Platelet-Rich Plasma (PRP) Injections:
In recent years, doctors have learned that the body has the ability to heal itself. Platelet-rich plasma therapy is a form of regenerative medicine that can harness those abilities and amplify the natural growth factors your body uses to heal tissue.
What is plasma and what are platelets?
Plasma is the liquid portion of whole blood. It is composed largely of water and proteins, and it provides a medium for red blood cells, white blood cells and platelets to circulate through the body. Platelets, also called thrombocytes, are blood cells that cause blood clots and other necessary growth healing functions.Platelet activation plays a key role in the body’s natural healing process.
What is platelet-rich plasma (PRP) and what are PRP injections?
Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscle , joints , hair , skin and totally each part of body that need regenerate . In this way, PRP injections use each individual patient’s own healing system to improve musculoskeletal problems.
PRP injections are prepared by taking anywhere from one to a few tubes of your own blood and running it through a centrifuge to concentrate the platelets. These activated platelets are then injected directly into your injured or diseased body tissue. This releases growth factors that stimulate and increase the number of reparative cells your body produces.
PRP is a facial rejuvenation treatment that uses your own plasma to stimulate collagen production and cell migration, allowing for the elimination of lines, folds, and wrinkles. Results from PRP therapy are natural looking and subtle, and they can last for as long as two years. What’s more, PRP is minimally invasive, has no risk of allergic reaction, and can be used to treat nearly any area of the body without risks of side-effects, making it ideal for patients who are not interested in or are not good candidates for injectable fillers.
How Does PRP Rejuvenate The Skin?
The body cells which aid the tissue in healing and producing new cells are called Platelets. PRP is injected into targeted areas of the skin and then forms an environment which helps in growing collagen, regenerates the tissues and makes your skin smooth and tight. PRP softens wrinkles and creates skin texture and tone that is smoother, younger and better.
How does PRP treatment for Skin Rejuvenation differ from fillers or other injection?
• Lines and skin folds are a common sight on the tired skin, especially around mouth area or plump lips. These are filled by the solid materials of Hyaluronic acid fillers, namely Restylane and Juvederm. These fillers can go on from 6-18 months and are to be redone after a certain period of time given by the doctor concerned.
• PRP enables the collagen grown by the body and stimulates it to engineer total facial rejuvenation instead of focusing on one wrinkle at a time. It is also used to stabilize the faces which look tired, aids in filling up hollowed cheeks, skin tone improvisation, making the skin tight and smooth, and fill in the skin areas which the hyaluronic acid either cannot fill either due to lack of reach or reactionary issues.
• PRP treatment for skin can be done in tandem with Hyaluronic fillers like Restylane and Juvederm. Theese are two kinds of treatments which complete each other in order to aid the patient in achieving a much younger face. What fillers cannot do is done by the PRP treatment, for e.g. Fillers helps in removing lines and folds and PRP focuses on volumizing the face and enhances the skin tone. PRP also improves the texture of the skin and makes it smooth.
PRP therapy is a very safe treatment because there is no risk of rejection, since your own blood is used to treat your body. Additionally, because there are no incisions, there is very little chance of infection.
Many patients who have had PRP therapy have reported it to be effective in reducing pain and other symptoms, which makes it a useful and reliable treatment option. It is a great treatment to add to any pain-management regimen also in skin and hair rejuvenation.
PRP is obtained from a sample of patients’own blood drawn at the time of treatment. A 30-40 cc venous blood draw will yield 3-5 cc of PRP depending on the baseline platelet count of an individual, the device used, and the technique employed. The blood draw occurs with the addition of an anticoagulant, such as citrate dextrose A to prevent platelet activation prior to its use.
In the PRP method, an initial centrifugation to separate red blood cells (RBC) is followed by a second centrifugation to concentrate platelets, which are suspended in the smallest final plasma volume. WB (whole blood) is initially collected in tubes that contain anticoagulants. The first spin step is performed at constant acceleration to separate RBCs from the remaining WB volume. After the first spin step, the WB separates into three layers: an upper layer that contains mostly platelets and WBC, an intermediate thin layer that is known as the buffy coat and that is rich in WBCs, and a bottom layer that consists mostly of RBCs. For the production of pure PRP (P-PRP), upper layer and superficial buffy coat are transferred to an empty sterile tube. For the production of leucocyte rich PRP (L-PRP), the entire layer of buffy coat and few RBCs are transferred. The second spin step is then performed. ‘g’ for second spin should be just adequate to aid in formation of soft pellets (erythrocyte-platelet) at the bottom of the tube. The upper portion of the volume that is composed mostly of PPP (platelet-poor plasma) is removed. Pellets are homogenized in lower 1/3rd (5 ml of plasma) to create the PRP (Platelet-Rich Plasma).
- Obtain Whole Blood in tubes with anticoagulant
- Do not chill the blood at any time before or during platelet separation.
- Centrifuge the blood using a ‘soft’ spin.
- Transfer the supernatant plasma containing platelets into another sterile tube (without anticoagulant).
- Centrifuge tube at a higher speed (a hard spin) to obtain a platelet concentrate.
- The lower 1/3rd is PRP and upper 2/3rd is platelet-poor plasma (PPP). At the bottom of the tube, platelet pellets are formed.
- Remove PPP and suspend the platelet pellets in a minimum quantity of plasma (2-4 mL) by gently shaking the tube.
- It’s Safe (it is an autologous product, PRP is very safe).
- Closed system kits to use for preparation sterile PRP.
- Effectiveness for long lasting. (Results from PRP take between three to four weeks to appear but are long-lasting, typically lasting 12 to 18 months after an initial series of three treatments).
- Using PRP for treating (Pain & Rejuvenation) is low costs.
Limitations for using PRP in patients with these symptoms:
- Patients with a variety of cancers, especially skin cancers.
- Disorders of Platelet Function
- Chronic diseases like non-healing diabetics ulcers
- Immune Deficiency
- Hemodynamically Unstable Patients
- Using anticoagulants drugs
What can we do before the PRP treatment?
- Drink a lot of fluids
- Make sure you don’t have any infectious disease like cold or flu.
Platelet Rich Plasma (PRP) Post-Treatment Instructions :
Please carefully read and follow these instructions after your PRP treatment. There are minimal restrictions after your PRP injections allowing you to return to your daily activities almost immediately.
- 1-DO NOT touch, press and rub or manipulate the treated area(s) for at least 8 hours after your treatment.
- AVOID Advil, Aleve, Aspirin, Ibuprofen, Motrin, Naprosyn, (all non-steroidal anti-inflammatory agents), Vitamin A, Vitamin E, Gingko Biloba, Garlic, Flax Oil, Cod Liver, Essential Fatty Acids (EPA, DHA), for at least 1 week prior to and 2 weeks after your treatment. Remember, our goal is to create inflammation. These listed medications will limit or prevent inflammation, which can diminish your results.
- If you must take Aspirin for cardiac reasons, you certainly may do so, but this may limit your results. It is normal to experience bruising, redness, itching, swelling and/or soreness that may last from 2-5 days following your procedure.
- If you experience any pain or discomfort you may take Tylenol or other Acetaminophen-containing products as directed. We would prefer if you could refrain from applying ice to the injected area as ice acts as an antiinflammatory.
- Do not wet your hair for at least 3 hours after your treatment. For the first 3 days, use shampoo that is pH balanced. Others include: Baby Shampoo and Wash ➢ Tea Tree Shampoo (any brand) Do not use any hair products for at least 6 hours after your treatment.
- AVOID saunas, steam rooms, swimming for 2 days after your treatment.
- AVOID vigorous exercise, sun and heat exposure for at least 2 days after your treatment.
- AVOID alcohol, caffeine, and cigarettes for 3 days after treatment. Smokers do not heal well and problems recur earlier and results may take longer.
- AVOID resuming Minoxidil or hair coloring or straightening for 3 days.
Platelet-rich plasma in Periorbital Hyperpigmentation & Wrinkles:
Recently, platelet-rich plasma has been used in treating dark circles due to tear trough deformity and wrinkles. A single session with intradermal injections of 1.5mL platelet-rich plasma was given into the tear trough area and wrinkles of crow’s feet. Effect was compared three months after treatment with baseline. The improvement in infraorbital color homogeneity was statistically significant.
Platelet-rich plasma in Face & Neck Wrinkles:
Using PRP for facial and neck rejuvenation is another way to fight the signs of aging naturally – it is an effective and safe treatment. Presently, a lot of people are using platelet-rich plasma for facial rejuvenation since it is a very viable treatment with no side effect. It gives both long-term and short-term results, as long as the body keeps absorbing its growth factors and uses them to create new and healthy tissue. Within a day, you can experience dramatic results that will last a long time. Additionally, the procedure is much more affordable than invasive and surgeries procedures. What’s more, you don’t require any aftercare and you can go come back to work quickly. The advantages of using platelet-rich plasma are numerous and the dangers are few, which makes it the perfect choice for people who want to rejuvenate their face and neck.
Platelet-rich plasma in Hand Wrinkles:
This type of aging occurs naturally as we age. The hands show decreased skin volume, less elasticity, more wrinkles, and more apparent veins, tendons, and joints. Intrinsic aging affects the deep tissue within the hands. This happens to the above layers of the skin known as the epidermal and dermal, or surface, layers of the skin, which can be caused by sun exposure, strong chemicals such as nicotine, diet, and certain lifestyle choices. After numbing the area, the plasma is then injected into the patient’s hand; it could be wrinkles, or an arthritic area, or an injured tendon. Unlike a surgical operation, PRP makes it possible for a patient to resume daily activities quickly. The patient’s specific recovery time is dependent upon the exact procedure. Most patients who have undergone PRP injections for their hands can resume their daily activities even on the day following the procedure.
Platelet-rich plasma in Acne Scars:
Acne is a significant clinical problem with sever social, psychological, and emotional implications. A mainly genetically determined host response pattern combined with bacterial ‘’triggering’’ is generally accepted as being important for the apparently unbalanced inflammatory activity. Platelet rich plasma is a good choice for the treatment of acne and atrophic scars reminiscent of the course of the disease. In addition, for being autologous, it reduces the possibility of side effects, such as skin dryness and rejection. It was demonstrated that PRP accelerates the healing process, regulates inflammation and promotes healing by inhibiting the P. acnes bacteria, additionally restoring collagen). The PRP’s mechanism of action also involves the release of powerful antimicrobial peptides from the platelets’ alpha granules. Although there are few studies on the PRP’s effectiveness in acne, it emerges as a potential therapeutic option in Dermatology and Aesthetic Medicine.Due to development of resistance in microorganisms causing acne to common antibiotics and differences in species and strains of the microorganisms in different regions, using PRP for treatment in this problem.
Platelet-rich plasma in Alopecia & Hair Regrowth:
Androgenetic alopecia (AGA) is a hereditary and androgen-dependent dermatological disorder characterized by miniaturization of scalp hair in a defined pattern. There is an alteration in the hair cycle dynamics leading to vellus transformation of terminal hair follicles. Due to the limited treatment options, it is a growing concern for dermatologist worldwide. The US Food and Drug Administration (FDA)-approved medical treatment options for the management of AGA are topical minoxidil and oral finasteride. Various other treatments have been tried beside FDA-approved options. Most of the existing treatment options are relatively slow to act because of which there has been a continuous search for newer modality of treatment among which platelet-rich plasma (PRP) therapy has shown promising results. PRP is autologous preparation of platelets in concentrated plasma. It contains more than 20 growth factors (GF), of which most important GFs include platelet-derived GFs, transforming GF-ß, vascular endothelial GF, and insulin-like GF-1 along with their isoforms. In AGA, PRP induces differentiation of stem cells, prolongs survival of dermal papilla cells, prolongs anagen phase of hair cycle, and increases perifollicular vascular plexus by multiple mechanisms through various GFs.PRP contains a range of growth factors that speed tissue repair. As some types of hair loss result from damage to hair follicles, researchers initially hypothesized that PRP could help regrow hair by reversing the process that occurs in androgenetic alopecia. In fact, PRP has become a popular method of restoring hair regrowth.
PRP in Wound Healing and Tissue Regeneration:
PRP in Burn Ulcers, Bed Sores & Pressure sores and Diabetic Foot Ulcers:
There are studies evaluating the effects of PRP on wound healing. In the early phase of wound healing, the clot formed in the injury area serves as a matrix for cell migration, and this phase is primarily affected by platelets. Platelets contain over 1100 proteins, including growth factors, immune system mediators, enzymes, enzyme inhibitors, and bioactive compounds involved in the wound healing process. PRP contains important growth factors deposited in alpha granules of platelets and plasma proteins such as fibrin, fibronectin, and vitronectin. Topical application of PRP accelerates the re epithelialization process by upregulating regulatory proteins of cell cycle such as cyclin A and CDK4. PRP is a potent matrix metalloproteinase (MMP)-1 stimulator and, thus, allows the extracellular matrix to be reorganized during wound healing.PRP may also suppress inflammation by suppressing cytokine release and increases regeneration and reepithelization by triggering capillary angiogenesis. The involvement of macrophages in the wound healing process is also mediated by signal proteins released from platelets. PRP has also been reported to exhibit antimicrobial activity against microorganisms such as Escherichia coli, MRSA, Candida albicans, and Cryptococcus neoformans and to have analgesic effect. Additionally, the pH 6.5–6.7 of the PRP may explain its antibacterial property. Although it has been suggested that leukocytes in PRP accelerate the recovery of soft tissue injury by suppressing bacterial growth, it has been also claimed that PRP may cause local pain and even suppress the healing process due to the inflammatory cytokines in it.