Does PRP Work for Alopecia Areata. Where It Fits Now That JAK Inhibitors Are on the NHS
Alopecia areata is an autoimmune attack on the follicle, not a pattern loss. The treatments with the strongest evidence are steroid injections for patches and JAK inhibitors for severe disease, which NICE now funds. PRP has 1 randomised trial of 45 patients from 2013, in which it beat steroid and placebo. It is an option for limited patches, not first-line.
Key points
A 2013 randomised, double-blind, placebo and active-controlled half-head trial in the British Journal of Dermatology gave 45 patients with alopecia areata 3 monthly injections of PRP, triamcinolone or placebo and followed them for a year. PRP significantly increased regrowth and reduced dystrophy and itching compared with both, with no side effects.
NICE technology appraisal 958, published in 2024, recommends ritlecitinib for severe alopecia areata in people aged 12 and over on the NHS. In trials nearly 25 percent achieved 80 percent scalp coverage at 24 weeks against 1.6 percent on placebo, rising to more than 40 percent after almost a year.
In the BRAVE-AA1 and BRAVE-AA2 trials of baricitinib in the New England Journal of Medicine in 2022, covering 1,200 adults with severe disease, 38.8 percent and 35.9 percent on 4 mg reached 80 percent scalp coverage at 36 weeks, against 6.2 percent and 3.3 percent on placebo.
A 2020 review in Dermatology and Therapy concluded that results with PRP in alopecia areata are not as consistent as in pattern hair loss, and intralesional triamcinolone remains the standard first treatment for limited patches.
If you have patches of hair loss and want to know what the evidence supports, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will tell you where PRP sits for your pattern, including if the answer is a dermatologist first.
What alopecia areata is, and why it is not a PRP-first condition
Alopecia areata is an autoimmune disease in which the immune system attacks the hair follicle, switching off growth in round or oval patches that can appear on the scalp, beard, eyebrows or body. It affects men and women of any age and often starts in childhood or early adulthood. In many people patches regrow on their own within months. In some the disease spreads to the whole scalp, alopecia totalis, or the whole body, alopecia universalis, and can persist for years. Unlike pattern hair loss, the follicles are not miniaturised. They are held in an inflamed, arrested state, and they can recover fully once the immune attack stops.
That difference decides the treatment. Pattern hair loss responds to growth factors because its follicles are shrinking. Alopecia areata responds to suppressing the immune attack, which is why the treatments with the strongest evidence are anti-inflammatory and immune-modulating, and why a growth factor injection into an actively inflamed patch is a second-line idea rather than a first. The first appointment for alopecia areata is with a doctor who can confirm the diagnosis and stage it, because the treatment for 2 small patches and the treatment for a whole scalp are different medicines.
What the standard treatments are in 2026
For limited patches, an intralesional injection of triamcinolone, a corticosteroid, remains the standard first treatment, given every 4 to 6 weeks into the patch, and it regrows hair in a majority of limited cases. Topical and oral steroids, minoxidil as an adjunct, and contact immunotherapy are the other established options for more extensive disease.
The change of the last 3 years is the JAK inhibitors. Baricitinib was tested in the BRAVE-AA1 and BRAVE-AA2 trials published in the New England Journal of Medicine in May 2022, covering 1,200 adults with severe disease, and 38.8 percent and 35.9 percent on the 4 mg dose reached 80 percent scalp coverage at 36 weeks against 6.2 percent and 3.3 percent on placebo. Ritlecitinib received its MHRA licence in November 2023 and NICE recommended it for routine NHS commissioning for severe alopecia areata in people aged 12 and over in technology appraisal 958, with nearly 25 percent achieving 80 percent coverage at 24 weeks against 1.6 percent on placebo, rising to more than 40 percent after almost a year. For the first time, severe alopecia areata has a licensed, NHS-funded treatment, and that is the conversation a patient with extensive loss should be having with a dermatologist.
Send us photographs of the patches on WhatsApp and a doctor will tell you whether the pattern is limited enough for PRP to be an option.
What the evidence says for PRP
There is 1 randomised trial worth the name. Published in the British Journal of Dermatology in 2013, it randomised 45 patients with alopecia areata to intralesional PRP, triamcinolone or placebo on one half of the scalp, with the other half untreated, gave 3 treatments a month apart, and followed patients for a year. PRP significantly increased hair regrowth and decreased hair dystrophy and burning or itching compared with both triamcinolone and placebo, and Ki-67 markers of cell proliferation were higher with PRP. No side effects were recorded. The authors called it a pilot and asked for larger controlled studies.
Those larger studies have not materialised in the 13 years since. There are comparative studies of PRP against triamcinolone, including a 2022 comparison, and case series, and a 2020 review in Dermatology and Therapy concluded the results with PRP in alopecia areata are not as consistent as in androgenetic alopecia. Alopecia areata also regrows spontaneously in many people, which makes small uncontrolled studies particularly unreliable. The honest summary is that PRP has a positive pilot, a plausible anti-inflammatory mechanism, and no trial of the size that now exists for JAK inhibitors. It is a reasonable option for a patient with limited patches who cannot have or does not want steroid injections. It is not a treatment for extensive or rapidly progressing disease, and the general safety picture is the same as for any scalp PRP.
Where PRP fits, and where it does not
PRP fits the adult with 1 to a few stable patches who has been assessed by a doctor, has had the diagnosis confirmed, and either did not respond to triamcinolone, wants to avoid repeated steroid injections and the skin thinning they can cause, or has patches in the beard or eyebrow where steroid atrophy matters more. In that patient the 2013 trial is a reasonable basis for a course of 3 monthly sessions, with honest expectations and a review at 3 months.
It does not fit the patient with rapidly spreading patches, more than half the scalp involved, or totalis or universalis, who should be with a dermatologist discussing JAK inhibitors and should not be spending money on PRP first. It does not fit a child, for whom alopecia areata needs paediatric dermatology. And it does not fit anyone who has not had the diagnosis confirmed, because patchy hair loss can also be fungal infection, a scarring alopecia or trichotillomania, and each needs something else. Diffuse loss across the whole scalp is a different problem again, usually telogen effluvium, and in women it overlaps with female pattern hair loss. A clinic offering PRP for alopecia areata without a diagnosis and a staging is offering a second-line treatment to a condition it has not identified.
A patchy hair loss check before any treatment
Work through this before booking anything, including here.
How many patches, and how much of the scalp. One to a few small patches is limited disease. More than half the scalp, or rapid spread, needs a dermatologist and a JAK inhibitor conversation.
Are the patches smooth and skin-coloured with short broken hairs at the edges. That fits alopecia areata. Scaling, redness or pustules fit infection or a scarring alopecia and need a different route.
Have you had triamcinolone injections, and did they work. If they did, that remains the standard treatment. If they did not, or the skin thinned, PRP is a reasonable alternative for limited patches.
Is the disease stable or spreading. Stable patches are candidates for local treatment. Spreading disease is systemic and needs systemic treatment.
Has the diagnosis been confirmed by a doctor with a dermatoscope. If not, that comes first.
Our doctors put it this way. Alopecia areata is an immune disease that happens to show on the scalp. The treatments that work switch off the attack, and in 2026 the NHS funds the strongest of them. PRP is a fair option for a few stubborn patches, and anyone offering it for a whole scalp is a decade behind the evidence.
Message us on WhatsApp with how many patches, how long, what has been tried, and photographs, and a doctor will give you a straight answer, including a dermatology referral if that is the answer.
What PRP does not do for alopecia areata
PRP does not stop the autoimmune attack driving the disease, does not treat extensive, totalis or universalis disease, and has no trial against the JAK inhibitors that now define standard care for severe cases. Its evidence is 1 randomised pilot of 45 patients from 2013, and a 2020 review found results inconsistent. It does not replace triamcinolone as the first treatment for limited patches, and it is not suitable for children. Alopecia areata regrows spontaneously in many people, so any treatment, PRP included, can take credit for recovery that would have happened anyway. It is not available on the NHS for this condition, whereas steroid injections and, for severe disease, ritlecitinib are. Newer scalp products such as exosomes and polynucleotides have less evidence again.
What it costs, and what the NHS now covers
Flagship Harley Street and Mayfair clinics commonly charge £600 to £850 or more per session of scalp PRP, with a course of 3 taking a plan past £2,000. Intralesional triamcinolone is available on the NHS through dermatology, and ritlecitinib is now NHS-funded for severe alopecia areata in people aged 12 and over under NICE technology appraisal 958.
The reframing is that for the first time the strongest treatment for the severe form of this disease is free at the point of use, and a patient with extensive loss who spends £2,000 on PRP before seeing a dermatologist has paid for the weaker option and delayed the stronger one. For limited patches the arithmetic is different, since steroid injections are cheap and effective and PRP is the alternative when they are not, priced as a course.
Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship rates, with your exact figure confirmed at the free suitability review, which for alopecia areata starts with confirming the diagnosis and, for extensive disease, ends with a referral rather than a booking.
Ask about the cost for your patches on WhatsApp and we will explain what the review covers.
The free suitability review
Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registered doctor confirms the diagnosis with a dermatoscope, stages the extent, takes a history of what has been tried, and gives one of two answers. Either you are approved for PRP, because the disease is limited and stable and steroid injection has failed or is unsuitable, with a course of 3 and realistic expectations, or you are not approved, with an honest explanation of what would serve you better, which for extensive or spreading disease is a dermatologist and a JAK inhibitor conversation.
We decline a meaningful share of the people who enquire. For alopecia areata that share is high, because the best treatments for most of it are not ours to sell.
Why people choose The London PRP Clinic by The Wellness
An 87 percent patient success rate across treatments.
A 32 percent average density increase reported in our hair restoration programme.
More than 187 five star reviews.
Every treatment performed by a GMC-registered doctor.
100 supervised treatments completed by every clinician before they treat a patient here unsupervised.
Frequently asked questions
Does PRP work for alopecia areata
In 1 randomised trial of 45 patients in 2013, PRP produced more regrowth than triamcinolone or placebo over a year with no side effects. No larger trial has followed, and a 2020 review found results inconsistent. It is a reasonable option for a few limited patches, not a treatment for extensive disease.
What is the best treatment for alopecia areata
For limited patches, intralesional triamcinolone injections. For severe disease, JAK inhibitors. Ritlecitinib is NHS-funded under NICE technology appraisal 958 for people aged 12 and over, with nearly 25 percent reaching 80 percent scalp coverage at 24 weeks against 1.6 percent on placebo, and more than 40 percent after almost a year.
Is PRP better than steroid injections for alopecia areata
In the 2013 trial, yes, PRP beat triamcinolone on regrowth, dystrophy and itching in 45 patients. That is a single pilot, and triamcinolone remains the standard first treatment for limited patches because it is cheap, available on the NHS and effective in most. PRP is the alternative when steroid fails or is unsuitable.
Can alopecia areata grow back on its own
Yes, often. Many patches regrow within months without treatment, which is why small uncontrolled studies of any treatment are unreliable in this condition. Extensive or long-standing disease is less likely to recover spontaneously and is the group in which JAK inhibitors have their evidence.
Are JAK inhibitors available on the NHS for alopecia areata
Ritlecitinib is, for severe alopecia areata in people aged 12 and over, under NICE technology appraisal 958 published in 2024. Baricitinib is licensed and was tested in 1,200 adults in the BRAVE-AA trials. Access is through a dermatologist, and referral pathways vary by area.
Does PRP work for beard or eyebrow alopecia areata
The 2013 trial was on the scalp. PRP is sometimes used for beard and eyebrow patches because steroid injections can thin the skin in those areas, but there is no trial evidence specific to them. It is a reasonable option on the scalp evidence, with honest expectations, after a doctor has confirmed the diagnosis.
References
British Journal of Dermatology, 2013. Trink et al. A randomised, double-blind, placebo and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata, 45 patients. https://pubmed.ncbi.nlm.nih.gov/23607773/
NICE, 2024. Ritlecitinib for treating severe alopecia areata in people 12 years and over, technology appraisal guidance 958. https://www.nice.org.uk/guidance/ta958
Alopecia UK, 2024. NICE recommends ritlecitinib for routine commissioning on the NHS, including the trial response rates. https://www.alopecia.org.uk
Alopecia UK. The process and evidence behind baricitinib for alopecia areata, summarising the BRAVE-AA1 and BRAVE-AA2 trials published in the New England Journal of Medicine in 2022. https://www.alopecia.org.uk
Dermatology and Therapy, 2020. Alves and Grimalt. A review of platelet-rich plasma for alopecia, including the finding that results in alopecia areata are not as consistent as in androgenetic alopecia.
London clinic price lists for scalp PRP, accessed September 2026.
This article is for general information and does not replace a medical assessment. Alopecia areata should be diagnosed and staged by a doctor, and severe disease needs a dermatologist. Speak to one of our doctors before deciding on any treatment.