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Comparison of the Efficacy of Fractional Radiofrequency Microneedling alone and in combination with platelet rich plasma in neck rejuvenation a clinical and optical coherence tomography study
Gawdat H, Allam Rshm, Hegazy R, Sameh B, Ragab N
Journal of cosmetic dermatology. 2021
Abstract
BACKGROUND Aesthetic improvement of the neck and cervicomental angle remains one of the most challenging aspects of rejuvenation. Fractional radiofrequency microneedling demonstrated significant skin tightening and lifting of lower third of the face. AIM OF WORK To evaluate and compare fractional radiofrequency microneedling alone and in combination with autologous platelet rich plasma (PRP) in neck rejuvenation. METHODS 20 patients with mild to moderate neck laxity were randomized to receive 3 sessions of either fractional radiofrequency microneedling + PRP (group A) or fractional radiofrequency microneedling monotherapy (group B). Evaluation was done using optical coherence tomographgy to detect dermis thickness, measurement of cervicomental angle, a score done by two investigators blinded to used modality (GAIS) and patient satisfaction score. RESULTS Both Groups showed a statistically significant improvement in all parameters. Comparing the two groups the mean dermal thickness after treatment was higher in group A compared to B but was found statistically insignificant. More favorable results were reported in group A according to GAIS. Other parameters showed comparable results. CONCLUSION Fractional micro-needle radiofrequency with insulated microneedles offers a safe and effective modality for mild to moderate neck laxity when used alone or in combination with PRP. It remains questionable whether combining fr-RF microneedling with PRP provides more favorable results in terms of efficacy and side effects.
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The Effects of Lower Versus Higher Cell Number of Platelet-Rich Plasma (PRP) in Hair Density and Diameter in Androgenetic Alopecia (AGA): A Randomized, Double-Blinded, Placebo, Paralleled Group Half-Scalp IRB Study
Sasaki GH
Aesthetic surgery journal. 2021
Abstract
BACKGROUND Androgenetic alopecia (AGA) is a common disorder in male and female patients that may benefit from the use of platelet-rich plasma. OBJECTIVES To compare the safety, efficacy, and satisfaction of a lower or higher number of platelets over 6 months. METHODS A prospective randomized, double-blinded, placebo, paralleled group, half-scalp IRB study among eight subjects with moderate AGA. Participants received intradermal PRP injections (baseline and month 3), according to two treatment protocols (high vs low platelet numbers) to the frontal and crown portions of the hemi-scalp and normal saline to control sites. Phototrichoscans were measured at baseline and six months, while global photography and subject and investigator satisfaction questionnaires were obtained at baseline, 3, and 6 months. RESULTS At the end of 6-month evaluation period, both groups demonstrated numerical increases in total hair densities, follicle diameters and terminal hair densities, as well as absolute and percent changes at the frontal and crown targeted sites compared to baseline. These improvements tended to occur more often in areas treated with higher platelet numbers than with lower numbers. Vellus hair densities did not exhibit any significant changes to either PRP dosages. Treatments were assessed by investigator and subjects as "satisfied" at month-3 and were associated with no adverse reactions. CONCLUSIONS Intradermal injections with two therapeutic quantities of platelets were equally safe and efficacious among men and women with androgenetic alopecia. Findings suggest that higher numbers of platelets may have a greater effect than lower number of platelets in regard to hair densities, follicle diameters and terminal hair densities but exhibited minimal effects on vellus hair densities at the month-6 evaluation period. Further studies are required to determine whether any significant advantages occur when delivering either lower or higher numbers of platelets in AGA treatments as long as therapeutic levels are administered.
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Subcision, Chemical peels, and Platelet-Rich Plasma: Combination approaches for the treatment of Striae Distensae
Ebrahim HM, Salem A, Salah T, Desoky F, Morsi HM
Dermatologic therapy. 2021
Abstract
Striae distensae (SD) are disfiguring skin condition causing cosmetic troubles and psychological distress. To compare the efficacy and safety of platelet-rich plasma (PRP) versus its combination with subcision or medium-depth peeling (glycolic acid 70% followed by trichloroacetic acid [TCA] 35%) for SD treatment. Seventy-five female patients with SD were divided into 3 equal groups with contralateral side in each patients is the control. Group A treated with PRP, group B received PRP + subcision while group C received PRP + combined peeling (GA70% + TCA35%). Primary outcome included clinical improvement, patients' satisfaction and Dermatology Life Quality Index (DLQI). Striae measurement, skin biopsies are also assessed. Very much improvement was achieved in 28%, 44%, 36% in groups A, B, and C respectively. The combined groups (B and C) showed significantly higher patients' satisfaction and DLQI than group A (P = 0.03), (P < 0.0001). A significant decrease in all striae measurements was achieved with all groups (P < 0.001) however, groups B and C showed more decrease (P = 0.2 and0.4). A highly significant decrease in the mean number of sessions was found in group B (P < 0.0001). All groups demonstrated improvement in dermal collagen deposition which was higher in the combined groups. Side effects were mild and well tolerated. The combination of PRP with subcision or peeling is more effective and gives a higher therapeutic response than PRP alone. Moreover, the subcision has superior efficacy in striae albae and safer in darker skin types. This article is protected by copyright. All rights reserved.
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Fractional Carbon Dioxide Laser or Erbium:Yttrium-Aluminum-Garnet Laser Assisted by Topical Application/Intradermal Injection of Platelet-Rich Plasma for Postacne Scars
Chen J, Wan Y, Lin Y, Jiang H
Plastic and reconstructive surgery. 2021;148(6):915e-927e
Abstract
BACKGROUND Fractional carbon dioxide or erbium:yttrium-aluminum-garnet (YAG) laser combined with platelet-rich plasma has been used for postacne scars. Nevertheless, there is limited evidence on its use because of the small size of relevant studies. This study aims to evaluate the efficacy of platelet-rich plasma-assisted laser for postacne scars. METHODS Randomized controlled trials comparing carbon dioxide or erbium:YAG laser combined with platelet-rich plasma to laser alone were searched for using the PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases. RESULTS In total, 13 studies involving 672 cases were included. The overall degree of clinical improvement favored platelet-rich plasma combined with carbon dioxide laser (mean difference, 0.55; 95 percent CI, 0.40 to 0.70) or erbium:YAG laser (mean difference, 0.63; 95 percent CI, 0.31 to 0.96). Notably, the use of carbon dioxide laser combined with platelet-rich plasma was more effective in both greater than 50 percent improvement of acne scars (OR, 1.63; 95 percent CI, 1.10 to 2.42) and greater than 75 percent improvement of acne scars (OR, 2.78; 95 percent CI, 1.75 to 4.42), compared with laser alone. Erbium:YAG laser combined with platelet-rich plasma was more effective in greater than 75 percent improvement of acne scars compared with laser alone (OR, 3.45; 95 percent CI, 1.31 to 9.05). Moreover, patient satisfaction was significantly higher with platelet-rich plasma combined with carbon dioxide laser (OR, 2.98; 95 percent CI, 1.72 to 5.16) or erbium:YAG laser (OR, 2.88; 95 percent CI, 1.33 to 6.21) compared to laser alone. CONCLUSION This meta-analysis provides reliable evidence that fractional carbon dioxide or erbium:YAG laser combined with platelet-rich plasma is an effective and safe combination therapy for postacne scars. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
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Platelet-rich plasma for striae distensae: What do we know about processed autologous blood contents for treating skin stretchmarks?-A systematic review
Sawetz I, Lebo PB, Nischwitz SP, Winter R, Schaunig C, Brinskelle P, Kamolz LP, Gualdi A, Lumenta DB
International wound journal. 2021
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Abstract
Striae distensae, also known as stretch marks, particularly associated with female sex, pregnancy, obesity, and/or hormonal change, are linear bands of benign dermal lesions. Although not posing any health risk, aesthetically unpleasing stretch marks can cause significant psychological distress among those affected. In abundance of therapeutic approaches, some literature sources proclaim platelet-rich plasma to be a promising treatment modality for striae distensae. We aimed to shed some light on the current literature evidence of platelet-rich plasma for treating stretch marks and performed an English literature analysis with two independent reviewers in accordance with PRISMA guidelines searching the PubMed and Web of Science databases in June 2019. Of the 12 found studies, 6 matched inclusion criteria. With no control groups in two, just two other reports used intraindividual comparisons, and all but one publication performed histopathological assessments. All studies observed clinical and subjective improvements without using validated scores or patient-reported outcome measures (PROMs). The main findings were that multiple treatments with platelet-rich plasma demonstrated increased epidermal thickness, rete ridges formation, and collagen/elastin formation, while decreasing the inflammatory cell infiltrate. The current literature evidence supporting the use of platelet-rich plasma for striae distensae is poor. We propose in this review an outline for a study protocol with intraindividual control groups, standardised scores, validated PROMs, and participant incentives to enhance the scientific power in future clinical trials.
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6.
Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Appraisal of the Available Clinical Evidence
Xiao H, Xu D, Mao R, Xiao M, Fang Y, Liu Y
Clinical, cosmetic and investigational dermatology. 2021;14:1697-1724
Abstract
PURPOSE Platelet-rich plasma (PRP) is a promising noninvasive technique for facial rejuvenation. This systematic literature review aims to appraise the nature and quality of published evidence evaluating the effectiveness and safety of PRP in facial rejuvenation. PATIENTS AND METHODS A systematic literature review was conducted with the search string "Platelet-rich plasma AND Facial rejuvenation" in PubMed and Embase. Clinical studies evaluating the outcomes after PRP-based facial rejuvenation either as monotherapy or in combination with other treatment modalities were included. Studies evaluating wound-healing properties of PRP were excluded. The outcomes included both patient-reported and physician-assessed outcomes. Nonstatistical synthesis of evidence was performed by qualitative assessment. The results are reported by the Synthesis Without Meta-analysis (SWiM) reporting standard. RESULTS A total of 36 studies that included a total of 3172 patients were considered for the evidence synthesis. The number of patients in the included studies ranging from 11 to 2005 with a median of 27.5 patients that reflects the challenges in clinically assessing the aesthetic outcomes after PRP-based facial rejuvenation. Among the 36 studies, 17 were observational studies and 18 were interventional studies with 1 being case report PRP was evaluated either alone or in combination with hyaluronic acid, lipofilling, micro-needling technique, and laser-based interventions. Among the studies, 1 study reported the enhanced platelet concentrate in a fibrin matrix to be relatively safe and effective with a maximum benefit observed at 12 weeks suggesting the platelet-rich fibrin matrix may provide desired aesthetic outcomes and it requires further studies to substantiate. CONCLUSION The results suggest very limited clinical evidence, and further clinical studies are warranted to establish the effectiveness of PRP in facial rejuvenation. Furthermore, a consensus for end points used for establishing clinical utility in patients requiring facial rejuvenation is warranted.
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Efficacy of platelet poor plasma gel in combination with fractional CO(2) laser in striae distensae: a clinical, histological and immunohistochemical study
Gad SE, Neinaa YME, Rizk OK, Ghaly NER
Journal of cosmetic dermatology. 2021
Abstract
BACKGROUND Platelet-poor plasma gel is a semi-solid plasma formulation that recently recommended as autologous bio-filler for treatment of atrophic dermal scars. OBJECTIVE To compare the therapeutic efficacy and safety of intradermal injection of plasma gel in combination with fractional CO(2) laser versus fractional CO(2) laser alone in striae distensae (SD). PATIENTS AND METHODS This study included 36 SD patients treated by 3 sessions (one session/1.5 months) of fractional CO(2) laser on all SD lesions following intradermal injection of plasma gel on one side, and saline (as placebo) on the other side. RESULTS Significant clinical improvements associated with remarkable narrowing of SD lesions and prominent enhancement of skin texture were observed on both treatment sides. Obviously, higher degrees of clinical improvements of SD lesions were reported following combined therapy with fractional CO(2) laser and plasma gel rather than fractional CO(2) laser monotherapy. However, post-inflammatory hyperpigmentation (PIH) was reported more frequently with fractional CO(2) laser monotherapy. Histopathological and immunohistochemical examinations revealed significant epidermal improvement, and homogenization, and orientation of dermal collagen bundles as a result of both therapeutic procedures. CONCLUSION Plasma gel in combination with fractional CO(2) laser could be considered a promising novel treatment modality for SD. Plasma gel not only improves the efficacy of fractional CO(2) laser, but also decreases the frequency of PIH.
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Improved wound healing of diabetic foot ulcers using human placenta-derived mesenchymal stem cells in gelatin electrospun nanofibrous scaffolds plus a platelet-rich plasma gel: A randomized clinical trial
Meamar R, Ghasemi-Mobarakeh L, Norouzi MR, Siavash M, Hamblin MR, Fesharaki M
International immunopharmacology. 2021;101(Pt B):108282
Abstract
AIM: The effectiveness of nanofibers containing human placenta-derived mesenchymal stem cells (hPDMSCs) plus platelet-rich plasma (PRP) for healing of diabetic foot ulcers (DFUs) was investigated. METHODS hPDMSCs were isolated from human donor placentas, and cultured in electrospun gelatin nanofibrous scaffolds (GNS). Twenty-eight patients with DFUs were randomized into three groups in a 12-week trial: (A) Treated with hPDMSCs; (B) Treated with hPDMSCs after coating the ulcer with PRP gel; (C) Control group received standard wound care. Wound area and pain freewalkingdistance were measured every 2 weeks. RESULTS Flow cytometry showed the expression of mesenchymal markers. SEM images and DAPI staining indicated significantly higher levels of hPDMSC proliferation on GNS after 3 and 7 days of culture. The MTS assay showed a significant increase in proliferation on GNS, compared to controls. Wound size reduction was 66% in group A, 71% in group B, and 36% in control group C. A significant difference in wound closure and pain-free walking distance was observed between groups A and B, compared to control group C (p < 0.05), but no difference between groups A and B. Biopsy of the implanted tissue showed the development of new capillary formation in groups A and B. CONCLUSION Implantation of hPDMSCs in GNS accelerated wound healing and improved clinical parameters in DFU patients.
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Comparison of 5% minoxidil lotion monotherapy versus its combination with autologous platelet rich plasma in androgenetic alopecia in hundred males
Ray R, Sharma A
Medical journal, Armed Forces India. 2021;77(3):355-362
Abstract
BACKGROUND Androgenetic alopecia (AGA) is the most common form of alopecia in men, affecting 70% by the age of 20 years. The present study was conducted with the objective of comparing the efficacy of monotherapy with topical 5% minoxidil and its combination with intradermal platelet rich plasma (PRP), in male AGA. METHODS This observational study was conducted at the dermatology department of a tertiary care hospital over a duration of 2 years. 100 patients with AGA were selected and divided randomly into 2 treatment arms: Group A (MM): received topical 5% Minoxidil monotherapy for 12 months and; Group B (M + PRP): received combination therapy of PRP and topical 5% Minoxidil for 12 months. The following parameters were subsequently analyzed on follow up: Physician-assessed global photography by a 4-point improvement scale and trichoscopic improvement of mean hair diameter. RESULTS The combination was statistically superior to the monotherapy group in promoting hair growth in men with AGA for both measures of hair growth - photographic assessment and trichoscopic mean diameter. CONCLUSION We hereby conclude that intradermal PRP injections should be offered to all patients with AGA along with the existing therapeutic modalities, for faster hair regrowth and improved compliance.
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Systematic review of platelet-rich plasma (prp) in treating alopecia: Focusing on efficacy, safety and therapeutic durability
Roohaninasab M, Goodarzi A, Ghassemi M, Sadeghzadeh-Bazargan A, Behrangi E, Najar Nobari N
Dermatologic therapy. 2021;:e14768
Abstract
BACKGROUND & AIM: Considering the different forms, alopecia could be a very common condition with particular therapeutic concerns; thus, recent therapies still require further assessments. Aim of this systematic review was to evaluate efficacy, safety and therapeutic durability of platelet rich plasma (PRP) in treating various forms of alopecia. METHOD A total of 64 articles were found through a systematic search, and 8 original articles were included in the study, based on inclusion/exclusion criteria. RESULTS In most studies (62.5%) patients' conditions had improved by receiving PRP therapy; these cases experienced an increase in growth and thickness of hair. Simultaneous use of PRP and Minoxidil demonstrated the highest rate of improvement and satisfaction. The highest efficacy in patients with alopecia areata was 76% and the lowest efficacy was 31.7% and in patients with androgenetic alopecia the highest efficacy was 42.75% and the lowest reported efficacy was 25.55%. The main side effect was pain due to PRP injection, which disappeared after ending the treatment and only one article reported more serious side effects. Recurrence after treatment was also reported in only one article. CONCLUSION PRP is a safe and easy method for treating hair loss and has limited adverse effects. Optimization of this method depends on dosage, number of sessions and their intervals, and injection techniques. According to the results, the use of PRP due to its relatively high efficiency, low and tolerable side effects, and low recurrence rate can be a good method for the treatment of alopecia and hair loss. This article is protected by copyright. All rights reserved.
