When comparing platelet-rich plasma (PRP) as monotherapy with PRP in combination with photoactivation in patients with melasma, researchers reported minimal differences in efficacy. Their results were published in the Journal of Cosmetic Dermatology.1
However, the researchers also found a moderate, positive and significant association between PRP treatment and improvement in melasma.
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Background and methods
There is a lot of PRP-related research in the field of melasma. Although it is relatively new, only a few years ago, its effects have already been investigated in several studies.
A 2021 review published in Dermatology and Therapy examined 10 studies on the use of PRP in the treatment and management of melasma. The review reported on the safety and efficacy of PRP in this indication.2
The present study, which aimed to compare PRP with and without additional photoactivation, included 38 patients with melasma, excluding those with systemic diseases, oral contraception or pregnancy. Participants were randomized to receive either photoactivated PRP or classical PRP treatments with 3 intradermal sessions every two weeks.
Results
Participants, evenly divided between the two treatment groups, had a mean age of 38 years, with melasma typically occurring at around 32.5 years of age, and average disease duration of 60 months. Most patients (94.7%) had centrofacial melasma, while a smaller proportion (5.3%) had the zygomatic type.
After treatment, both PRP and photoactivated PRP were associated with a significant reduction in melasma severity and an improvement in quality of life. Pretreatment assessments revealed a mean Melasma Area and Severity Index (MASI) score of 14.5, which decreased to a median of 9 after treatment.
Likewise, the Melasma Quality of Life Index (MELASQoL) score improved from an average of 36.5 to 17. These improvements were statistically significant for both treatments.
However, there were no significant differences between PRP and photoactivated PRP in terms of MASI and MELASQoL scores before or after treatment. This improvement in MASI scores was observed in different melasma types, without significant differences in treatment response depending on the type.
When comparing the degree of improvement, patients who received photoactivated PRP showed a higher tendency toward a 25 to 50 percent reduction in MASI scores than patients treated with PRP alone. However, this difference was not statistically significant.
In addition, the researchers observed a moderate, positive correlation between improvements in MASI scores and MELASQoL scores.
Conclusions
According to study authors Demir et al., this is the first study to investigate the effects of photoactivated PRP in melasma. Future studies are needed to better understand the relationship between PRP and photoactivation, if any. These studies could address the limitations of the present study, which include a limited sample size and a limited follow-up period.
“Although there was no statistically significant difference between the efficacy of P-PRP and C-PRP, the number of patients with a 25 to 50% decrease in MASI scores after treatment with P-PRP was 1.7 times higher than in the C-PRP group,” said Demir et al. “The application of P-PRP can be a novel and exciting area of research in the field of dermatology.”
References
- Demir FT, Altun E. Comparison of the efficacy of platelet-rich plasma with and without photoactivation in melasma: a randomized double-blind study. J Cosmet Dermatol. August 23, 2024. https://doi.org/10.1111/jocd.16540
- Zhao L, Hu M, Xiao Q, et al. Efficacy and safety of platelet-rich plasma in melasma: a systematic review and meta-analysis. Dermatol Ther (Heidelb). 2021; 11(5): 1587-1597. doi:10.1007/s13555-021-00575-z
