Autologous intralesional platelet rich plasma improves melasma

Abstract

Platelet rich plasma (PRP) is an upcoming interventional therapy for the treatment of melasma. Its efficacy is due to the multiple growth factors present in it which decrease melanogenesis by various signal transduction pathways. The present study evaluated the efficacy of PRP as a standalone agent in treatment of melasma. This is an open labeled prospective trial. Forty patients were given intralesional PRP at once monthly interval. Three such PRP sessions were carried out and the patients were followed up for 3 months. Assessment was done by calculating the modified melasma area severity index score (mMASI) for each patient. Patients were also asked to selfevaluate their improvement based on a scale. There was an average 54.5% reduction in the mMASI score at the end of the study. There was no relapse in any patient. This reduction was irrespective of the skin type, gender, and type of melasma. Patients self-evaluation showed that more than 90% of the patients were pleased or very pleased with the results. There were no significant side effects. PRP appears to be a potential new therapy with significant efficacy in improving pigmentation of melasma, standalone as monotherapy.

Efficacy and Safety of Platelet-Rich Plasma in Melasma: A Systematic Review and Meta-Analysis

“…A further four articles were excluded for the lack of essential information. Ultimately, ten studies were included in the data integration for MASI scores and subjective evaluation [19][20][21][22][23][24][25][26][27][28]. The inclusion and exclusion process of the studies is shown in Fig.…”

“…The year of publication ranged from 2018 to 2021. In terms of study design, there were four RCTs [19][20][21][22], three split-face trials [23,24,27] and three self-controlled trials [25,26,28]. Thelocations of these trials were China (3 trials), India (2 trials), Egypt (3 trials), Thailand (1 trial) and Pakistan (1 trial).…”

Platelet‐rich plasma is a promising therapy for melasma

“…Being autologous, the adverse effects of PRP therapy are rare and minimal which include pain in the injected area, infection, skin discoloration, allergic reaction, and blood clot formation 29 . The mitogenic effects of PRP are only limited to augmentation of the normal healing process and is theoretically not mutagenic, as the growth factors released do not enter the cell or its nucleus, but only bind to the membrane receptors and induce signal transduction mechanisms.…”

How I manage resistant melasma?

“…TGF decreases melanogenesis by downregulating microphthalmia-associated transcription factor promoter activity and inhibiting the expression of paired-box homeo-c gene (PAX 3), which at the protein level, reduces the production of tyrosinase and tyrosinase-related protein 1 and 2. [9] EGF inhibits prostaglandin-E2 expression and tyrosinase enzyme activity. [10] PRP can be used stand alone and with microneedling, radiofrequency, and lasers.…”