Hair loss in women is much rarer compared to the male field. Due to the accepted social norms for the appearance of a woman, where she is expected to have thick and long hair, women who have a problem with hair loss face a much bigger problem than what is visible at first glance. Hair loss in women can lead to social isolation and even depression, so solving alopecia is a challenge for many doctors. In women distribution of hair loss is different than in mean. Female pattern (model) hair loss has 2 general distributions: diffuse thinning across the central scalp “Christmas tree” pattern and prominent hair thinning towards the front of the scalp with minimal involvement of the hairline [1]. Diagnosis of Female pattern hair loss can be confirmed by review of a patient's medical history and a physical examination. The diagnostic procedures used to diagnose hair loss are trichoscopy, trichogram, in very rare cases a biopsy is used, and in women with signs of hyperandrogenism, ovarian or adrenal examination should be performed. Mild to moderate hair loss in women can be treated with oral antiandrogen therapies (cyproterone acetate and spironolactone) and / or topical monoxide with good results in many cases [2].Till now, though many studies have been conducted with different therapies and evaluated by various methods, we decided to work according to a special scheme of 3 cycles of mesotherapy and 3 cycles of PRP treatment and to follow the results after 3 months. Mesotherapy is a Greek word which means treating the middle layer of skin - mesoderm. It involves microinjections of multiple conventional medications, vitamins, pharmaceuticals, and other ingredients into the mesoderm [3]. PRP is a simple and effective method of treating all types of non-scarring alopecia, it is derived from the centrifugation of the patient’s own blood and contains growth factors working on different target cells that playing an important role in tissue repair mechanisms and regeneration at various levels [4].

We present 3 cases of women with hair loss, aged from 28 to 37 years. They all complain of increased hair loss and thinning of the central scalp. All of them were tested for hormonal status which was orderly, orderly gynecological status and orderly laboratory findings. No other disease has been registered in any of them. They all had a tidy pregnancy.We all decided to try the same type of treatment which consists of 3 mesotherapies and 3 PRP hair treatments. We started the PRP treatment the first week, and the next week with mesotherapy. In total, the whole treatment lasted 6 weeks, and we followed the patients for a period of 3 months. In the first weeks, the patients reported that they noticed the cessation of hair loss, after three months we noticed the appearance of new follicles and hair growth. Before treatment, the patients were advised not to take medications that might prolong bleeding. It was also necessary for each patient to wash their hair well at home before treatment. The mesococktail we used in the patients consisted of Protective buffer with FGF( fibroblast growth factor),GM peptide (antiage peptides), sodium DNA, amino acids, trace elements, vitamins, terpenes, fatty acids, flavonoids, antioxidants. The each threatment lasted separately around 30 minutes. After the treatment, the patients were not allowed to wash their hair for 48 hours. For pain, they were advised to use acetaminophen. During treatment, none of the patients complained of major problems other than minimal redness and slight numbing of the scalp in one patient.

Figure 1-3:  Before treatment and 3 months after the threatment.

Hair loss can be the result of heredity, hormonal changes, medical conditions or a normal part of aging. It is more common in men, but it is usually much worse accepted by women. Mesotherapy can help to reduce hair fall and treat hair loss problems with advanced and minimally-invasive methods, it is very often treatment in hair disorders. It is defined as a technique that involves the use of multiple intradermal injections of a mixture of compounds in low doses, at many points, near/over the affected sites [5]. Platelet-rich plasma (PRP) is a treatment that is used to accelerate healing in different pathologies.  This is an excellent treatment for impaired hair growth as it affects almost all essential components required for the survival of hair follicles: keratinocytes, stem cells, arrector pili muscles, blood vessels, and neural cells [4].

Diagnosis, prognosis, and treatment options have a major impact on the patient's psychological aspect, and together they make upthe key determinants in resolving hair loss problem [6]. There are numerous studies that compare the effect between mesotherapy and PRP treatment, but we have concluded that it is best to use them together in combination to get the best results.This combination of treatments is completely safe for the patients, with minimal side effects. We obtained satisfactory results in all three patients.We conclude that this combination of treatments should be considered in the treatment of hair loss.

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3. Gajjar PC, Mehta HH, Barvaliya M, Sonagra B. Comparative Study between Mesotherapy and Topical 5% Minoxidil by Dermoscopic Evaluation for Androgenic Alopecia in Male: A Randomized Controlled Trial. Int J Trichology. 2019; 11: 58-67.
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