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Platelet-rich plasma for facial rejuvenation, a

systematic review

Article · May 2016

DOI: 10.15846/jam.2016.0003

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May 2016 1 Volume 2  •   Issue 1

Copyright © 2016 Original Article Journal of Aesthetic Medicine

Platelet-rich plasma for facial rejuvenation, a systematic

review
Ravi Jandhyala MSc MBBS MRCS MFPM LLM MBA
The Jandhyala Institute, Banbury, UK.
Consultant Pharmaceutical Physician, Medical Director, Latralis Ltd
Editor-in-Chief of the Journal of Aesthetic Medicine
ABSTRACT
The use of platelet rich plasma is becoming popularised as a treatment for the aging face. In an attempt to assess the quality of
evidence supporting this treatment for facial rejuvenation, a systematic review of randomised controlled trials was conducted. All trials
were included until February 2016.
The review failed to identify any clinical studies meeting the inclusion criteria.
The efficacy, short and long-term safety of platelet rich plasma for facial rejuvenation has not been demonstrated. The appropriateness
of delivering these treatments in the absence of these data is questionable.

Keywords: platelet-rich plasma; PRP; facial rejuvenation; systematic review

Date received: 2 April 2016; accepted 12 April 2016

J Aesth Med. 2016;2(1):1–3.

Introduction

P© 2016-Journal of Aesthetic Medicine.

latelet-rich plasma (PRP) is derived from centrifuging
whole blood drawn from the patient. The resulting solu-
tion contains a platelet-rich fraction with a higher plate-
let concentration than that of the original whole blood.1,2 The
preparation process yields a number of growth factors such as:
rejuvenation of their face where the comparator was any other
treatment. The search criteria used are listed (Table 1).
Results

All Rights Reserved

The searches failed to identify any studies meeting the
transforming growth factor–b (TGF-b), platelet-derived growth
criteria (Figure 1).
factor (PDGF), insulin-like growth factor (IGF-I, IGF-II), fibro-
blast growth factor (FGF), epidermal growth factor, vascular
endothelial growth factor (VEGF) and endothelial cell growth Discussion
factor which are responsible for enhancing tissue recovery1,2.
The results of this systematic review demonstrate the com-
As an intervention for subjects seeking facial rejuvenation, PRP
plete lack of data assessing the use of PRP for facial rejuve-
might work by delivering these growth factors to the site of
nation. There may be a number of reasons for this. Firstly,
injured skin where they are expected to enhance tissue regen-
PRP is neither a prescription only medicine nor a medical
eration and improve angiogenesis.3
device, it is merely the result of a process. As such, it's ad-
ministration falls outside the jurisdiction of any of the tradi-
Cochrane reviews found that: there were insufficient evidence
tional regulatory bodies in medicine. Consequently, there
to support the use of PRP for treating musculoskeletal soft tis-
has not been a requirement for interested parties to generate
sue injuries4 and no evidence to suggest that PRP is of value in
what would be considered basic data on efficacy and safety to
treating chronic wounds.5
enable its use.

Methodology
A systematic review was conducted in Cochrane library,
Pubmed and ResearchGate to include studies until 19th Febru-
ary 2016. The search criteria involved collecting: all randomised
controlled trials using PRP as an intention in subjects needing
It can be seen therefore, the use of PRP in the face may have
simply been propagated on the basis of clinical opinion and
promotion on the part commercial organisations manufactur-
ing the materials necessary for the process. Though the prepa-
ration process has been described in a degree of detail, the

© 2016-Journal of Aesthetic Medicine. All Rights Reserved.

This document contains proprietary information, images and marks of Journal of Drugs in Dermatology (JDD).
No reproduction or use of any portion of the contents of these materials may be made without the express written consent of JDD.
ISSN: In progress If you feel you have obtained this copy illegally, please contact JDD immediately. DOI: 10.15846/jam.2016.0003
 To order reprints or e-prints of JAM articles please contact editor@jaesthmed.org
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Journal of Aesthetic Medicine R. Jandhyala
May 2016  • Volume 2  •  Issue 1

Table 1.

Search strategies employed by database.

Cochrane search Pubmed search

#1 exp Skin Aging/ #17 Select 29 document(s) 29

#2 exp Rejuvenation/ #16 Search #18 AND #19 Sort by: Author

#3 exp Facelift/ #15 Search #16 OR #17

#4 aging NEAR/3 skin #14 Search #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14

#5 wrinkl* NEAR fac* #13 Search platelet*rich plasma

#6 line* NEAR fac* #12 Search “Platelet-Rich Plasma”[Mesh]

#7 glabellar (line* OR wrinkl*) #11 Search volum* AND fac*

#8 forehead (line* OR wrinkl*) #10 Search marionette (line* OR wrinkl*)

#9 frown (line* OR wrinkl*) #9 Search lateral canthal (line* OR wrinkl*)

#10 crow’s feet #8 Search crow’s feet

#11 lateral canthal (line* OR wrinkl*) #7 Search frown (line* OR wrinkl*)

#12 marionette (line* OR wrinkl*) #6 Search forehead (line* OR wrinkl*)

© 2016-Journal of Aesthetic Medicine.

#13 cheek* (line* OR wrinkl*)

#14 volum* NEAR fac*

#5 Search glabellar (line* OR wrinkl*)

#4 Search line* AND fac*

All Rights Reserved

#15 exp Platelet-Rich Plasma/ #3 Search wrinkl* AND fac*

#16 platelet*rich plasma #2 Search aging AND skin

#17 {or #1-#14} #1 Search “Skin Aging”[Mesh]

#18 {or #15-#16}

#19 #17 AND #18

exact manner in which PRP is to be administered to the face
has not. Products need to be tested in conjunction with their
method of administration to ensure the properties of the prod-
uct remain preserved once delivered and whether the delivery
mechanism is appropriate to achieve the aim.
The central tenet of medicine is primum non nochere, first do
no harm. Perhaps of greater concern than the absence of any
data supporting any benefit of PRP for facial rejuvenation is the
absence of any short, medium and long term safety data. There
is simply no appreciation of the effects of the administration
of growth factors to the face. Questions must be raised as to
whether use of PRP for this indication is appropriate until such
data is available.
Given the level of interest in the use of PRP for facial reju-
venation, the execution of a simple randomized controlled
trial of PRP versus placebo, with an appropriate delivery
method should be possible. Investigators should ensure both
objective and subject endpoints are used in assessment and
an appropriate safety surveillance or follow up program is
implemented.

© 2016-Journal of Aesthetic Medicine. All Rights Reserved.

This document contains proprietary information, images and marks of Journal of Drugs in Dermatology (JDD).
.
ISSN: In progress Doi: 10.15846/jam.2016.0003
 To order reprints or e-prints of JAM articles please contact editor@jaesthmed.org
  3
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Journal of Aesthetic Medicine R. Jandhyala
May 2016  • Volume 2  •  Issue 1

© 2016-Journal of Aesthetic Medicine.

All Rights Reserved

Figure 1. PRISMA summary for the systematic review.

5. Martinez-Zapata MJ, Martí-Carvajal AJ, Solà I, Expósito JA, Bolíbar I,

Conflict of interest statement Rodríguez L, Garcia J. Autologous platelet-rich plasma for treating chronic
wounds. Cochrane Database of Systematic Reviews 2012, Issue 10. Art.
The author has received research funding from Merz Pharma in No.: CD006899. DOI: 10.1002/14651858.CD006899.pub2.
relation to other studies.­­

References
1. Foster TE, Puskas BL, Mandelbaum BL, Gerhardt MB, Rodeo SA. Platelet- AUTHOR CORRESPONDENCE
rich plasma: from basic science to clinical applications. American Journal of
Sports Medicine 2009;37(11):2259–2272.
2. Lee K, Wilson JJ, Rabago DP, Baer GS, Jacobson JA, Borrero CG. Ravi Jandhyala MSc(Lond) MBBS(Lond)
Musculoskeletal applications of platelet-rich plasma: fad or future?. American MRCS(Lond) MFPM LLM MBA
Journal of Roentgenology 2011;196(3):628–636.
3. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of Address:..............................The Jandhyala Institute, 13 Horse Fair,
platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- Banbury, OXON, OX16 0AN
and platelet-rich fibrin (L-PRF). Trends in Biotechnology 2009;27(3): E-mail:..................................rjandhyala@latralis.com
158–167.
4. Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. Platelet-rich therapies for Telephone:...........................441295712661
musculoskeletal soft tissue injuries. Cochrane Database of Systematic Reviews Fax:......................................441295712661
2014, Issue 4. Art. No.: CD010071. DOI: 10.1002/14651858.CD010071.pub3

© 2016-Journal of Aesthetic Medicine. All Rights Reserved.

This document contains proprietary information, images and marks of Journal of Drugs in Dermatology (JDD).
No reproduction or use of any portion of the contents of these materials may be made without the express written consent of JDD.
ISSN: In progress If you feel you have obtained this copy illegally, please contact JDD immediately. Doi: 10.15846/jam.2016.0003
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