Objective results

A study by Amgar et al41 is one of the very few studies concentrating only on the objective results of PRP. It uses biometric parameters for scientifically measurable means of assessing the results from the PRP injections. Skin hydration was made after compensating for the ambient humidity level. The hydration was expressed by a standard index. Anisotropy measures the distribution of micro-lines in 360, and is expressed as a percentage. Following marked swelling of the skin, a number of micro-lines on the surface of the skin can be observed. The projection and distribution of these micro-lines, two-dimensionally in all directions (360), is indicative of young skin. The older the skin, the more these lines will change orientation and become parallel.

[pull_quote align=”right” ]With the accumulated knowledge on this procedure, we now have the most complete, versatile and active treatment for skin rejuvenation and anti-ageing.[/pull_quote]

The study tracked 37 patients for a period of 3 weeks following PRP treatment, and 27 for an additional 10 weeks post-treatment. A good anti-ageing effect was assessed by measured anisotropy values of -24.1% and -16.9%., respectively. Additionally, a cross-analysis involving the initial anisotropy readings demonstrated further improvement. The anisotropy correlates were -33% and -39.7%, respectively, if the treatment is provided to patients who would mostly benefit from it (anisotropy > 30%). The study also demonstrated that the effects of one PRP treatment could last for up to 10 months.

In another study which combined PRP with fractional laser therapy for dermal rejuvenation42, a high concentration of PRP induced an up-regulation of type I collagen, MMP-1, and MMP-2 expression in human skin fibroblasts. Taken together, PRP treatment induced an increase in expression of G1 cell cycle regulators, type I collagen and MMP-1, thereby accelerating the wound healing process. Ablative CO2 fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and oedema, which may affect the daily lives of patients. Treatment with PRP after ablative CO2 fractional resurfacing enhances recovery of laser-damaged skin and synergistically improves the clinical appearance of acne scarring43, 44.

Significantly faster recovery of TEWL  (transepidermal water loss) was seen on the PRP-treated side. The erythema index and melanin index on the PRP-treated side were lower than on the control side. Biopsy specimens from the PRP-treated side showed thicker collagen bundles than those from the control side.

Findings from a histological examination by Sclafani et al45 support the clinical observations of soft-tissue augmentation. As early as 7 days post-treatment, activated fibroblasts and new collagen deposition were noted and continued to be evident throughout the course of the study. Development of new blood vessels was noted by day 19; also at this time, intradermal collections of adipocytes and stimulation of subdermal adipocytes were noted. Injection of PRFM into the deep dermis and subdermis of the skin stimulates a number of cellular changes that can be harnessed for use.

Conclusions

Since 1950 and the discovery of growth factors, and the fast developments of aesthetic medicine, there have been increasing numbers of research and study publications. As doctors, we are always looking for safe and effective treatments. With the accumulated knowledge on this procedure, we now have the most complete, versatile and active treatment for skin rejuvenation and anti-ageing.

Dermal fillers will replace the lost volume that comes with ageing, and lasers will act on collagen. However, as the facial ageing process involves more than just collagen depletion and gravity, but also bone resorption, with PRP a natural, safe, and efficient treatment is available to act on all aspects of ageing compartments (including bone loss).