The Power of Platelet Rich Plasma (PRP)
The human body has a remarkable capacity to heal itself. Regeneration of new tissue is accomplished by stem cells and is fostered by growth factors and hormones. Platelet-rich plasma (PRP) is an emerging treatment in a many medical specialties: orthopedics, wound healing, surgery, aesthetic and sexual medicine. We are happy to offer a number of treatments utilizing PRP and see it as one of the exciting new trends in modern medicine.
How Does Platelet Rich Plasma (PRP) work?
Remember when you skinned your knee as a kid and you got that yellow goo when it started healing? That is the PRP. When we are injured the body signals platelets and other components in our blood supply to migrate to the site of injury. Platelets are the injury’s first responders, and under normal conditions these platelets release various factors that initiate and subsequently stimulate bone and cartilage regeneration and repair, promote new blood vessel development to accelerate tissue regeneration, and stop the bleeding. Platelets release many other bioactive proteins responsible for attracting macrophages, mesenchymal stem cells, and osteoblasts.1
Inside the platelet are 2 types of granules, namely, alpha granules and dense bodies. Alpha granules contain the clotting and growth factors that are released in the healing process. Normally at the resting state, platelets require a trigger to activate and become a participant in wound healing and hemostasis.
Growth factors and other cytokines in platelets include the following: platelet-derived growth factor, transforming growth factor, fibroblast growth factor, insulinlike growth factor 1, insulinlike growth factor 2, vascular endothelial growth factor, epidermal growth factor, interleukin 8, keratinocyte growth factor, and connective tissue growth factor.
How do we get the Platelet Rich Plasma (PRP) used in my procedure?
Modern technology allows us to concentrate platelets and white blood cells from a patient’s blood (autologous therapy) and to induce the release of growth factors by injecting the solution directly into the tissue target, simulating a regenerative response. This all means that we will draw blood from you, separate the best healing parts out and re inject it into the desired location.
Advantages of using Platelet Rich Plasma (PRP)
Advantages of using PRP include the following: tissue regeneration and rejuvenation, induction of cell differentiation, extracellular matrix formation, recruitment of other cells to the site, and an increase in collagen production, which can increase skin thickness and overall skin health. In addition, PRP is nonallergenic, is an autologous physiological product, eliminates donor transmissible infections, and is a biological glue for tissue adhesion, especially in skin flaps, bone grafts, and trauma.
Preparing the Platelet Rich Plasma (PRP) for your procedure.
To prepare PRP, blood is drawn from the patient’s arm. The blood is then placed in a centrifuge that spins at high speed and separates the platelets from the rest of the blood components. The typical baseline blood platelet count is approximately 200 000 per microliter; therapeutic PRP centrifuges concentrate the platelets by roughly 5-fold. However, broad variability exists in the production of PRP by various concentrating equipment and techniques. The platelets collected in PRP are activated by the addition of thrombin and/or calcium glucarate, which induces the release of these factors from alpha granules.
The entire process takes less than 30 minutes and increases the concentration of platelets and growth factors up to 600%, along with an inherent rise in human stem cell proliferation due to exposure to concentrated platelets up to 10 times above native levels. The concentrated PRP is then injected into and around the affected area, jump-starting and significantly strengthening the body’s natural healing signals. Injections of PRP heal the area over time, during 1 to 3 months. Because the patient’s blood is used, there is no risk of a transmissible infection and a low risk of allergic reaction.
Clinical Applications and Procedure
In humans, PRP has been investigated and used as a clinical tool for many types of medical treatments, including nerve injury, tendonitis, osteoarthritis, cardiac muscle injury, bone repair and regeneration, plastic surgery, and oral surgery. It has received attention in the popular media because of its use in treating sports injuries in professional athletes.
Aging of the skin, dermal components, and cells means that the skin texture and appearance deteriorate and have been damaged. Aging affects the hands and soft tissue of the face, neck, and décolleté. This is characterized by sagging jowls, thinning of the skin, puffiness, age spots, and wrinkling.
In dermatology and cosmetic medicine, PRP has been used to treat acne, scarring, and alopecia (especially in women). It is also effective for skin rejuvenation and tightening around the eyes (for thin crepe-like skin and fine lines) and in the following areas: cheeks and midface, thinning skin on the neck, jawline and submalar regions, back of hands, décolleté, and others (eg, knees, elbows, and upper arms, as well as for postpregnancy skin laxity).
In cosmetic procedures, platelet-rich plasma is injected by multiple tiny punctures under the dermis, with or without topical local anesthesia. The process is painless if sufficient topical anesthesia is applied. When PRP is injected into the damaged area, it stimulates the tissue, causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures, it begins to shrink and tightens and strengthens the skin. Improvement in skin texture and tone is noticeable within 3 weeks. Full collagen regeneration requires 3 months. Topical skin care and light therapies can enhance these results.
The PRP treatments can be used on all skin types and tones. Minimal swelling, bruising, and redness for the initial 12 to 24 hours are expected. A bruise at the needlestick site may be visible for 2 to 3 days. Swelling from the fluid is what the patient will notice first. During several weeks, the platelets stimulate growth factors, which assists in more collagen stimulation. Treatment results vary but last up to 18 months in most patients. Biannual touch-up treatments will maintain the results.
As an initial treatment strategy, up to 3 injections may be given within a 6-month time frame. These are usually performed 2 to 3 weeks apart.
Considerations before Platelet Rich Plasma (PRP) Treatment
Certain factors (eg, smoking and alcohol intake) diminish stem cell release. Avoiding these will increase the success of the PRP procedure. The platelets work by causing an inflammatory reaction. If this inflammatory reaction is diminished, the clinical outcome is significantly compromised. For this reason, the use of anti-inflammatory drugs after the procedure is not recommended. This restriction should be in place for about 1 to 2 weeks.
Proponents of PRP therapy argue that negative clinical results are associated with poor-quality PRP harvest or concentration by inadequate devices. At Well Medical Arts we use the most current and cutting edge equipment available. More platelets is not necessarily better. Variability in platelet concentrating techniques may alter platelet degranulation characteristics, which could affect clinical results. The right concentration and handling will yield the best results.
Who should not have Platelet Rich Plasma (PRP) Treatment?
Although PRP is a promising therapy for most patients, there are a few special considerations. Contraindications include the following: sepsis, cancer, chemotherapy, platelet dysfunction syndrome, critical thrombocytopenia, hypofibrinogenemia, hemodynamic instability, anticoagulation therapy, acute and chronic infections, chronic pathological conditions of the liver, severe metabolic and systemic disorders, and skin disease (systemic lupus erythematosus, porphyria, and allergies), as well as heavy nicotine, drug, and alcohol consumption.
Adverse effects of Platelet Rich Plasma (PRP) Treatment
Adverse effects are rare but can occur. Adverse effects of PRP treatment may occur, some of which are significant. The most common adverse effects are infection, skin discoloration and bruising, pain in the injected area, allergic reaction (a rare occurrence), and blood clot (because PRP therapy uses a needle, a vein could be damaged).
Technique is Key
As with all therapies, adequate training and experience are paramount. The beauty of the PRP technique, especially in dermatology and as an adjunctive tool in practice, is that it can be used as part of a multifaceted or layered approach.
Drawing Blood in preparation for the Platelet Rich Plasma procedure.
Spinning up the PRP (platelet rich plasma) in Seattle and getting ready for a vampire facial.