Blood is an amazing, specialised fluid in the body that has many different functions, including transporting oxygen and nutrients to the lungs and tissues, as well as aiding in metabolic waste expulsion. While the sight of blood is rather alarming for most people, indicating some form of injury, to aesthetic doctors, it is the very elixir of life. Paola Chellew chats to Dr Nerina Wilkinson, Dr Burt Jooste, Dr Cathy Davies, and Dr Marisa Heyns about the merits of PRP.
Platelet-rich plasma (PRP) therapy – aka the vampire facial – made fashionable by Kim Kardashian, is one of the most popular elective cosmetic procedures and is incredibly effective for skin rejuvenation. It pairs microneedling with your own blood plasma, resulting in healthy, beautiful-looking skin.
But, in order to understand how this treatment works, we need to brush up on our biology.
Blood is thicker than water
Blood is made up of red and white blood cells, plasma, and platelets. The platelets are responsible for making our blood clot and they also produce growth factor proteins that induce the healing process and contain anti-inflammatory benefits. Platelets, therefore, promote cell growth and regeneration.
To obtain PRP, all the various cellular components (red and white blood cells) are separated through a process of centrifugation, leaving a concentration of platelets suspended in plasma, hence the term platelet-rich plasma.
PRP is the part of your blood that contains growth factors and proteins that encourage healing on a cellular level. So, when it’s injected into the skin, there is an improvement in texture and a boost to collagen growth.
Dr Nerina Wilkinson
With that in mind, I asked Dr Nerina Wilkinson to elaborate on whether the blood quality of the patient is paramount to the procedure being successful.
Dr Nerina Wilkinson: “We often need to either cancel a patient scheduled for a ‘vampire’ or change their treatment to another skin biostimulating treatment with growth factors if their own blood growth factors not ideal or they have been ill.
What impact does growth factor quality have?
“The quality of growth factors in PRP can significantly impact its effectiveness in skin rejuvenation. Several factors can influence the quality of growth factors in PRP:
- Platelet concentration: The concentration of platelets in PRP plays a crucial role in determining the quality of growth factors.
- Preparation method: The method used to prepare PRP can affect the quality of growth factors.
- Patient’s health status: The overall health of the patient can influence the quality of growth factors in PRP. Patients with chronic health conditions, nutritional deficiencies, or those on certain medications may have lower quality PRP, as these factors can affect the platelet count and the composition of growth factors in the blood. Anti-inflammatory medications can potentially affect the quality of PRP and its effectiveness in some cases.
- Age of the patient: Age can also play a role in the quality of growth factors.
- Individual variation: Growth factor quality can vary from person to person. Some individuals may naturally have higher concentrations of growth factors in their blood, making their PRP more effective for skin rejuvenation.
“There are many more contraindications – the most common being patients who are on chronic anti-inflammatory meds or corticosteroids. If a patient has a medical history, then baseline bloods are essential. A healthy skin can only be achieved if the body is healthy.”
Do you need blood tests before PRP?
Dr Burt Jooste
I asked Dr Burt Jooste whether a patient should be sent for blood tests before undergoing PRP.
Dr Burt Jooste: “It’s an interesting and relevant question. In terms of the actual procedure, I think it is vital to consult with the patient first, clarifying to them that we only use their blood, so the quality of your PRP is directly related to the quality and health of your blood and, therefore, the success of your treatment.
“In order to optimise your blood quality, you will have to optimise in both the short term (level of hydration, avoidance of alcohol, caffeine and other stimulants at least for a week before procedure, quality of nutrition and sleep, level of exercise and fitness, and stress management) and long term (overall health of liver, kidneys, adrenal glands, thyroid, hormone balance and optimisation, iron levels, and person-specific supplementation to ensure that all your deficiencies are corrected). These can be determined or identified with a proper blood analysis and consultation. You can lower cellular inflammation, boost detoxification, optimise gut health, and improve cardiovascular health (lowering of cholesterol).
“I think all patients going for any type of PRP need to have certain basic bloods done beforehand, but a proper assessment with comprehensive blood tests would be ideal. The added benefit of this is that other shortfalls and deficiencies could also be identified and subsequently rectified in order for the body to work better as a whole.
“Although the lifespan of a platelet is usually between 7-10 days, the overall health of the blood and body system will also affect the quality of the platelet – hence my emphasis on both short- and long-term factors. Vitamin C, B vitamins, and magnesium all play an important role in the production and health of our platelets.”
Dr Cathy Davies
Dr Cathy Davies, an aesthetic doctor who specialises in hair restoration, agrees.
Dr Cathy Davies: “Platelet therapies such as PRF ( Platelet Rich Fibrin) and PRP (Platelet Rich Plasma) have become a popular regenerative treatment for rejuvenating skin and hair, healing wounds and joints, and improving sexual wellness.
“PRP injections are created by isolating the platelets from a patient’s blood and concentrating them into a serum which is then injected into the treatment area. PRF (Platelet Rich Fibrin) injections, on the other hand, are created by adding a fibrin matrix to the platelets, which creates a more cohesive and stable injectable product, encouraging the development of new healthy skin cells and boosting collagen production.
What are the contraindications?
“Absolute contraindications include:
- a history of haematopoietic cancer, cancer of the bone marrow, or metastatic cancer
- pregnancy and breastfeeding
- infections of the target area (treat first)
- incidence of recent fever or illness
- history of severe liver disease.
“Looking at relative contraindications, these include:
- a low platelet count, meaning you may bruise or bleed more than usual
- eating a vegan diet characterised by low iron or B12 intake
“If the patient is being treated with anticoagulant medication, their doctor may ask them to avoid the drugs for a few weeks before and after PRP therapy. This should not be done without medical supervision. If the patient cannot stop the medicine, they may be advised to wait until after they have completed the prescribed courses.
How can you optimise your PRP/PRF results?
“Here are some tips for optimising PRP results:
- Two weeks before: Discontinue cortisone or steroid-based medications. Avoid smoking.
- One week before: Avoid intake of any ibuprofen, aspirin, or NSAIDs. Discontinue use of any anticoagulant medications (only after discussing this with your doctor). Ask your doctor about any other herbs or vitamins you may be taking.
- 24 hours before: Drink plenty of water, eat well, and get a good night’s rest.
- Treatment day: Stay hydrated and eat a full, nutritious meal. If you are vegan/vegetarian, ensure your iron and B12 intake are adequate.
“There is very little downtime after your PRP treatment; you may even be cleared to return to work the same day. But it is advised to rest and take it easy for a couple of days post-procedure.
“Follow these guidelines to make sure your healing progresses well and you have optimal outcomes from your procedure:
- Do not touch, rub, or massage the injection site for at least eight hours.
- Do not bathe, shower, or swim for eight hours after treatment.
- Do not take any medications, vitamins, or supplements unless approved by your doctor. Your doctor may approve paracetamol as a therapy for pain.
- Avoid applying ice or heat at the site for three days after your injection.
- Do not apply lotions, oils, or make-up to the injection site for six hours.
- Avoid strenuous activities and exercise for three days after.
How does PRP/PRF aid in the management of hair loss?
“The precise mechanism of action of PRP in the promotion of hair growth is still not completely defined. Treatments such as PRP/platelet-rich fibrin rely on platelets in the plasma of one’s own blood to release numerous growth factors. Some of these contribute to hair regeneration.
“The growth factors released from platelets also act on stem cells in the hair follicles and stimulate the development of new blood vessels and the growth of hair follicles.
“Another proposed mechanism is that the growth factors affect hair cycling by prolonging the length of the anagen phase (the growth phase of hair cycle).
“It is important to note that the success of these therapies for hair loss can vary according to the cause of your hair loss. These factors may play a role:
- the presence of inactive hair follicles that aren’t growing hair
- hair loss caused by a scarring condition
- auto-immune condition
- hormone imbalance
- cancer treatments, including chemotherapy (rather wait until the course is completed)
- a scalp condition like a rash or infection causing the hair loss.”
True blood: Can you use PRP alongside other treatments?
If you are contemplating including PRP in your skincare journey, Dr Marisa Heyns explains how and why it could be beneficial:
Dr Marisa Heyns
“A successful PRP treatment depends on two factors: first, being able to extract an optimal amount of platelets; and second, how our skin responds to the effect of these magical growth factors. These act as an on switch for the regenerative abilities of the skin (building collagen, elastin, and hyaluronic acid) as well as other beneficial effects such as decreased inflammation and improved blood supply. This in turn improves the quality and functioning of the skin, giving you firmer, plumper skin with a radiant glow.
“Apart from the standard PRP skin treatments, we also use PRP in combination with deep skin needling and radiofrequency microneedling treatments to promote a faster healing response post-treatment. We also like to use it as a sole ingredient in intimate wellness treatments such as the O- and G-shot, as well as scalp treatments for androgenetic (male) hair loss.
“The number of sessions and the longevity of results depend on the overall journey plan that we design for each individual. As a stand-alone treatment, one will generally require an initial three sessions monthly, followed by maintenance treatments every 6-12 months. Ultimately, the best skin results depend on the aesthetic concern – e.g. weak and inflamed skin barriers resulting from chronic sun damage, melasma, rosacea, and acne. The use of multiple modalities – which includes PRP – helps us to obtain the best and longest-lasting results.
“But, ultimately, it is how our skins are able to respond to this activation process that will guarantee amazing results. This is where a healthy lifestyle and good nutrition come in, to ensure the skin’s optimal receptiveness when exposed to growth factors.”
Drawing the distinction: Your health determines your chances of success
In the long run, it’s safe to say that there is consensus among the doctors that optimal health is an advantage when considering platelet-rich therapies. The success of the outcome ultimately depends on the quality of your blood, so it’s in your best interest to make good lifestyle choices and – even more importantly – follow the advice of your medical practitioner.
References:
- https://www.ironwoodcrc.com/boost-your-platelets-with-nutrition/
- https://journals.lww.com/jbioxresearch/fulltext/2021/06000/factors_aff
- https://www.forbes.com/health/wellness/platelet-rich-plasma/
- Stevens J, Khetarpal S. ‘Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol’. Int J Women’s Dermatol. 2018 Sep 21;5(1):46-51. doi: 10.1016/j.ijwd.2018.08.004. PMID: 30809579; PMCID: PMC6374694.
Paola Chellew is a freelance journalist and regularly writes for a number of publications. A former professional contemporary dancer, she has always loved the arts in all their forms. She has been a freelance writer for many years and has been published in various magazines including Live Out Loud, Private Life and Do It now magazines. Her passion for beauty and skincare started in her teens, when she would read every beauty editor’s picks and reviews. Serious about skincare, she has researched medical-grade products for over ten years, as well as aesthetic treatments to restore and repair skin to look its best. Having turned 60 last year, she has dedicated her blog to the “over 50s and beyond Club”, shining a spotlight on a generation that is seemingly side-lined by the beauty industry. “There is no age limit for when you stop being beautiful – a gorgeous lipstick, a sexy fragrance, radiant skin- these are not synonymous with youth- they are just things that add an extra sparkle to my day”.
📸 Profile photo credited to Lerissa Kemp Photography
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
