We are often asked, “Can you help with acne scars?” For many the answer is yes. We have seen many patients over the years with various levels and degrees of acne scaring who have benefitted from our PRP treatments. What are our PRP treatments and how do they work?

  • Platelet Rich Plasma (PRP) is a blood product that comes from you. We draw your blood and then spin it in a high speed centrifuge to separate the plasma from the red blood cells. What is left are a “platelet rich plasma” that contains concentrated growth factors and healing cells.
  • “Micro-needling,’ gently pricking your skin stimulates the creation of new skin cells and regeneration of damaged cells. Your own PRP is then massaged into the skin. The goal is to stimulate the production of collagen and elastin, and the creation of new skin cells.

The science – PRP treatments, safe, effective, economical for deep acne scars

In the medical publication Skin Therapy Letter, Dr. Jason Emer writes: “Several reports demonstrate improvements in traumatic scars and acne scars with PRP treatment. Increases in collagen density and dermal elastic fibers are notable benefits when using PRP in aesthetic dermatology. When PRP is used in combination with other therapies, such as laser treatments, microneedling, and hyaluronic acid fillers, further improvements in skin appearance are achieved.” (1)

A study in the journal Dermatologic therapy (2) looked at some of these combined and various treatments (similar to the treatments we use here) with PRP injections in treating twenty patients with different types of atrophic acne scars on the face.

After 3 months of treatment the researchers found:

  • 30% (6 of 20 patients) had excellent improvement,
  • 20% (4 of 20 patients) of patients had good improvement,
  • 20% (4 of 20 patients) of patients had moderate improvement, and
  • 30% (6 of 20 patients) of patients had mild improvement.

The dermatologists of this study found all types of the patient’s acne scars showed significant improvement with no significant difference between them.The also found combination techniques (needling, skin laser) was found to be “a safe and cost-effective treatment option for atrophic acne scars.”

In a study from Egypt,(3) doctors speculated that PRP may be beneficial in the treatment of atrophic acne scars by promoting collagen deposition. Simply, this is the replenishment of new collagen in the scar. To accelerate this PRP induced process, the Egyptian doctors also performed skin needling (or microneedling) a technique that uses a sterile dermaroller (or  Dermapen® see below) to puncture the skin and release growth factors. The doctors speculated that the combination of skin needling and PRP could enhance the efficacy of both modalities.

The doctors took Forty-five patients with atrophic acne scars and randomly assigned to 3 equal groups;

  • Group A received intradermal injection of PRP alone,
  • Group B received chemical reconstruction of skin scars,
  • and Group C was treated by combined skin needling and PRP. Each patient underwent 3 sessions at 2-week interval.

The 3 groups showed statistically highly significant improvement in the degree of acne scars after treatment No major adverse effects were observed in the studied groups.

Since one group of patients derived benefit from the PRP injections alone, the doctors were able to conclude that PRP is a beneficial treatment for acne scars.

This research was continued by another team of researchers who published their review in The Journal of dermatological treatment. (4)

Here the objective was to evaluate the effectiveness and safety of microneedling alone versus microneedling combined with platelet rich plasma in the treatment of post acne scars..

  • The study included 35 patients with mild to severe post acne atrophic scar.
  • All the patients received four sequential treatments of skin microneedling alone on the right side of the face and skin microneedling followed by topical application of platelet rich plasma (PRP) on the left side of the face with an interval of 3 weeks.
  • Two blinded dermatologists evaluated the clinical response. Patients are queried about their satisfaction with the treatment outcomes.

RESULTS:

  • There was a significant improvement in the degree of scar severity before and after treatment on both the sides. Regarding patient’s satisfaction grades, there was a significant improvement after both treatment modalities with insignificant differences between both treatment modalities.
  • Both microneedling and microneedling in combined with PRP showed satisfactory results.

Dermapen® is an affordable treatment that can tighten and lifts skin through a fractional micro-needling device.  Unlike laser fractional treatments;  Dermapen® is safe for most everybody, including darker skin types when used with a careful post-procedure regimen that includes sunblock.

 Dermapen® treatments are  used for the following issues:

  • Minimize fine lines and wrinkles
  • Decrease pore size
  • Diminish appearance of acne scars, surgical scars and stretch marks

Dermapen® offers better, safer results than rolling micro-needling systems. There is also less pain, bruising, and recovery time. Dermapen® uses collagen induction therapy, (CIT) which stimulates your own body to increase production of collagen. This “controlled injury”  stimulates the production of new cells, which heals scars, minimizes wrinkles and diminishes stretch marks.  Ideal regimens are 4-6 treatments over a space of 2-6 months. Each treatment is done approximately 4-5 weeks apart.

A review of the research

In September 2019, investigators published their review of PRP’s effectiveness in treating acne scarring in the medical journal Aesthetic plastic surgery. (5) Here is what they wrote: “A number of studies have investigated the role of platelet-rich plasma (PRP) as an assisted therapy for atrophic acne scars. However, the results are diverse, and no up-to-date meta-analysis was found that exclusively examined atrophic acne scar treatment.”

To better understand how PRP could work, they looked at seven published research articles. In these seven studies PRP was utilized as an additive therapy. The major therapies included fractional carbon laser therapy and microneedling. The investigators concluded: “This review shows that PRP is a useful assisted therapy for atrophic acne scars, which can achieve better improvement.”

Further, a good summary can be drawn from combined research from the University of michigan and John Hopkins University. This comes from the Journal of the American Academy of Dermatology (June 2019).

The field of dermatology has seen numerous therapeutic innovations in the past decade, with platelet-rich plasma recently garnering significant interest in acne scarring. . . This review reveals that activated, leukocyte- and platelet-rich plasma in combination with fractional ablative laser treatment administered in 2 or 3 sequential sessions 1 month apart improves the appearance of acne scars. The evidence for the use of platelet-rich plasma with microneedling is less supportive. Because of the heterogeneity of the studies and widely variable outcome measures, comparison between platelet-rich plasma treatments and subsequent statistical analysis could not be performed. Although these studies use various subjective and objective evaluation methods, the addition of platelet-rich plasma provides improvements in acne scarring, higher patient satisfaction, and decreased postprocedure downtime.” (6)

 

 

References:

1 Emer J. Platelet-Rich Plasma (PRP): Current Applications in Dermatology. Skin therapy letter. 2019 Sep;24(5):1-6.
2 Ibrahim ZA, Elgarhy L. Evaluation of PSP technique including Dot Peeling, Subcision and Intradermal Injection of PRP in The Treatment of Atrophic Post‐Acne Scars. Dermatologic therapy. 2019 Aug 15:e13067.
3 Nofal E, Helmy A, Nofal A, Alakad R, Nasr M. Platelet-rich plasma versus CROSS technique with 100% trichloroacetic acid versus combined skin needling and platelet rich plasma in the treatment of atrophic acne scars: a comparative study. Dermatologic Surgery. 2014 Aug 1;40(8):864-73.
4 Ibrahim MK, Ibrahim SM, Salem AM. Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study. J Dermatolog Treat 2018; 29: 281–286.
5 Hsieh TS, Chiu WK, Yang TF, Wang HJ, Chen C. A Meta-analysis of the Evidence for Assisted Therapy with Platelet-Rich Plasma for Atrophic Acne Scars. Aesthetic plastic surgery. 2019 Jan 1:1-9.
6 Hesseler MJ, Shyam N. Platelet-rich plasma and its utility in the treatment of acne scars-A systematic review. Journal of the American Academy of Dermatology. 2019 Feb 8.