Can Platelet-Rich Plasma Rejuvenate Dermatology Treatments?

🔍 Key Finding Platelet-rich plasma (PRP) therapy shows promise for various dermatological conditions like wound healing, alopecia, and pigmentary disorders, by stimulating cellular proliferation, matrix formation, angiogenesis, and modulating inflammation through the release of growth factors. Further research is needed to fully elucidate PRP’s mechanisms of action and expand its clinical applications.

🔬 Methodology Overview

• Design: Narrative review.
• Data Sources: PubMed.
• Selection Criteria: Papers related to platelet-rich plasma (PRP) therapy in dermatology, with a focus on cellular and molecular mechanisms of action. Emphasis on recent and lesser-known effects.
• Analysis Approach: Qualitative synthesis of findings from selected studies.
• Scope: Mechanisms of PRP in various dermatological conditions including wound healing, alopecia, pigmentary disorders, scars, rejuvenation, lichen sclerosus, and other inflammatory dermatoses. Also includes discussion of future directions and potential applications.

📊 Results

• PRP therapy stimulates secretion of growth factors, with 95% released within one hour of injection and continued production for seven days.
• Optimal platelet concentration for PRP in skin diseases is 11.5 million platelets/L.
• L-PRP contains 14.9±4.5 (10³/mL) leukocytes and a 0.7-fold blood concentration of erythrocytes, while P-PRP contains 0.2±0.2 (10³/mL) leukocytes and very few erythrocytes.
• PRP exhibits antimicrobial effects through release of kinocidins, defensins, thymosin 4, and reactive oxygen species, as well as interaction with leukocytes and dendritic cells.
• In alopecia, PRP promotes hair growth via angiogenesis, hair follicle cell proliferation, and anagen phase lengthening, mediated by VEGF, PDGF, IGF, EGF, FGF, and GDNF.
• In melasma, PRP may decrease melanin synthesis via TGF-β1 and EGF, and increase skin volume through PDGF-stimulated collagen synthesis.
• In vitiligo, PRP may promote melanocyte regeneration, strengthen intercellular adhesion, and exert anti-inflammatory effects.

💡 Clinical Impact PRP therapy offers a promising regenerative approach for various dermatological conditions, including wound healing, alopecia, pigmentary disorders, and lichen sclerosus, potentially improving patient outcomes and expanding treatment options for conditions resistant to conventional therapies. Further research, particularly randomized clinical trials, is needed to solidify the evidence base and refine treatment protocols.

🤔 Limitations

• Unclear etiopathogenesis of many skin disorders limits understanding of PRP’s mechanisms of action.
• Limited randomized clinical trials for many PRP applications in dermatology.
• Controversial mechanisms for PRP’s effects on pigmentary disorders like melasma and vitiligo.
• Weak evidence for PRP’s efficacy in burn management and Zoon vulvitis.
• Lack of standardized PRP preparations and protocols.
• Limited long-term data on PRP’s efficacy and durability for chronic skin conditions.
• Insufficient research on less-studied pathways and potential applications of PRP in dermatology.

✨ What It Means For You This review comprehensively details the cellular and molecular mechanisms of PRP therapy, offering clinicians a deeper understanding of its benefits and clinical relevance in various dermatological conditions like wound healing, alopecia, and pigmentary disorders. This enhanced understanding can guide treatment decisions, potentially expanding PRP’s application to other inflammatory and scarring skin diseases with similar pathogeneses.

Reference Vladulescu D, Scurtu LG, Simionescu AA, Scurtu F, Popescu MI, Simionescu O. Platelet-Rich Plasma (PRP) in Dermatology: Cellular and Molecular Mechanisms of Action. Biomedicines. 2024;12:7. https://doi.org/10.3390/biomedicines12010007