Platelet Rich Plasma (PRP) – hype or reality?

It’s often hard to separate hype from reality when evaluating medical news. Platelet rich plasma, or PRP, was first used in the late 90s. Initially it was proposed to help heal sports injuries, and treat arthritis or tendonitis. But recently, it has been used as a means of performing nonsurgical facelifts, with celebrities like Kim Kardashian and Angelina Jolie jumping on the bandwagon.

PRP is a component of your blood

What is PRP?

Platelet rich plasma is a component of human blood. A bit of your own blood is spun in a centrifuge for 15 minutes. This separates out all the components of the blood into layers. One of the layers contains cells called platelets, suspended in a fluid called plasma. Platelets are tiny cells in the blood that have an important role in healing wounds and forming blood clots. Since all these platelets are now in a very small quantity of fluid, this is a very concentrated platelet mixture – hence the name Platelet-Rich Plasma. The PRP can then be injected back into a muscle, ligament, or into the skin.

Investigating PRP

In my practice I take care of patients with arthritis and tendonitis in their hands, as well as patients who are interested in reversing the signs of aging. As a result, PRP is of particular interest to me. So, as I do with any new medical technique or technology, I investigated three questions about PRP:
1) Does it consistently produce the results that are claimed?
2) What are the risks?
3) How does it compare to the alternatives?

PRP is often used for joint pain

Does PRP work for musculoskeletal injuries?

The short answer is, it depends.
The original thinking around PRP was that it would help treat chronic injuries (like arthritis or tendonitis) and speed up the healing of acute injuries (like torn ligaments). The data on this front are mixed. There have been many famous athletes who have reportedly received these treatments (for example, Tiger Woods, Peyton Manning, and Rafael Nadal). But a couple of systematic analyses of all PRP studies showed that treating muscle, tendon, or ligament injuries with PRP was, at best, only marginally useful in the long run. But, PRP may help athletes return to their sports more quickly – explaining why professional athletes would find PRP very useful.

Does PRP work to rejuvenate skin?

Maybe. There is certainly good evidence that PRP can help treat hair loss, and improve acne scars. And PRP may reduce swelling and bruising after a surgical facelift. The jury is still out, however, on whether PRP can produce facelift-like results without surgery.

What are the risks and benefits of PRP?

The biggest potential benefit of PRP is that it is “natural”. Since it is derived from your own blood, there is no risk of allergic or immune reaction. In general, therefore, it is quite safe. The risks include accidentally introducing infection during the process of drawing and processing blood, and pain during the injection. PRP has been used for facial rejuvenation for about a decade, so we don’t know whether there are any long-term risks associated with it. The non-medical risk of PRP is that it can be quite expensive!

On the flip side, since PRP only involves drawing some blood and having some injections, it does not tend to require a long recovery period. The recovery after a PRP treatment is similar to any other injectable – such as Botox or fillers (like Juvederm and Restylane). It certainly has a quicker recovery than any surgical procedure.

How does PRP compare to the alternatives?

As I have mentioned above, PRP is not a slam dunk option – the jury is still out on whether it can provide good results. So patients generally consider PRP when the alternatives don’t sound very appealing. For example, when treating arthritis, the options are generally NSAID medications (like Alleve), therapy and splints, steroid injections, and surgery. If these options have failed for you, and you wish to avoid surgery, PRP might be a potential choice.

Similarly, facial rejuvenation options include Botox, dermal fillers, lasers, peels, and surgery (e.g. facelift, blepharoplasty, etc.). PRP is more invasive than Botox, fillers, and even a laser, but far less so than a surgery. And, your recovery after PRP is comparable to a Botox or filler treatment.

In conclusion…

The science behind PRP is still in its infancy. As a result, we don’t really understand yet exactly how – or if – it works. It is a low risk procedure, but can be quite expensive. It’s also not clear how often you need PRP treatments to maintain the results, and whether it has any long-term risks. As always, discuss your goals with your plastic surgeon during your in-person evaluation. This will help you and your surgeon determine which of the many treatment options are the best choice for you.