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Should You Get Plasma Rich Platelet Injections?

About The Author:  FutureDerm is pleased to welcome dermatologist Dr. Hanan Taha, M.D. to our staff as a Contributing Writer. For a complete bio please visit our About page. English: Angelina Jolie at the Cannes film fes... Platelets play an important part in wound healing. When you are wounded, platelets aggregate together and break down to produce factors that start the healing process. This property is the reason they are in focus recently as a form of skin rejuvenation. Angelina Jolie is rumored to have had PRP injections. So what are they exactly?

What is PRP?

From left to right: erythrocyte, thrombocyte, ... Blood is made up of many cell types: plasma, red blood cells, white blood cells, and platelets. These cells, naturally, vary in their size and weight. Therefore, when blood is put in a tube and centrifuged (i.e. made to spin in a special machine at a very high speed), the heavier cells (red and white blood cells) move to the bottom of the tube, while lighter components (plasma and platelets) stay at the top. This leads to a plasma super rich in platelets, at a much higher percentage than would be found in normal blood concentrations, since now the same original number of platelets is concentrated in a smaller volume. It is termed “autologous” PRP, because it comes from you and is then injected back into you.

Applications in Medicine

[caption id="" align="aligncenter" width="300"]Hines Ward Hines Ward is one of several athletes who has received PRP for treating injuries.[/caption] RP has been used for years in various fields of medicine. Most known is its role in treating sports injuries (known names that used PRP include Tiger Woods, and Pittsburgh Steelers Hines Ward and Troy Polamalu). It is also used in orthopedics, dentistry, neurosurgery, and in treating burns, and unhealing ulcers such as seen in diabetics. All these fields employ PRP’s property of wound healing and tissue repair. PRP pints are also given intravenously to prevent hemorrhage caused by platelet depletion. A rather new application is the use PRP as a form of mesotherapy for skin rejuvenation.

The Theory

[caption id="" align="aligncenter" width="300"]English: Skin layers The layers of the skin. PRP is thought to promote regeneration of skin cells and blood vessels, and to stimulate fibroblast production of collagen. (All things that make you look younger!)[/caption] Platelets are rich in various growth factors, which play an important role in the healing process, as they promote regeneration of skin cells, and skin blood vessels. Platelets also induce proliferation of dermal fibroblast.  Fibroblasts are cells found in the skin that play a key role in fighting the ageing process; they do so by interacting with skin cells and by producing collagen and other extra cellular matrix proteins. Other treatment modalities, such as laser therapy, aim at activating these very same fibroblasts. In theory, if regular concentrations of platelets can close wounds and heal the skin, then super concentrated plasma would lead to even more efficient healing and tissue regeneration.

What to Expect at the Clinic

Your doctor will most likely ask for a complete blood count (CBC) to check your platelets level beforehand. Normal is between 150,000 and 450,000. After signing an informed consent form, your photo will be taken for before and after comparisons. The procedure itself is very simple and not very time-consuming. Topical anesthesia may be applied first. A small amount of your blood is drawn into a special tube containing an anticoagulant, which is spun in a centrifuge for 5 - 8 minutes. This separates the different components of blood, leaving plasma at the top, rich in platelets. This plasma is then drawn and an activating agent (e.g. calcium chloride) is added to it to activate the platelets and release their content. The PRP is then injected into the skin. PRP can be injected anywhere on the face and neck, but your doctor might also concentrate more of the injected volume into wrinkles, acne scars or discolored areas. PRP can also be used for rejuvenating the skin of the hands and other areas, such as stretch marks.

How Many Injections?

[caption id="" align="aligncenter" width="300"]Syringe 5 with drops. Most people require more than one PRP injection to see results. The total number of injections recommended varies depending on the patient.[/caption] The number of injections varies widely from one patient to the next. You will most likely need more than one injection, and as this is a procedure that is easy and has no side effects, you can have as many as you like, or you can choose to stop after achieving an end result that is desirable for you. Treatments are usually spaced one month apart.

The End Result

[caption id="attachment_7530" align="aligncenter" width="300"]PRP before and after PRP before and after, with facial fat transfer. Photo courtesy RealSelf.com.[/caption] PRP injection can treat or dramatically improve:
  • Skin volume.
  • Skin tone and texture.
  • Photodamage.
  • Wrinkles around the eyes, around the mouth, on the forehead, on the neck, as well as nasolabial grooves.
  • Under eye circles and bags.
  • Discoloration.
  • Acne scars.
Of the many benefits mentioned above, what you actually end up seeing depends on your own blood. The platelet level and the levels of growth factors in these platelets differ from one person to the next. Therefore, each person reports a different experience: some report smoother skin, some report improved discoloration, some report improved wrinkles or scarring, and some will have varying combinations of these. So really your dermatologist cannot predict how it will work for you, but one thing’s for sure, you will get something out of PRP. One shortcoming a patient must be made aware of is that deeper wrinkles and more severe acne scarring may not show enough improvement with PRP alone, and will need adjunctive therapies such as laser therapy or fillers. Advantages to PRP over Laser Therapy or Fillers
  • It is your own blood, so there is no chance of an allergic response.
  • It is a minor procedure with very minimal downtime.
Disadvantages to PRP vs. Laser Therapy and Fillers They are all minor and transient and include:
  • Bruising – should fade within a few days.
  • Burning sensation for a few minutes post injection, probably due to the activating agent.

The Cost

Prices start from around $400. Larger areas can cost double that.  As with most procedures, price will vary based upon the experience and location of the practitioner as well.

Bottom Line

Autologous PRP mesotherapy is a very promising technique that has the advantage of being easy, fast, with little down time and no side effects. It would be an excellent addition to a regimen worked out with your dermatologist to treat wrinkles, scaring, discoloration, and photoaging, in conjunction with other treatment modalities such as, for example, fraxel or radiofrequency sessions.     Thanks for reading! Remember, stop by my blog, Elbashra, or tell your friends if interested in reading about skin care in Arabic! Sources: N. Kakudo et al. Proliferation Promoting Effect of Platelet Rich Plasma on Human Adipose Derived Stem Cells and Human Dermal Fibroblasts. Plastic and Reconstructive Surgery 2008; 122 (5): 1352-60. A. Redaelli. Face and Neck Revitalization with Platelet Rich Plasma: Clinical Outcome in a Series of 23 Consecutively Treated Patients. Journal of Drugs in Dermatology 2010; 9 (5): 466-7. DA. Kim et al. Can Platelet Rich Plasma be used for Skin Rejuvenation? Evaluation of Effects of Platelet Rich Plasma on Human Dermal Fibroblasts. Annals of Dermatology 2011; 23 (4): 424-31.