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

Abstract

Introduction: Melasma is a chronic and recurrent skin problem for which an effective therapy is currently lacking. Platelet-rich plasma (PRP) has recently emerged as a novel treatment for melasma, but to date there has been no systematic evaluation of its efficacy and safety. Methods: The Web of Science, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and the Cochrane Library databases were searched for relevant articles using the search items ''melasma,'' ''chloasma'' and ''platelet-rich plasma.'' STATA version 15.1 software was used to analyze data. Study outcomes were calculated using standardized mean differences with 95% confidence intervals (CIs). Results: The database search identified ten studies involving 395 adult patients that met the inclusion criteria and were included in the meta-analysis. Analysis of pre-and post-treatment data from these studies revealed that the post-treatment modified Melasma Area and Severity Index (mMASI) score decreased by 1.18 (95% CI 0.89-1.47; p = 0.02). Subjective satisfaction evaluation of PRP treatment showed that melasma treated with the combination therapy of PRP ? microneedling may have been the most efficacious treatment compared to PRP alone or in combination with intradermal injection. Adverse reactions were minor, with only a few patients reporting local congestion, temporary erythema, hyperpigmentation and discoloration. Conclusion: These results support the efficacy and safety of PRP used in combination or alone as treatment for melasma.

Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis

“…Interestingly, a recent study has shown that, compared to the use of microneedling alone, combined treatment with microneedling and PRP was associated with a marked excellent improvement of the skin lesions, a more significant deposition of collagen and elastic fibers, and an increased proliferative activity in the epidermis in people with striae distensa, which may also reflect the synergetic benefits of action microneedling and PRP on scar formation and collagen/dermal remodeling ( 40 ). Interestingly, the efficacy of combined treatment with microneedling and PRP has also been observed in people with androgenetic alopecia ( 41 ) and melisma ( 42 ). The exact molecular mechanisms underlying the benefits of a combined therapy with microneedling and PRP for atrophic acne scars should be further evaluated.…”

Application of PRP in Chloasma: A Meta-Analysis and Systematic Review

“…The safety, efficacy, and prognosis of PRP have not been fully confirmed. Zhao et al [ 12 ] recently reported a systematic review on PRP in the treatment of chloasma, which included studies without controlled experimental designs. We will elaborate on the application of PRP in chloasma under more stringent inclusion and exclusion criteria and bias evaluation and try to explore the evaluation of efficacy and safety by multiple factors including ethnic differences and pharmacological effects.…”

Platelet rich plasma in treatment of topical steroid damaged face: A retrospective analytical study

“…In addition to the direct effect of PRP on cell proliferation, migration, cell differentiation and angiogenesis, PRP also affects tissue regeneration and local control of inflammatory conditions. TGF‐β1 in PRP delays activation of extracellular signal‐regulated kinase thus inhibiting melanin synthesis 14 . In addition, PDGF in PRP may help in increasing the skin volume by angiogenesis, collagen synthesis, and extracellular matrix formation that result in reduced pigmentation and skin luster, elasticity and improvement in cosmetic appearance 13,15,16 …”

“…3,13 Some of the growth factors released by platelets in PRP are platelet-derived growth factor (PDGF), epithelial growth factor (EGF), vascular endothelial growth factor (VEGF), endothelial cell growth factor (ECGF), fibroblast growth factor (FGF), transforming growth factor beta (TGF-β), and insulin-like growth factor (IGF). 14,15 In addition to the direct effect of PRP on cell proliferation, migration, cell differentiation and angiogenesis, PRP also affects tissue regeneration and local control of inflammatory conditions. TGF-β1 in PRP delays activation of extracellular signal-regulated kinase thus inhibiting melanin synthesis.…”

“…TGF-β1 in PRP delays activation of extracellular signal-regulated kinase thus inhibiting melanin synthesis. 14 In addition, PDGF in PRP may help in increasing the skin volume by angiogenesis, collagen synthesis, and extracellular matrix formation that result in reduced pigmentation and skin luster, elasticity and improvement in cosmetic appearance. 13,15,16…”