Study of autologous platelet‐rich‐plasma versus its combination with intense pulsed light in treatment of melasma

Abstract

Melasma is a common acquired hypermelanosis of variably successful therapies with frequent relapse. Platelet-rich-plasma (PRP) is a promising treatment in melasma, alone or combined with other treatments. We evaluated efficacy of autologous PRP in melasma treatment and the effect of combined intense pulsed light (IPL). Study included 20 Egyptian female melasma patients. PRP was injected in all melasma area and IPL was used on the right hemi-face. Melasma Area and Scoring Index (MASI) of melasma area, modified-MASI (mMASI) of PRP-IPL side and of PRP side significantly decreased after treatments (p-value < 0.05). There was no statistically significant difference between both sides regarding mMASI score or patient and physician satisfaction (p-value > 0.05). Our study provides the first comparison between PRP versus its combination with IPL in melasma treatment. We think the improvement of melasma with regression of melasma scores after PRP treatment is an important finding.

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

“…Gamea et al [ 19 ] used PRP therapy in combination with topical 5% tranexamic acid, compared to topical 5% tranexamic acid monotherapy, which showed significantly better treatment results and patient satisfaction was detected in patients of combination therapy group. Adel et al [ 18 ] compared PRP alone versus intense pulsed light (IPL) plus PRP, proving an obvious improvement of chloasma after PRP treatment ( p < 0.05). However, no statistically significant difference was found between the two groups regarding mMASI score or patient satisfaction ( p > 0.05).…”

“…Four studies comparing the mMASI between experimental (PRP treatment) group and control group were enrolled in the meta-analysis [ 3 , 4 , 18 , 19 ]. The baseline mMASI were comparable between experimental and control groups in all included studies ( p > 0.05).…”

“…The heterogeneousness was substantial ( p < 0.05; I 2 = 87 percent). The study by Sirithanabadeekul et al [ 4 ] was conducted in Thailand, whereas other studies were conducted in Egypt [ 3 , 18 , 19 ]. The racial difference may account for the heterogeneousness.…”

“…Hofny et al [ 3 ] found that both the MASI and mMASI scores decreased and that more than 80% of patients improved mildly or significantly but that the difference between two different PRP injections was insignificant. According to Adel et al [ 18 ], clinical efficacy of PRP alone or PRP combined with IPL was improved, but there was no significant difference between the two groups.…”

“…In two of the RCTs looking at PRP versus other therapies, patient satisfaction was significantly higher under PRP than in the control group [ 4 , 19 ]. In the study of the effect of two different injection methods of PRP and the randomized controlled study examining the efficacy of PRP alone and in combination with PRP and IPL, there was no significant difference in satisfaction with the efficacy between the experimental group and the control group [ 3 , 18 ]. And in another prospective before-and-after self-control studies, more than 90% of patients were satisfied with the efficacy of PRP [ 2 ] ( Table 4 ).…”