Benefits and Risks of Platelet-Rich Plasma Vampire Facials

Benefits and Risks of Platelet-Rich Plasma Vampire Facials
Tara Y. T. Chen, Dr. Austin Mardon

Introduction
    As humans age, our skin loses its youthful appearance due to wrinkles, sun damage, acne, smoking and more. Aged skin also loses its ability to rapidly repair itself, replace dead skin cells, produce collagen and retain moisture, which contribute to a loss of skin elasticity (Wang et al., 2020). One popular method to improve the texture and appearance of aged skin is by undergoing platelet-rich plasma (PRP) treatments, which are also called “vampire facials”. This procedure is performed by dermatologists and has been marketed to improve hyperpigmentation, reduce wrinkles and rejuvenate soft tissue (Goddard & Waterhouse, 2020). The procedure involves drawing blood from the client’s arm, extracting the platelets from blood plasma and injecting the client’s face with the concentrated platelets (Goddard & Waterhouse, 2020). However, there are several benefits and risks to this procedure that clients should be aware of before seeking PRP treatment. 

What is PRP?
    PRP is retrieved by centrifuging the client’s blood to extract plasma with platelets that are between three to seven times more concentrated than in unaltered plasma (Wang et al., 2020). The ability of PRP to improve skin irregularities is due to its high amount of plasma proteins, growth factors and chemokines, which activate stem cells and induce cellular differentiation (Wang et al., 2020). In addition, PRP can produce hyaluronic acid and collagen to retain the elasticity and smoothness of skin (Wang et al., 2020). 

Benefits
The benefits of PRP facials have been studied in clinical trials. For instance, in a randomized control study, adults with wrinkles classified as type 2 on the Glogau Wrinkle Scale received a single PRP treatment to target the effects of photodamage, enlarged pores and wrinkles. At six months post-treatment, the skin had a decreased amount of wrinkles and smoother texture, indicating the efficacy of PRP treatments in improving skin texture (Alam et al., 2018). 
Another randomized clinical trial assessed the ability of PRP to treat atrophic scars due to collagen breakdown. PRP was administered through intradermal injections and after microneedling sessions once every two to four weeks. Most clients originally had acne scar grades between three and four, according to the Goodman and Baron grading system. After treatment with PRP, the acne scar grade for clients improved to grades one, two or three (Ibrahim et al., 2017). Additionally, skin thickness improved by 140% and collagen I synthesis increased (Ibrahim et al., 2017). These results reveal that PRP used in combination with microneedling and intradermal injections can improve skin texture for adults with long-term atrophic scars. 
    Moreover, for clients with melasma, many traditional therapies have not been effective in treating the appearance of gray patches and freckles that are characteristic of the condition. However, across ten studies with 395 adults, PRP treatments performed in combination with microneedling or intradermal injections improved the symptoms of melasma. According to the Melasma Area and Severity Index (MASI) score, which is a scale ranging from zero to three, the overall MASI score decreased by 1.18 for all adults in the studies (Zhao et al., 2021). This suggests that PRP procedures may be potential treatments for melasma. 

Risks
    Despite the benefits of using PRP to improve skin texture and improve scars, there are a few risks associated with the procedure. For instance, in a study assessing the efficacy of PRP intradermal injections, some clients experienced variable degrees of swelling and skin rashes up to three days after treatment (Nofal et al., 2014).   
In another instance, two individuals tested positive for the human immunodeficiency virus (HIV) in 2018 after receiving PRP treatment with microneedling at a spa in New Mexico (Goddard & Waterhouse, 2020). Dermatologists who perform microneedling should educate their clients about proper postprocedural care to minimize the risk of infections. Clients should also be aware of the sanitation processes at different clinics before undergoing PRP treatments to ensure that the procedure is performed properly (Gowda et al., 2021). 
Despite the aforementioned risks, PRP is a generally low-pain procedure with temporary adverse side effects of swelling, bruising and rashes (Nanda et al., 2021). PRP treatments also have fewer side effects compared to other aesthetic facial procedures, such as laser therapy (Nanda et al., 2021).

Conclusion
    Overall, PRP treatments contain growth factors and plasma proteins that can promote collagen synthesis, stem cell activation and cellular differentiation (Wang et al., 2020). Vampire facials have been beneficial for wrinkles, photoaged skin, atrophic scars, melasma and more (Alam et al., 2018; Ibrahim et al., 2017; Zhao et al., 2021). However, clients should be aware of the risks and proper postprocedural care before undergoing PRP treatments. 

References
Alam, M., Hughart, R., Champlain, A., Geisler, A., Paghdal, K., Whiting, D., Hammel, J. A., 
Maisel, A., Rapcan, M. J., West, D. P., & Poon, E. (2018). Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin: A Randomized Clinical Trial. JAMA dermatology, 154(12), 1447–1452. https://doi.org/10.1001/jamadermatol.2018.3977
Goddard, N. V., & Waterhouse, N. (2020). Regenerative Medicine, Stem Cell Therapies, and 
Platelet-Rich Plasma: Where Is the Evidence?. Aesthetic surgery journal, 40(4), 460–465. https://doi.org/10.1093/asj/sjz317
Gowda, A., Healey, B., Ezaldein, H., & Merati, M. (2021). A Systematic Review Examining the 
Potential Adverse Effects of Microneedling. The Journal of clinical and aesthetic dermatology, 14(1), 45–54.
Ibrahim, Z. A., El-Ashmawy, A. A., & Shora, O. A. (2017). Therapeutic effect of microneedling 
and autologous platelet-rich plasma in the treatment of atrophic scars: A randomized study. Journal of cosmetic dermatology, 16(3), 388–399. https://doi.org/10.1111/jocd.12356
Nanda, S., Chauhan, K., Shetty, V., Dashore, S., & Bhatia, S. (2021). Platelet-Rich Plasma in 
Aesthetics. Indian dermatology online journal, 12(Suppl 1), S41–S54. https://doi.org/10.4103/idoj.idoj_290_21
Nofal, E., Helmy, A., Nofal, A., Alakad, R., & Nasr, M. (2014). Platelet-rich plasma versus 
CROSS technique with 100% trichloroacetic acid versus combined skin needling and platelet rich plasma in the treatment of atrophic acne scars: a comparative study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 40(8), 864–873. https://doi.org/10.1111/dsu.0000000000000091
Wang, J. V., Schoenberg, E., Saedi, N., & Ibrahim, O. (2020). Platelet-rich Plasma, Collagen 
Peptides, and Stem Cells for Cutaneous Rejuvenation. The Journal of clinical and aesthetic dermatology, 13(1), 44–49.
Zhao, L., Hu, M., Xiao, Q., Zhou, R., Li, Y., Xiong, L., & Li, L. (2021). Efficacy and Safety of 
      Platelet-Rich Plasma in Melasma: A Systematic Review and Meta-Analysis. Dermatology    
      and therapy, 11(5), 1587–1597. https://doi.org/10.1007/s13555-021-00575-z

Biographies
Tara Y. T. Chen is a third-year undergraduate student studying medical sciences at the University of Western Ontario in Canada. In the past, she has presented her research on psoriasis treatments at the Western Student Research Conference 2021 and has written several science academic books. 
Dr. Austin Mardon is an assistant adjunct professor at the John Dossetor Health Ethics Centre at the University of Alberta, and the founder and director of Antarctic Institute of Canada.