PRP for skin: what it can and cannot do

Key takeaways

• PRP is made from your own blood, spun in a centrifuge to concentrate the platelets and their growth factors.
• For acne scars, systematic reviews suggest PRP adds benefit when combined with fractional laser or microneedling.
• For facial rejuvenation, a 2021 systematic appraisal found the evidence very limited and the methods varied a lot.
• There is no standard recipe. How PRP is prepared differs widely between studies and clinics.
• Side effects are usually mild: redness, swelling and bruising for a few days.

What exactly is PRP?

People often come in saying, "Doctor, I want the vampire facial." Okay, sure. Let's talk about what it actually is first.

Basically, PRP is your own blood, processed. A small amount is drawn from the arm, like a routine blood test. It is spun in a centrifuge, which separates the red cells from the plasma. The layer rich in platelets is collected. Platelets carry growth factors, proteins that signal tissues to repair. The idea is that putting a concentrated dose of these signals into the skin encourages healing and collagen.

It is then used in one of three ways: - Topically during microneedling, so it enters through tiny channels - Topically after fractional laser, the same principle - Injected into the skin in small amounts

Because it is your own blood, allergic reactions are not expected. But a fair question is always: how much benefit does it add, and for what?

Where is the evidence strongest?

Acne scars. This is where the research is most useful.

A systematic review in the Journal of the American Academy of Dermatology in 2019 looked at PRP for acne scars. It concluded that PRP combined with fractional ablative laser, in two or three sessions about a month apart, improved the appearance of acne scars, with higher patient satisfaction and less downtime. It found weaker evidence for PRP with microneedling, and noted that the studies were too varied to compare directly.

A 2021 meta-analysis in Frontiers in Medicine pooled 14 studies of microneedling with or without PRP for acne scars. Adding PRP was associated with better improvement and higher satisfaction than microneedling alone. But most studies were small, many were split-face designs, and the authors called for larger randomised trials. Interestingly, most of the studies came from India and Egypt, so they are relevant to brown skin.

So my reading is: for acne scars, PRP is a reasonable add-on to a proper scar treatment, not a treatment by itself. My article on acne scar treatments explains the main options.

What about glow, fine lines and rejuvenation?

This is where I am careful. A 2021 systematic appraisal in Clinical, Cosmetic and Investigational Dermatology reviewed 36 studies of PRP for facial rejuvenation. The authors judged the evidence very limited, noted that PRP was used in many different combinations, and called for agreed outcome measures before its clinical value can be established.

That does not mean it does nothing. It means we do not yet know reliably how much it does, for whom, or with which preparation. That is very important to understand before you spend money on it.

Why do results vary so much?

There is no single standard PRP. Studies differ in: - How fast and how long the blood is spun - How concentrated the platelets are; the Frontiers review found concentrations from about 4.5 to 10 times normal in the studies that reported it - Whether the PRP is "activated" before use - What it is combined with: microneedling, laser, fillers - How many sessions, and how far apart

So two clinics can both say "PRP" and be doing quite different things. If you are considering it, ask how it is prepared and what it is being combined with.

What does a PRP session involve?

Who should avoid it or check first: people with low platelets or blood disorders, those on blood thinners, people with active skin infection at the site, and anyone with a serious illness or during pregnancy. Tell your doctor about all medicines and supplements.

Side effects: usually mild and short-lived: redness, swelling, bruising and some tenderness. In the acne scar meta-analysis, severe redness and swelling were not significantly more common with PRP than without, though that was based on few studies. Infection is uncommon when sterile technique is used. As with any procedure on brown skin, there is a small risk of temporary darkening, so sun protection after treatment matters.

How we approach this at Dr Tvacha

PRP is one of the treatments available at our Thane, Andheri, Bandra and Dahisar centres. Under the Second Layer Skin Plan, I first decide whether you need it at all. For acne scars, I may suggest it as an add-on to a proper scar treatment. For general dullness, I usually start with simpler, better-evidenced steps such as sunscreen, a retinoid and treating pigmentation. If PRP is part of your plan, the number of sessions and the fee are written down before you begin. For ageing concerns, my article on PRP for ageing skin sets realistic expectations.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.