Platelet-Rich Plasma Injections For Face: The Good, The Bad, The Beautiful & The Ugly

Platelet-Rich Plasma Injections For Face: The Good, The Bad, The Beautiful, & The Ugly

A friend asked me to comment on the dangers and positive potentials of Platelet-Rich Plasma injections for the Face.

Though I am not a dermatologist, I have been looking into using PRP for my severe dry eye patients. There are some things everyone should know about PRP for the face.

1. All cosmetic procedures have risks.
2. Nothing is 100% guaranteed
3. There is a risk of infection, scar formation, increased skin pigmentation (1 case I could find in the literature) and making things worse
4. The literature, even the best performed study gives part of the truth, but you may fall in the complication group, so always keep that in mind.
5. Some studies are sponsored by the industry that is trying to encourage you to part with your hard earned cash. Be always aware of studies that show “glowing results.” Also be careful with doctors who have stock in a company or are paid consultants by the company. Their suggestions may be swayed by who is paying them.
6. I am personally a bit skeptical of cosmetic surgery outcomes results since there is a lack of objective measures in cosmetic surgery studies from what I can see. A statement of “am I better or not” is often left to the patient in some studies without objective, standardized measures of “improvement” or “more beautiful.” Note that if a patient has just paid thousands of dollars for a treatment, they may be more inclined in some populations to say “they look better.” But some studies did have some objective measures of “more pimples or scars per square mm of face.” Look carefully at results for objective measures of success.


Platelet-rich plasma (PRP) has been used over the last several years as an effective treatment in various medical and surgical fields. I am currently looking to use PRP for my severe dry eye patients. There are publication about the use of PRP in wound treatment, maxillofacial surgery, soft tissue injuries, periodontal and oral surgery, orthopedic surgery, trauma surgery, gastrointestinal surgeries, burns, cosmetic and plastic surgery. PRP specifically has attracted the attention of dermatologists in the aesthetic field for skin rejuvenation for many years now. 
A patient’s blood is drawn, and the platelets are isolated. PRP contains a high concentration of several growth factors in α-granules of platelets, secreted after the activation of platelets by aggregation initiators. Several growth factors and cytokines work in the stimulation process of fibroblast collagen synthesis, which can help modify cell structure.

So here is what I found:
1.  Many studies published were not in the US. Most of these studies did not say if the authors were consultants to any company. See references below.
2. Most studies in the last years were very positive.
3. 1 study below reported increased pigmentation in the skin of a patient having PRP injections of the face.
4. It is important to go to a reputable/safe doctor to avoid complications.

Most Studies have the following statements & conclusions:

Side-effects such as mild bruising/ecchymosis (black& blue changes on skin)/hematoma (blood clot under skin), occasional swelling, mild or prolonged erythema (redness), burning sensation, and rarely infections were reported. I found 1 case report below of increased skin pigmentation after PRP for the face. Mild erythema occurred probably due to calcium chloride. Mild and transient side effect such as bruising/ecchymosis, burning sensation, mild erythema, and severe erythema were observed in the present study. We did not observe any serious side effects due to PRP. We considered that PRP is a safe choice as a cosmetic procedure for facial skin rejuvenation.

PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique ‘point by point’). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.

In Conclusion:

Platelet-Rich Plasma Injections For Face is safe in the majority of patients but it is not 100% without risk of complications. 

Be sure you go to an MD who you can trust and is not out there just to make money on this 

Sandra Lora Cremers, MD, FACS


 2016 Jul 19. [Epub ahead of print]

Does Platelet-Rich Plasma Therapy Increase Pigmentation?

Author information

  • 1Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey.


Platelet-rich plasma (PRP) is an autologous solution of plasma containing 4 to 7 times the baseline concentration of human platelets. Platelet-rich plasma has been widely popular in facial rejuvenation to attenuate wrinkles and has been practically used. The authors have been encountering various patients of increased hiperpigmentation following PRP applications that were performed to attenuate the postinflammatory hiperpigmentation especially after laser treatment. The authors have been using PRP for facial rejuvenation in selected patients and in 1 patient the authors have encountered increased pigmentation over the pigmented skin lesions that were present before the application. The authors recommend that the PRP might increase pigmentation especially in the face region and precautions might be taken before and after the application. Platelet-rich plasma should not be used for the treatment of post inflammatory hiperpigmentation.

 2016 Dec;28(6):718-724. Epub 2016 Nov 23.

Histologic Evidence of New Collagen Formulation Using Platelet Rich Plasma in Skin Rejuvenation: A Prospective Controlled Clinical Study.

Author information

  • 1Department of Dermatology, Acıbadem Fulya Hospital, Istanbul, Turkey.
  • 2Department of Dermatology, Eskisehir Military Hospital, Eskisehir, Turkey.
  • 3Department of Pathology, Anadolu Medical Center, Kocaeli, Turkey.
  • 4Department of Dermatology, Yunus Emre Government Hospital, Eskisehir, Turkey.
  • 5Department of Pathology, Eskisehir Military Hospital, Eskisehir, Turkey.
  • 6Department of Dermatology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey.



Platelet-rich plasma (PRP) is an autologous concentration of human platelets contained in a small volume of plasma and has recently been shown to accelerate rejuvenate aging skin by various growth factors and cell adhesion molecules.


This study was conducted to evaluate the efficacy and safety of intradermal injection of PRP in the human facial rejuvenation.


This study was a prospective, single-center, single-dose, open-label, non-randomized controlled clinical study. PRP injected to the upper site of this right infra-auricular area and all face. Saline was injected to the left infra-auricular area. Histopathological examinations were performed before PRP treatment, 28 days after the PRP, and saline (control) treatments.


Twenty women ranging in age from 40 to 49 years (mean age, 43.65±2.43 years) were enrolled in the study. The mean optical densities (MODs) of collagen in the pre-treatment, control, and PRP-treated area were measured. They were 539±93.2, 787±134.15, 1,019±178, respectively. In the MOD of PRP, 89.05 percent improvement was found when MOD of PRP was compared with MOD of pre-treatment. The mean MOD of collagen fibers was clearly highest on the PRP side (p<0.001). The PRP-to-saline improvement ratio (89.05% to 46.01%) was 1.93:1. No serious side effects were detected.


PRP increases dermal collagen levels not only by growth factors, but also by skin needling (the mesotherapy technique ‘point by point’). PRP application could be considered as an effective (even a single application) and safety procedure for facial skin rejuvenation.
 2016 Sep 5. doi: 10.1111/jocd.12271. [Epub ahead of print]

Platelet-rich plasma and hyaluronic acid – an efficient biostimulation method for face rejuvenation.

Author information

  • 1Department of Plastic Reconstructive and Aesthetic Surgery, Balikesir University, Balikesir, Turkey.



Cosmetic applications of platelet-rich plasma (PRP) are new, and reports are scarce and dispersed in the literature. There are a variety of commercially available kits and injection techniques, and the number and intervals of injections vary. New investigations should focus on developing a standardized procedure for PRP preparation and application methods to augment its efficacy and potency.


In this report, we aim to provide data and commentary to assist and add to current guidelines.


A series of 94 female patients with varying degrees of facial aging signs were treated with PRP and hyaluronic acid (HA). Mean age was 53.0 ± 5.6. The mean injection number was 3.6 ± 2.0. Platelet-poor and platelet– rich plasma parts were mixed with 0.5 cc %3.5 hyaluronic acid and 0.5 cc procaine and injected with a 30G, 13-mm needle into deep dermis and hypodermis. Patients were asked to rate their personal satisfaction with their skin texture, pigmentation, and sagging. In addition, the overall results were rated by three independent physicians and the patients themselves. The outcomes were peer-reviewed, and correlations between the degree of the aesthetic scores and the number of injections were explored.


There was a statistically significant difference in general appearance, skin firmness-sagging and skin texture according to the patients’ before and after applications of PRP. A statistically significant correlation was found between the number of injections and overall satisfaction.


Compared to the baseline, the PRP and HA injections provided clinically visible and statistically significant improvement on facial skin. The improvements were more remarkable as the injection numbers increased.

 2016 Dec 15. pii: S1748-6815(16)30556-3. doi: 10.1016/j.bjps.2016.11.028. [Epub ahead of print]

Tissue sealants may reduce haematoma and complications in face-lifts: A meta-analysis of comparative studies.


The use of tissue sealants has increased among different surgical specialities. Face-lift and rhytidoplasty may cause several complications such as haematoma, ecchymosis, oedema, seroma, skin necrosis, wound dehiscence and wound infection. However, administration of tissue sealants may prevent the occurrence of some complications. We performed a meta-analysis of studies that compared tissue sealant use with controls to evaluate the outcomes. A systematic literature search was performed. The primary outcome was the incidence of haematoma. Secondary outcomes were wound drainage amount, oedema, ecchymosis, seroma, skin necrosis and hypertrophic scarring. Thirteen studies involving 2434 patients were retrieved and included in the present analysis. A statistically significantly decrease in post-operative haematoma [risk ratio (RR), 0.37; 95% CI, 0.18-0.74; p = 0.005] and wound drainage (MD, -16.90, 95% CI = -25.71, -8.08, p < 0.001) was observed with tissue sealant use. A significant decrease in oedema was detected (RR, 0.30; 95% CI, 0.11-0.85, p = 0.02) but not in ecchymosis, seroma, skin necrosis, and hypertrophic scarring with tissue sealant use. The use of tissue sealants prevents post-operative haematomas and reduces wound drainage. Previous studies have shown a similar trend, but the power of this meta-analysis could verify this perception.



 2016 Jul 29. doi: 10.1111/jocd.12258. [Epub ahead of print]

Assessment of the efficacy and safety of single platelet-rich plasma injection on different types and grades of facial wrinkles.

Author information

  • 1Department of Dermatology and Venereology, Faculty of Medicine, Tanta University Hospitals, Tanta University, Tanta, Egypt.
  • 2Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.



Platelet-rich plasma (PRP) is considered as a growing modality for tissue regeneration and a developing research area for clinicians and researchers. PRP injection treatment provides supraphysiological concentrations of growth factors that may help in accelerated tissue remodeling and regeneration.


To evaluate the efficacy and safety of single autologous PRP intradermal injection for treatment of facial wrinkles and for facial rejuvenation.


A total of 20 subjects with different types of facial wrinkles were included in this study. All subjects received single PRP intradermal injection and were clinically assessed before and after treatment for a period of 8 weeks using Wrinkle Severity Rating Scale (WSRS), Skin Homogeneity and Texture (SHnT) Scale, Physician Assessment Scale, and Subject Satisfaction Scale.


The mean value of WSRS reduced from 2.90 ± 0.91 before treatment to 2.10 ± 0.79 after 8 weeks of treatment. The most significant results were with younger subjects that have mild and moderate wrinkles of the nasolabial folds (NLFs). Fourteen of seventeen subjects with NLFs showed more than 25% improvement in their appearance. Side effects of PRP treatment were minimal to mild and with excellent tolerability.


Single PRP intradermal injection is well tolerated and capable of rejuvenating the face and producing a significant correction of wrinkles especially the NLFs.

 2016 Jan 8. doi: 10.1111/jocd.12207. [Epub ahead of print]

Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study.

Author information

  • 1Department of Dermatology, Venereology, and Leprosy, National Institute of Medical Sciences, Jaipur, Rajasthan, India.



Acne scarring causes cosmetic discomfort, depression, low self-esteem and reduced quality of life. Microneedling is an established treatment for scars, although the efficacy of platelet-rich plasma (PRP) has not been explored much.


The objective of this study was to evaluate the efficacy and safety of platelet-rich plasma (PRP) combined with microneedling for the treatment of atrophic acne scars.


Fifty patients of 17-32 years of age with atrophic acne scars were enrolled. Microneedling was performed on both halves of the face. Intradermal injections as well as topical application of PRP was given on right half of the face, while the left half of the face was treated with intradermal administration of distilled water. Three treatment sessions were given at an interval of 1 month consecutively. Goodman’s Quantitative scale and Quantitative scale were used for the final evaluation of results.


Right and left halves showed 62.20% and 45.84% improvement, respectively, on Goodman’s Quantitative scale. Goodman’s Qualitative scale showed excellent response in 20 (40%) patients and good response in 30 (60%) patients over right half of the face, while the left half of the face showed excellent response in 5 (10%) patients, good response in 42 (6%) patients and poor response in three patients.


We conclude that PRP has efficacy in the management of atrophic acne scars. It can be combined with microneedling to enhance the final clinical outcomes in comparison with microneedling alone.

Platelet-Rich Plasma Injections For Face: The Good, The Bad & The Ugly

Platelet-rich Plasma For Skin Rejuvenation & Anti-Aging
A procedure that has been used successfully for years to heal sports injuries is now becoming the treatment of choice by women to improve the appearance of wrinkles, scars, sun damage and even dark circles under their eyes.
The treatment, Platelet-Rich Plasma, is gaining in popularity for the same reasons athletes chose it: because of its organic nature and because it works. It uses plasma taken from the patient’s own blood instead of chemicals injected into the body. The possibility of side effects is practically nonexistent because the body is unlikely to reject its own blood.
The treatment has become popularly known as the Vampire Facelift thanks to one celebrity, Kim Kardashian, who tried and recommended the procedure, and gave it its nickname.
Scientific Proof
The National Institutes of Health website cites several articles from peer-reviewed medical journals on studies of the Vampire Facelift procedure.
One such study, published by the Journal of Drugs in Dermatology in its May, 2010 issue, took place over a three-month period. Twenty-three patients were treated once every month. The mixture of PRP and an activating agent was injected into standard injection points on the face and neck.
The study participants were photographed both before and after their treatments with medical imaging devices, a dermoscope, and a digital camera. A month after the final treatment, the patients came back for a final evaluation. Based on all the scores, the study concluded that results were satisfactory, the treatment is effective and that the patients who participated experienced no serious or persistent side effects. Several other studies are also on the website.
Real Results
The majority of the women who reviewed their own Vampire Facelift on the website say they are happy with their results. The RealSelf website allows women to share their experiences with cosmetic surgery and ask questions that are answered by doctors. The reviewers also rate their own doctors. One reviewer said her results were still lasting three months after she had the injections. Another said her face was still glowing and her skin was still tighter five weeks after her treatment. A 54-year-old woman in New York opted for PRP for Face instead of Botox after hearing too many negative stories about the latter treatment. She said she noticed a difference in her face and was happy with the way it looked.
Platelet-Rich Plasma & Microneedling
Combining PRP With Microneedling For Even Better Results
A study in the Journal of Cutaneous and Aesthetic Surgery compared the results of two different combination treatments. The first combination paired PRP with a treatment called Microneedling, which is collagen induction therapy. This combination was compared to Microneedling paired with Vitamin C. The treatments were conducted on patients with acne scars.
Thirty patients ages 18 to 34 participated in the 2013 study, and received four treatments each, with an interval of four weeks between each treatment. The right side of each patient’s face was treated with the PRP combo and the left side with the Vitamin C combination. To be included in the study, the scarring from acne had to be rated with a Grade II, III or IV on the Goodman and Baron scale. Digital photos of both sides of each patient’s face were taken before the treatments began and after they were concluded using the same positions, lighting and background.
The acne scars were again graded using the Goodman and Baron scale after treatments. Both patients and doctors rated the improvement and change of grade of the acne scars. All the results were entered into Microsoft Excel database and analyzed using standard statistical methods. Of the 30 patients, the scars of 23 were reduced by one or two grades with the PRP combination.
If you’re not using PRP and Microneedling you’re missing out
Most women who have tried the combination of collagen and PRP have given the treatment good to excellent reviews. One plastic surgeon who administers the treatment to her patients had it done herself and highly recommends it. Dr. Lisa Zdinak, chief surgeon at Precision Aesthetics, said the plasma in the PRP stimulates the patient’s stem cells naturally and “wakes them up” causing them to produce more collagen, which is what makes the skin more youthful. Zdinak said the plasma contains molecules and proteins that provide nutrients to the skin’s cells, so it’s the healthiest, most natural way to improve the appearance of wrinkles, scars and other effects of aging. Coupled with additional collagen, which is also natural to the body, it’s even more effective.
Precautions to be taken
Most doctors who administer PRP treatments ice their patients’ faces immediately following the procedure to minimize the temporary bruising that can occur at the injection points. Icing will also help minimize any swelling or skin irritation for patients who have sensitive skin. All these effects are temporary and are almost always gone within a few days.
Patients with sensitive skin may need to take extra precautions recommended by their doctors. Allow sufficient intervals between the treatments so the skin has time to heal itself. Too many microneedling procedures too close together can cause swelling and even skin infection.
Platelet-Rich Plasma & Fractional Laser
Combining PRP with Fractional Laser
Twenty-two women participated in a study, published by the American Society of Dermatologic Surgery, that combined PRP with Fractional Laser treatments to analyze the effects on rejuvenating their skin. Eleven had a topical application of PRP along with three Fractional laser treatments, while the other 11 just had three Fractional Laser treatments alone. The patients were evaluated both before they were treated and 30 days after their treatments. Several different types of assessments were employed, including blind clinical evaluations, patient satisfaction and even biopsies of the skin. The results showed that skin rejuvenation was better with PRP, and patient satisfaction was higher with PRP compared to Fractional Laser alone.
PRP’s Effects Are Lasting
Women who have had the Vampire Facelift treatment find their faces look even better several months after they have had the treatments. That’s because the plasma stimulates their skin’s stem cells to produce more collagen, grow new cells and literally rejuvenate their skin. The new cell growth in your skin generated by the Platelet Rich Plasma takes weeks to months, which is why it looks so much better after more time passes. Botox and other filler treatments break down with time, but the Platelet Rich Plasma lasts and looks better as long as 18 months to two years. The FDA has not imposed regulations on the use of PRP because it come from the patient’s own body and is not a drug. The use of PRP with other substances and some systems that prepare the PRP for use have been FDA cleared, so make certain the one your doctor recommends is one of them.
Regenerative Medicine: Why There’s No Bad Side Effects With It
Platelet Rich Plasma literally stimulates new cell growth in the patient’s body wherever it is injected. It helps the body heal itself the natural way without using chemicals or foreign substances of any kind. The possibility of an allergic reaction or infection is almost nil because the plasma comes from the patient’s own body.

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