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PRP vs saline for skin rejuvenation

Article-PRP vs saline for skin rejuvenation

injection in man's forehead

In a split-face single-session comparison of platelet-rich plasma (PRP) and saline injections, recipients reported reduced signs of facial aging, according to a randomized clinical trial in JAMA Dermatology

The 27 participants, between the ages of 18 and 70, had bilateral cheek rhytids of Glogau class II or greater. Each patient received intradermal injections of PRP (3 mL total) in one cheek and sterile normal saline in the contralateral cheek.

“Six months later, patients noted that the side treated with PRP was smoother, with less roughness and fine wrinkles,” lead investigator Murad Alam, M.D., of Northwestern University, tells The Aesthetic Channel.

However, dermatologist raters of before-and-after photographs did not observe a difference between the two sides.  

“This suggests that PRP may improve skin texture by a small amount after one treatment,” Dr. Alam says. “It may have been easier for patients, who knew their faces well, to notice a small but real improvement.”

Dr. Alam says that although PRP is becoming an increasingly popular treatment for facial rejuvenation, “there is very little scientific evidence to show that it works, or what specific benefits it provides to patients.”

Regardless, the treatment is attractive because it is natural in that it uses a patient's own blood, according to Dr. Alam. “PRP is also minimally invasive, relatively quick to perform and without much downtime,” he says.

Now that the current study has compared PRP to placebo (saline), the next step might be to compare PRP to other, more established treatments for facial rejuvenation, like lasers and energy devices.

“Perhaps PRP could be used in combination with these other treatment options,” Dr. Alam says.

One of the largest unanswered questions, though, is how long PRP results last. “That answer would tell us how often we need to treat patients,” Dr. Alam says. “This, in turn, would help patients understand the cost and number of visits per year, so they could decide if PRP is worth the expense.”

A related question is whether PRP and similar treatments could slow the emergence of skin aging. “For example, might PRP be injected, like botulinum toxin, to stop wrinkles before they begin?” Dr. Alam poses.

In any event, PRP appears to be very safe, according to Dr. Alam. “Even though it is a blood product, risk of infection and allergy is exceedingly low because it is made with your own blood,” he says.

Moreover, a series of PRP treatments may lead to greater benefit, as is the case with many other dermatologic treatments.

Dr. Alam and his colleagues plan to study the changes in the skin after several treatments of topical PRP combined with microneedling and duration of results.

“It would also be interesting if future studies showed PRP improved skin color and complexion, which our initial study did not,” Dr. Alam says.