Comparative efficacy of photodynamic therapy, autologous platelet-rich plasma therapy, and their combination in the treatment of diffuse telogen effluvium

Background. Diffuse telogen effluvium accounts for a significant proportion of visits to trichologists and reduces the quality of life of patients. However, comparative data on the effectiveness of various physiotherapeutic methods for this condition remain limited. Photodynamic therapy and PRP therapy are considered promising methods for stimulating hair growth by targeting various pathogenesis factors, but the feasibility of their combined use remains poorly understood.

AIM:To evaluate the clinical  efficacy of photodynamic therapy, PRP therapy, and their combination in women with acute telogen effluvium based on a prospective, controlled study using objective methods to assess hair condition, patient quality of life and the psychoemotional state of the patients before and after therapy.

Methods:A prospective, controlled study was conducted at the V.A. Rakhmanov Department of Skin and Venereal Diseases from September 2025 to March 2026. The study included 60 women aged 18 to 45 years with clinical signs of diffuse telogen effluvium lasting from 2 to 6 months and an increase in the proportion of telogen hairs by more than 15%, confirmed by phototrichogram data. Participants were divided into three groups of 20 patients . The first group received photodynamic therapy monotherapy with a course of 10 weekly procedures, the second group received combined treatment with photodynamic therapy and PRP therapy, and the third group received PRP therapy monotherapy with a course of 5 procedures with an interval of 2 weeks. The primary efficacy indicator was the change in the percentage of telogen hairs according to phototrichogram data 3 months from treatment initiation . Additional assessments included hair density, average hair shaft diameter, percentage of anagen hairs, and quality of life indicators using the Dermatological Quality of Life Index and the Skindex-29 questionnaire. Statistically significant intergroup differences were found for all studied parameters (p<0.05).

Results. Sixty women completed the study protocol; the average age was 28.4±4.2 years, and the average disease duration was 3.8±1.3 months. The baseline percentage of telogen hair in all groups ranged from 37,6–39,4%, with no significant intergroup differences. After completion of therapy, a statistically significant reduction in the percentage of telogen hair was observed in all groups, with the most pronounced effect in the combination therapy group, where the average reduction was 16.8±5.2% versus 11.7±4.8% in the PRP therapy group and 9.8±4.3% in the photodynamic therapy group. A significant improvement with a reduction in the proportion of telogen hairs by 20% or more was achieved in 70.0% of the participants in the combination therapy group, 35.0% of women in the PRP therapy group, and 25.0% of patients in the photodynamic therapy group. Hair density increased by 35.7±11.2 hairs/cm² in the combination therapy group, by 21.1±9.4 hairs/cm² in the PRP therapy group, and by 16.5±8.7 hairs/cm² in the photodynamic therapy group. The average diameter of hair shafts showed a maximum increase in the combination therapy group by 11.4±4.2 μm versus 7.3±3.8 μm with PRP therapy and 6.3±3.4 μm with photodynamic therapy. Quality of life indicators significantly improved in all groups, with the greatest improvement in the combination therapy group, where the Dermatological Quality of Life Index decreased by an average of 10.0 points, and the total Skindex-29 score decreased by 33.5 points, compared to 27.5 points with PRP therapy and 20.0 points with photodynamic therapy.

Conclusion. The combined use of photodynamic therapy and PRP therapy provides a more significant improvement in objective trichological parameters and quality of life in patients with diffuse telogen effluvium compared to monotherapy with each method, which is explained by a synergistic effect on various stages of the disease's pathogenesis. These data support the introduction of this combined approach into clinical practice by dermatologists and trichologists to improve the effectiveness of treatment for patients with diffuse telogen effluvium