Platelet Rich Plasma (PRP) - fact or fiction?

Platelet Rich Plasma (PRP) for beautiful skin?

 

If you don't already know, platelets are little sub-cells in our blood that essentially help cause clotting and stop bleeding when we cut ourselves.

PRP is a concentrated plasma product derived from your own blood, once all the red blood cells are removed, leaving only high numbers of platelets.

 This enriched source of platelets is then reinjected into the surface layers of your face or other regions, and supposedly makes that area of skin look younger. Popularly known as the "Vampire Face Lift", this treatment is widely offered by numerous clinics, sometimes combining it with various needling or needle stamping, as a way to miraculously rejuvenate and regenerate old worn out skin, apparently shedding years off your look.

Sounds great!.................Ummm, no!

PRP does have a place in medicine, and as explained below, even in cosmetics. But claiming it rejuvenates and makes skin grow younger, really starts stretching the science and facts. The problem is, however, this myth does have some underlying threads of truth to it, in that PRP does have regenerative properties.

I personally have been using PRP for over 20 years now, and was very likely the first doctor in the world to have ever used PRP for facial cosmetic purposes back in 2000. But this was for healing a wound, not for filling wrinkles.

Back in early 2000, I read an article about this PRP stuff being mixed in with dead crushed up bone, and then it all being packed into broken jaws or thinned out jaws (that were too thin to take implants), and yes, miraculously, the dead bone grew into healed or thicker live bone! Wow! Reportedly, the platelets were said to release various growth factors to stimulate and accelerate the healing process (at this point there was no mention or realisation of a crucial entity called: STEM CELLS).

At this same time, I had been struggling a bit with the unsightly bleeding that occurred immediately following the facial laser resurfacing procedures I had been performing over the preceding 2 years. Coincidently, also at that time, I happened to hear about the first ever available and affordable test tube kit for producing platelets (PRP). Until this time, the only way to obtain platelets had been by some very expensive equipment available only to the likes of blood banks, and thus not clinically available to us.

With a bit of logic and theory, I hoped that platelets could help stop or reduce the bleeding problem, and possibly even help the healing, and so I set about applying this PRP to my next 2 laser patients. Unfortunately, at the time I was very disappointed that neither of the 2 patients showed any reduction in immediate post laser bleeding, but several days later when I reviewed these patients, both showed an incredible accelerated wound healing and superior cosmetic result. This was so profound, that from that point onwards, every laser case that I have since done has received this post laser PRP treatment. In this sense, I was first in the world to use PRP for purely cosmetic reasons, but have since also used PRP for healing otherwise stubborn leg ulcers, chronic wounds, marginal wound flaps and grafts (why this PRP has not been used in the public hospital sector for burn victims and ulcer patients etc eludes me) and over the last decade, I have incorporated PRP into all our stem cell therapies at the New Zealand Stem Cell Clinic.

This is all because PRP stimulates stem cells (well not quite true; the platelets need to be finally activated so that they release their growth factors; the platelets themselves are actually discarded leaving behind only their highly enriched hormone serum which is what turns on the stem cells).

So, where does this all leave us with the “Vampire Lift”?

Like I said earlier, it’s all a bit of a stretch really.

Yes, activated PRP turns on stem cells, and yes plausibly with enough PRP and enough treatments, stem cells in the skin may try and do something:

If there’s a whole lot of needling done at the time, then the PRP will logically speed up the healing of all the needle wounds. The overall point of that though, seems a bit self-defeating, with little more than thousands of perhaps well healed needle scars and the micro scar tissue that goes with them. Some may call this tightening; it’s not, it’s micro-scarring.

PRP injecting with or without micro-needling, will also cause injury swelling in the dermis layer of the skin. It will temporarily cause plumping or tightening, but it doesn’t last. Any type of injury swelling is usually for 3-6months, which coincidentally seems to match the vague time line improvements reported by Vampire Lift victims!

PRP is not stem cells. PRP is indirect, second step removed and only acts by turning on stem cells. How many stem cells are present in the skin dermis is difficult to know, and most probably decreases with age. Most people I see for cosmetic procedures are generally of a higher age demographic, and if they have skin requiring rejuvenation, then they’re almost certainly going to be in that higher bracket. I do not typically see the younger Kardashian type people needing skin “rejuvenation” – they don’t, they want lips! So repeatedly injecting bucket loads of PRP into older faces with inherently less stem cells, to me seems questionable. Perhaps some of the local stem cells may uprate or wake up and plausibly could try and turn into something. This might result in some limited general skin condition improvements. But to think a local stem cell is going to wake up and start specifically filling in a wrinkle, is absurd.

Supporting this rationale, is that for over 20 years I have been injecting fat into older faces to replenish volume, and in that time we have seen the remarkable “dermal bloom” and regeneration that fat transfer is known for. This effect can persist for well over 10 years following the treatment and is due to the hundreds of millions of stem cells that inherently transfer with the fat into the layers just beneath the dermis. This is literally a direct stem cell bonanza for the skin. However, as I always explain to my patients, fat transfer with all of its stem cells, is not a treatment for wrinkles. The skin will bloom, the volume will replenish, but dermal wrinkles will remain. Stem cells don’t fill wrinkles!

So summing PRP.

PRP has a place in medicine, the basis being in it’s relationship to stem cells.

PRP works through the chemical hormones and growth factors it contains, having the ability to turn on or activate stem cells.

I do not believe that stem cells were ever “designed” to specifically fill in wrinkles, nor does PRP activation specifically enable them to do so.

I base my opinion on over 20 years of clinical PRP and Stem cell development.

And yes, I did try it on wrinkled skin many years ago and thought it was rubbish. I can do better, quicker, less traumaticly and cheaper with other treatments. At conferences, I’ve struggled to appreciate the difference in before and after photo presentations of PRP. Lastly, I think it is testament to ineffectiveness of this treatment, all the people I have seen over the years wishing a second opinion or upset in the time and money they spent on this treatment elsewhere.