Improving Scar Tissue using PRP

Platelet-Rich Plasma (PRP) is demonstrating success in healing and improving scar tissue, resulting from wounds or conditions [1]. Due to its ability to deliver a high concentration of growth factors to target tissues and potentially improve wound healing and scarring, PRP provides a clinical advantage, with clinical studies focused on atrophic acne scarring [1].

As with most clinical trials using PRP as a treatment arm, protocols and formulations are heterogenous. In lieu of standardized formulations or reporting, the following can be gleaned from available literature:

  • PRP has a definitive role in post-acne scar management, especially when used as an adjuvant to another modality, such as fractional ablative CO2 laser (FACL) [2] [3] or microneedling [4] [5] [6].

  • 3-4 sessions of microneedling + PRP at 3-4 week intervals [4] [5] [6] was found to be effective in management acne scarring.

  • Any side effects (such as redness or swelling) typically resolve within 2-3 days [5]. In addition, patients treated with both PRP + microneedling experience significantly less erythema and edema than with microneedling alone [5].

  • When used as an adjuvant to other scar treatments, such as FACL, PRP helps to resolve post-laser edema, erythema, and hyperpigmentation [2].

  • One possible protocol includes activating PRP with 10% calcium chloride in a 1:9 ratio. This mixture was split into two aliquots:

    • One portion was injected intradermally, targeting acne scars.

    • The remaining portion + Platelet-Poor Plasma (PPP) (also mixed with 10% calcium chloride in a 1:9 ratio) was allowed to form a gel and applied to the face post-microneedling [4].

Acne scar of a 25-years-old male with pretreatment and post-treatment right and left half of face showing significant improvement (margin of each scar can still be appreciated in left half). Comparison photo taken after three sessions of PRP + microneedling, provided at one month intervals.

 

Photo Credit: Mohd Asif et al. [4]

 

Citations:

[1] Alser, Osaid H, and Ioannis Goutos. “The Evidence behind the Use of Platelet-Rich Plasma (PRP) in Scar Management: A Literature Review.” Scars, Burns & Healing, vol. 4, 2018, p. 205951311880877., https://doi.org/10.1177/2059513118808773.

[2] Arsiwala, Nazneed Z, et al. “A Comparative Study to Assess the Efficacy of Fractional Carbon Dioxide Laser and Combination of Fractional Carbon Dioxide Laser with Topical Autologous Platelet-Rich Plasma in Post-Acne Atrophic Scars.” J Cutan Aesthet Surg, vol. 13, 2020, pp. 11–17., https://doi.org/10.4103/JCAS.JCAS_142_19.

[3] Sharma, Saurabh, et al. “Fractional Carbon Dioxide Laser versus Combined Fractional Carbon Dioxide Laser with Platelet-Rich Plasma in the Treatment of Atrophic Post-Acne Scars: A Split-Face Comparative Study.” J Cutan Aesthet Surg, vol. 14, 2021, pp. 35–40., https://doi.org/10.4103/JCAS.JCAS_147_19. 

[4] Asif, Mohd, et al. “Combined Autologous Platelet-Rich Plasma with Microneedling Verses Microneedling with Distilled Water in the Treatment of Atrophic Acne Scars: A Concurrent Split-Face Study.” Journal of Cosmetic Dermatology, vol. 15, no. 4, 2016, pp. 434–443., https://doi.org/10.1111/jocd.12207.

[5] Ibrahim, Mohamed Kotb, et al. “Skin Microneedling plus Platelet-Rich Plasma versus Skin Microneedling Alone in the Treatment of Atrophic Post Acne Scars: A Split Face Comparative Study.” Journal of Dermatological Treatment, vol. 29, no. 3, 2017, pp. 281–286., https://doi.org/10.1080/09546634.2017.1365111.

[6] Nandini, AS, et al. “Split-Face Comparative Study of Efficacy of Platelet-Rich Plasma Combined with Microneedling versus Microneedling Alone in Treatment of Post-Acne Scars.” J Cutan Aesthet Surg, vol. 14, no. 20, ser. 5, 2021. 5, https://doi.org/10.4103/JCAS.JCAS_160_18.


04/15/22