, Ismail MA, El Attar YA. Evaluation of adding platelet-rich plasma to combined medical therapy in androgenetic alopecia. J Cosmet Dermatol. 2021;20(5):1427–34.

    Article  PubMed  Google Scholar 

  28. Singh SK, Singh S. Effect of platelet counts and activator in platelet-rich plasma on the treatment of androgenetic alopecia, split-head comparison: a randomised, double-blind study. Indian J Dermatol Venereol Leprol. 2023;89(5):647–55.

    Article  PubMed  Google Scholar 

  29. Hausauer AK, Jones DH. Evaluating the efficacy of different platelet-rich plasma regimens for management of androgenetic alopecia: a single-center, blinded, randomized clinical trial. Dermatol Surg. 2018;44(9):1191–200.

    Article  CAS  PubMed  Google Scholar 

  30. Singh SK, Kumar V, Rai T. Comparison of efficacy of platelet-rich plasma therapy with or without topical 5% minoxidil in male-type baldness: a randomized, double-blind placebo control trial. Indian J Dermatol Venereol Leprol. 2020;86:150.

    Article  PubMed  Google Scholar 

  31. Bruce AJ, Pincelli TP, Heckman MG, Desmond CM, Arthurs JR, Diehl NN, et al. A randomized, controlled pilot trial comparing platelet-rich plasma to topical minoxidil foam for treatment of androgenic alopecia in women. Dermatol Surg. 2020;46(6):826–32.

    Article  CAS  PubMed  Google Scholar 

  32. Gupta N. Clinical evaluation of intradermal platelet rich plasma administration along with oral biotin supplement for the management of androgenetic alopecia in adult males: a randomised clinical trial. J Clin Diagn Res 2022;16(11).

  33. Sasaki GH. The effects of lower vs higher cell number of platelet-rich plasma (PRP) on hair density and diameter in androgenetic alopecia (AGA): a randomized, double-blinded, placebo, parallel-group half-scalp IRB-approved study. Aesthet Surg J. 2021;41(11):NP1659–72.

    Article  PubMed  Google Scholar 

  34. Balasundaram M, Kumari R, Ramassamy S. Efficacy of autologous platelet-rich plasma therapy versus topical minoxidil in men with moderate androgenetic alopecia: a randomized open-label trial. J Dermatolog Treat. 2023;34(1):2182618.

    Article  PubMed  Google Scholar 

  35. Padhiar B, Raveendran S. Comparison of efficacy of topical 5% minoxidil alone versus topical 5% minoxidil with autologous platelet rich plasma (PRP) therapy in treatment of androgenetic alopecia: a randomised open label study. IP Indian J Clin Exp Dermatol. 2021;7(2):107–14.

    Article  Google Scholar 

  36. Mapar MA, Shahriari S, Haghighizadeh MH. Efficacy of platelet-rich plasma in the treatment of androgenetic (male-patterned) alopecia: a pilot randomized controlled trial. J Cosmet Laser Ther. 2016;18(8):452–5.

    Article  PubMed  Google Scholar 

  37. Shapiro J, Ho A, Sukhdeo K, Yin L, Sicco KL. Evaluation of platelet-rich plasma as a treatment for androgenetic alopecia: a randomized controlled trial. J Am Acad Dermatol. 2020;83(5):1298–303.

    Article  CAS  PubMed  Google Scholar 

  38. Puig CJ, Reese R, Peters M. Double-blind, placebo-controlled pilot study on the use of platelet-rich plasma in women with female androgenetic alopecia. Dermatol Surg. 2016;42(11):1243–7.

    Article  CAS  PubMed  Google Scholar 

  39. Gressenberger P, Pregartner G, Thomas G, Peter W, Kopera D. Platelet-rich plasma for androgenetic alopecia treatment: a randomized placebo-controlled pilot study. Acta Dermato-Venereol. 2020;100(15):adv00247.

    Article  CAS  Google Scholar 

  40. Wu S, Liu S, Chen J, Dai D, Liu W, Le D, et al. Evaluation of platelet-rich plasma plus basic fibroblast growth factor combined with minoxidil in the treatment of androgenetic alopecia: a randomized controlled trial. J Cosmet Dermatol. 2023;22(7):1995–2002.

    Article  PubMed  Google Scholar 

  41. Legiawati L, Suseno LS, Sitohang IBS, Yusharyahya SN, Pawitan JA, Liem IK, et al. Combination of adipose-derived stem cell conditioned media and minoxidil for hair regrowth in male androgenetic alopecia: a randomized, double-blind clinical trial. Stem Cell Res Ther. 2023;14(1):210.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Tak YJ, Lee SY, Cho AR, Kim YS. A randomized, double-blind, vehicle-controlled clinical study of hair regeneration using adipose-derived stem cell constituent extract in androgenetic alopecia. Stem Cells Transl Med. 2020;9(8):839–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Tan P-C, Zhang P-Q, Xie Y, Gao Y-M, Li Q-F, Zhou S-B, et al. Autologous concentrated growth factors combined with topical minoxidil for the treatment of male androgenetic alopecia: a randomized controlled clinical trial. Facial Plast Surg Aesthet Med. 2021;23(4):255–62.

    Article  PubMed  Google Scholar 

  44. Pathania V, Sood A, Beniwal N, Baveja S, Shankar P, Patrikar S. Randomized control trial to study the efficacy and safety of platelet-rich plasma as intraoperative holding solution in hair restoration surgery: a pilot study. Med J Armed Forces India. 2023;79(1):46–53.

    Article  PubMed  Google Scholar 

  45. Gupta S, Relhan V, Garg VK, Sahoo B. Autologous noncultured melanocyte–keratinocyte transplantation in stable vitiligo: a randomized comparative study of recipient site preparation by two techniques. Indian J Dermatol Venereol Leprol. 2019;85(1):32–8.

    Article  PubMed  Google Scholar 

  46. Jamal-Edine AM, El-Barbary RA, Moftah NH. Fractional versus full ablative CO(2) laser in recipient site of non-cultured melanocytes and keratinocyte transplantation in treatment of vitiligo. J Cosmet Dermatol. 2022;21(4):1506–13.

    Article  PubMed  Google Scholar 

  47. Hasan MS, Almohsen AM, Nasr MI, Rageh MA. Dermabrasion versus microneedling in transplantation of autologous noncultured melanocyte–keratinocyte cell suspension in patients with vitiligo. Dermatol Surg. 2023;49(5):494–502.

    Article  CAS  PubMed  Google Scholar 

  48. van Geel N, Ongenae K, De Mil M, Haeghen YV, Vervaet C, Naeyaert JM. Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo. Arch Dermatol. 2004;140(10):1203–8.

    PubMed  Google Scholar 

  49. Toossi P, Shahidi-Dadras M, Mahmoudi Rad M, Fesharaki RJ. Non-cultured melanocyte–keratinocyte transplantation for the treatment of vitiligo: a clinical trial in an Iranian population. J Eur Acad Dermatol Venereol. 2011;25(10):1182–6.

    Article  CAS  PubMed  Google Scholar 

  50. Parambath N, Sharma VK, Parihar AS, Sahni K, Gupta S. Use of platelet-rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double-blind randomized controlled trial. Int J Dermatol. 2019;58(4):472–6.

    Article  CAS  PubMed  Google Scholar 

  51. Abdel Halim DM, Fekry A, Mogawer RM. The value of adding platelet-rich plasma (PRP) to noncultured epidermal cell suspension (NCECS) in surgical treatment of stable resistant vitiligo: a self-controlled randomised double-blinded study. Aust J Dermatol. 2023;64(3):359–67.

    Article  Google Scholar 

  52. Razmi TM, Parsad D, Kumaran SM. Combined epidermal and follicular cell suspension as a novel surgical approach for acral vitiligo. J Am Acad Dermatol. 2017;76(3):564–7.

    Article  Google Scholar 

  53. Gunaabalaji DR, Pangti R, Challa A, Chauhan S, Sahni K, Arava SK, et al. Comparison of efficacy of noncultured hair follicle cell suspension and noncultured epidermal cell suspension in repigmentation of leukotrichia and skin patch in vitiligo: a randomized trial. Int J Dermatol. 2020;59(11):1393–400.

    Article  CAS  PubMed  Google Scholar 

  54. Singh C, Parsad D, Kanwar AJ, Dogra S, Kumar R. Comparison between autologous noncultured extracted hair follicle outer root sheath cell suspension and autologous noncultured epidermal cell suspension in the treatment of stable vitiligo: a randomized study. Br J Dermatol. 2013;169(2):287–93.

    Article  CAS  PubMed  Google Scholar 

  55. Mrigpuri S, Razmi TM, Sendhil Kumaran M, Vinay K, Srivastava N, Parsad D. Four compartment method as an efficacious and simplified technique for autologous non-cultured epidermal cell suspension preparation in vitiligo surgery: a randomized, active-controlled study. J Eur Acad Dermatol Venereol. 2019;33(1):185–90.

    Article  CAS  PubMed  Google Scholar 

  56. Deng Y, Li J, Yang G. 308-nm excimer laser plus platelet-rich plasma for treatment of stable vitiligo: a prospective, randomized case-control study. Clin Cosmet Investig Dermatol. 2020;13:461–7.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Khattab FM, Abdelbary E, Fawzi M. Evaluation of combined excimer laser and platelet-rich plasma for the treatment of nonsegmental vitiligo: a prospective comparative study. J Cosmet Dermatol. 2020;19(4):869–77.

    Article  PubMed  Google Scholar 

  58. Afify AA, Zuelfakkar NM, Eshafi MA. Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (a randomized clinical trial). Lasers Med Sci. 2021;36(7):1479–86.

    Article  PubMed  Google Scholar 

  59. Abdelghani R, Ahmed NA, Darwish HM. Combined treatment with fractional carbon dioxide laser, autologous platelet-rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: a prospective, randomized comparative trial. J Cosmet Dermatol. 2018;17(3):365–72.

    Article  PubMed  Google Scholar 

  60. Sahni K, Parsad D, Kanwar AJ, Mehta SD. Autologous noncultured melanocyte transplantation for stable vitiligo: Can suspending autologous melanocytes in the patients’ own serum improve repigmentation and patient satisfaction? Dermatol Surg. 2011;37(2):176–82.

    Article  CAS  PubMed  Google Scholar 

  61. Zhang DM, Hong WS, Fu LF, Wei XD, Xu AE. A randomized controlled study of the effects of different modalities of narrow-band ultraviolet B therapy on the outcome of cultured autologous melanocytes transplantation in treating vitiligo. Dermatol Surg. 2014;40(4):420–6.

    Article  CAS  PubMed  Google Scholar 

  62. Vashisht KR, Arava SK, Tembhre MK, Parihar AS, Sharma VK, Das BK, et al. A randomized pilot study to compare hair follicle cell suspensions prepared using trypsin alone versus trypsin in combination with collagenase type I for transplantation in vitiligo. Clin Exp Dermatol. 2020;45(2):172–9.

    Article  CAS  PubMed  Google Scholar 

  63. Khan FA, Hussain M, Khan BM, Afsar S, Shafique M, Haq SU, Akbar N, Siddique A. Comparative study between intralesional injection of platelet rich plasma and intra lesional triamcinolone for the treatment of alopecia areata. J Ayub Med Coll Abbottabad. 2022;34(4):762–5.

    Article  PubMed  Google Scholar 

  64. Hegde P, Relhan V, Sahoo B, Garg VK. A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp. Dermatol Ther. 2020;33(6):e14388. https://doi.org/10.1111/dth.14388.

    Article  CAS  PubMed  Google Scholar 

  65. Trink A, Sorbellini E, Bezzola P, Rodella L, Rezzani R, Ramot Y, et al. A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol. 2013;169(3):690–4.

    Article  CAS  PubMed  Google Scholar 

  66. Ragab SEM, Nassar SO, Morad HA, Hegab DS. Platelet-rich plasma in alopecia areata: intradermal injection versus topical application with transepidermal delivery via either fractional carbon dioxide laser or microneedling. Acta Dermatovenerol Alp Pannonica Adriat. 2020;29(4):169–73.

    PubMed  Google Scholar 

  67. El Taieb MA, Ibrahim H, Nada EA, Seif Al-Din M. Platelets rich plasma versus minoxidil 5% in treatment of alopecia areata: a trichoscopic evaluation. Dermatol Ther. 2017. https://doi.org/10.1111/dth.12437.

    Article  PubMed  Google Scholar 

  68. Sirithanabadeekul P, Dannarongchai A, Suwanchinda A. Platelet-rich plasma treatment for melasma: a pilot study. J Cosmet Dermatol. 2020;19(6):1321–7.

    Article  PubMed  Google Scholar 

  69. Adelipour M, Sorkheh H, Kiani Z, Bahrami H, Berageah N, Salimi A, Naghashpour M, Zahedi A, Golabi S. Umbilical cord as a source of mesenchymal stem cells improves melasma in parturients: a clinicalrandomized trial. Physiol Pharmacol. 2023;27(1):9–15.

    Google Scholar 

  70. Tedesco M, Bellei B, Garelli V, Caputo S, Latini A, Giuliani M, Cota C, Chichierchia G, Romani C, Foddai ML, Cristaudo A, Morrone A, Migliano E. Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet-rich plasma grafting: new regenerative perspectives in genital lichen sclerosus. Dermatol Ther. 2020;33(6):e14277. https://doi.org/10.1111/dth.14277.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors’ would like to express their gratitude to the authorities of Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) for technical and editorial assistance. The authors declare that artificial intelligence is not used in this study.

Funding

This study did not receive any funding in any form.

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Authors and Affiliations

  1. Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Niayesh Street, Sattar Khan Avenue, Tehran, 1445613131, Iran

    Alireza Jafarzadeh, Haniyeh Keramati, Roya Zeinali & Azadeh Goodarzi

  2. Faculty of Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, 1449614535, Iran

    Arash Pour Mohammad & Mina Khosravi

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Contributions

AG and AJ designed the study. AJ, AP, HK, RZ and MK wrote the paper. AG edited the manuscript. All authors have read and approved the content of the manuscript.

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Correspondence to Azadeh Goodarzi.

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Ethics approval and consent to participate

All collected data were kept confidential and analyzed without specific names attached. The study adhered to Helsinki ethical principles. The project was registered at Iran University of Medical Sciences with registration No. IR.IUMS.SD8784232452891Z1 on 18 December 2023, bearing the scientific title “Regenerative Medicine in the Treatment of Specific Dermatologic Disorders: A Systematic Review of Randomized Controlled Clinical Trials.” It was approved by the Research Council under the ethics code number IR.IUMS.FMD.REC.1402.124.

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Jafarzadeh, A., Pour Mohammad, A., Keramati, H. et al. Regenerative medicine in the treatment of specific dermatologic disorders: a systematic review of randomized controlled clinical trials. Stem Cell Res Ther 15, 176 (2024). https://doi.org/10.1186/s13287-024-03800-6

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Stem Cell Research & Therapy

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