Single Injection of Platelet-Rich Plasma Yields Minimal Benefit for Photoaged Skin

By Marilynn Larkin

November 16, 2018

NEW YORK (Reuters Health) - Compared with placebo, a single injection of platelet-rich plasma (PRP) may reduce signs of photoaging as perceived by recipients of the treatment, researchers say.

Dr. Murad Alam of Northwestern University in Chicago and colleagues studied 19 patients (mean age, 46; 17 women) with bilateral cheek rhytids of Glogau class II or greater who received a 3 mL injection of PRP in one cheek and normal saline in the other.

As reported online November 17 in JAMA Dermatology, mean photoaging scores as rated by two dermatologists masked to the treatments showed no significant differences between PRP and normal saline for fine lines at baseline or at two weeks, three months or six months.

Similarly, no significant differences were seen at any time points for mottled pigmentation, skin roughness, or skin sallowness.

However, at six months, participants rated the PRP-treated side as significantly more improved for texture (mean self-assessment score, 2.00 vs. 1.21 on a 5-point scale) and wrinkles (1.74 vs. 1.21).

Reported adverse events, which were not associated with the study agent, included redness in 18 patients, swelling in 16, bruising in 14, and pruritus in one, skin scaling in one, and skin dryness in one.

No participants reported any adverse events at 12 months.

"Masked participants noted that both fine and coarse texture improved significantly more with a single treatment of PRP than with normal saline," the authors state. "Both participants and raters found PRP to be nominally but not significantly superior to normal saline."

"Typically, patients receive PRP treatments every few months," Dr. Alam noted in an email to Reuters Health.

"Our study shows that some benefits of PRP can be seen for at least six months, but we don't know when and if these changes eventually disappear," he said. "So, one of the biggest unanswered questions is how long the results of PRP last."

"The answer would tell us how often we need to treat patients," he said. "This, in turn, would help patients understand the cost and number of visits per year, so they could decide if PRP is worth it for them."

"A related question," he added, "is whether PRP and similar treatments could slow the emergence of skin aging. Could PRP be used, like botulinum toxin, to stop wrinkles before they begin?"

A systematic review last month in Aesthetic Plastic Surgery by researchers in China concluded, based on in vitro and in vivo studies, that PRP may play a role in promoting tissue regeneration, oxidative stress and revascularization. (http://bit.ly/2zY2EhE)

Another next step "might be to compare PRP to other, more established treatments for facial rejuvenation, like lasers and energy devices for smoothening the facial skin," Dr. Alam said. "We might then find out whether PRP is more effective than lasers, or if it offers a different type of benefit and could be used in combination with these other treatments."

Dr. Suzanne Friedler, a clinical instructor of dermatology at the Mount Sinai Health System in New York City, commented by email, "The findings of this study were a very modest improvement noted in self-assessment by participants six months post-treatment, with no statistically significant improvement noted by dermatologists rating photographs before treatment (or) post-treatment."

"Patients were able to appreciate the difference because only half the face was treated," she told Reuters Health. "If patients were paying for this treatment and had an entire face treated, the improvement may be less noticeable to the participant and participant satisfaction may be lower."

"The treatment protocol for this study involved only one PRP session using injections into the dermis," she added. "This is not the most common PRP protocol for facial rejuvenation. Most often, PRP is administered following micro-needling or laser and sessions are repeated three to four times."

"Further study is needed to determine whether additional sessions and different methods of administration will enhance the improvement noted by participants and observers," Dr. Friedler concluded.

SOURCE: http://bit.ly/2zSnGOJ

JAMA Dermatol 2018.

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