Ice Pack Compression, Vibration Anesthesia Device Reduce Pain During Scalp Injections

Pain from inactivated platelet-rich plasma (PRP) scalp injections can be reduced with the use of ice pack compression and a vibration anesthesia device (VAD), researchers reported in the Journal of the American Academy of Dermatology.

The randomized controlled split-scalp study included 31 patients with alopecia, in which the researchers assessed the effect of an ice pack and a VAD for pain reduction during inactivated PRP injections.

Participants were randomly assigned to 1 of 3 groups. Group 1 (n = 10) received PRP with or without ice on each side of the scalp, group 2 (n = 10) received PRP with or without VAD on each side of the scalp, and group 3 (n = 11) received PRP with ice or with VAD on each side of the scalp. All participants received inactivated PRP.

The patients’ left or right side of the scalp was randomly selected for each intervention, and the administration of injections with and without intervention for all patients was randomized. The study authors used the Numerical Rating Scale (NRS) — ranging from 0 (no pain) to 10 (worst pain) — to measure self‐reported pain.

In group 1, 90% of patients reported that they felt less pain on the side that used ice compression (mean pain score, 4.1 vs 6.6 without ice; P =.001), and preferred the application of ice compression in future PRP treatments.

In group 2, 90% of patients reported that they felt less pain on the side that used the VAD (mean pain score, 4.8 vs 6.1 without the VAD, P =.270), and preferred the application of the VAD for future PRP treatments.

In group 3, 55% of patients felt less pain with the VAD, 36% patients felt less pain with ice, and 9% felt no difference between the 2 modalities (mean pain score, 5 with ice vs 5.2 with the VAD; P =.806).

“We have demonstrated that pain from inactivated PRP scalp injections can be reduced with the use of ice pack compression and a VAD,” stated the researchers.

Both modalities are inexpensive and easily accessible, and they can be used together for synergistic effect, noted the investigators. They advised that clinicians be cautious with their use of a VAD, as 2 patients in groups 2 and 3 reported increased pain sensitivity with the device.

The researchers recommended that a simple spot test be performed with the VAD before PRP treatment is initiated. In addition, because the VAD and ice pack compression were assessed with use of inactivated PRP, their compatibility with other PRP types should be determined based on clinical recommendations.

Reference

Suh S, Casale FS, Atanaskova Mesinkovska N. Effective strategies to reduce pain during platelet-rich plasma scalp injections: a randomized split-scalp study. J Am Acad Dermatol. Published online February 16, 2021. doi:10.1016/j.jaad.2021.02.029