“The literature regarding adjunctive PRP with laser for acne scarring is better compared to PRP with microneedling,” Dr. Hesseler says. “That’s not to say that PRP is ineffective with microneedling. But we’re seeing mixed results in the setting of a relatively lower quality of evidence.”
While laser-PRP studies used fairly consistent PRP types and regimens, says study co-author Nikhil Shyam, M.D., the variability of microneedling study designs made it much more diffcult to draw meaningful conclusions from them. He is a New York-based dermatologist in private practice.
Microneedling-PRP studies reviewed by Drs. Hesseler and Shyam included topical and intradermal application, although most of these evaluated adjunctive topical PRP.
“Again,” Dr. Hesseler says, “this comes back to not having a consensus in regard to processing or delivering the PRP, and there are many different researchers testing this independently from one another.”
Nevertheless, Dr. Hesseler says, the dermatology community is beginning to organize its thoughts further about platelet-rich products — how to use them and for what dermatologic conditions they appear effective. For example, five of the seven laser studies he and Dr. Shyam reviewed used leukocyte-rich PRP (L-PRP). Unlike pure or leukocyte-poor PRP, L-PRP involves including the buffy coat of leukocytes and higher-density platelets that settle above the layer of red blood cells after centrifugation.
The physiology behind platelet-rich products makes sense, Dr. Hesseler says.
Drs. Hesseler, Shyam and Huang report no relevant financial interests.
Dr. Tanghetti is a consultant for Cynosure, DEKA, Quanta, Cartessa and Aesthetics Biomedical but owns no stock in these companies.
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