Acne scarring, post-procedural symptoms, and patient satisfaction improved with use of platelet-rich plasma (PRP) combined with ablative laser therapy, according to a study published in the Journal of the American Academy of Dermatology.
In this review, researchers conducted a search on PubMed using the following search terms: “platelet rich plasma,” “platelet releasate,” “platelet gel,” or “PRP” and “dermatology,” “skin,” “hair,” “alopecia,” “acne scar,” or “cutaneous.” After applying exclusions, investigators selected 13 articles with 6 studies that evaluated PRP combined with microneedling (n=210) and 7 studies that evaluated PRP with fractional ablative laser therapy (n=167). Comparison between PRP methods and subsequent statistical analysis was not performed due to heterogeneity of the studies.
Patients reported greater satisfaction with treatments utilizing PRP. Investigators hypothesize that this may be due to reduced post-procedural erythema and edema.
Of the studies using fractional ablative laser treatment, 71.4% were performed using activated, leukocyte and PRP. The addition of leukocyte and PRP to laser ablation produced better results in acne scarring in 5 of 7 studies. Improvements in erythema, edema, and pain were seen in 6 of the 7 studies. A 2-spin centrifugation method was utilized to produce PRP in 2 to 3 sequential treatment sessions administered 1 month apart in all studies. One study showed that topical non-activated leukocyte and PRP with laser ablation did not show any benefit in acne scarring.
Study results were mixed for combination therapy with PRP and microneedling. Of the 6 studies that investigated this therapy, 3 studies showed improved acne scarring compared with microneedling alone, but the 3 other studies did not show any added benefit.
This review is limited by the paucity, small sample sizes, and mixed results in the studies analyzed. Because of this, it is unclear whether the addition of PRP to microneedling objectively improves acne scarring. Comparison between studies is limited by the variability in laser settings and PRP preparation methods.
Future studies with longer follow-up are needed to determine whether certain patients with more severe acne scarring may require more intensive or frequent combination therapies with PRP. Currently, there is no standardization in delivery technique for PRP for treatment of acne scarring.
Hesseler MJ, Shyam N. Platelet-rich plasma and its utility in the treatment of acne scars – A systematic review [published online February 8, 2019]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.11.029