Objectives: The objective of this lecture is to show the effect of Platelet Rich Plasma (PRP ) in the treatment of Melasma.
Introduction: Melasma is a common acquired disorder of hyperpigmentation char. by light brown to gray patches seen in the face and caused by several factors like heredity,UV radiation, hormonal changes, etc..Principles of Melasma Rx are protection from sun exposure, inhibition of Tyrosinase activity and removal and disruption of melanin granules.Treatment of Melasma has always been a big challenge for both patients and dermatologists as it can be resistant to diff therapeutic approaches and high relapse rate.So there's need for other treatment options like PRP, an autologous plasma containing GF/cytokines.
Materials / method: PRP kits includes Test tube with anticoagulant
EMLA,Centrifuge,Syringes-10,5,1 mls,g 30 needles
Method:
Extraction of 8 ml blood from the patient and placed in an anti coagulated test tube and centrifuged(Regen lab) for 8 min at 3500 RPM,separating the platelets from the rest of the blood.Then 5 ml of PRP is pipetted from the test-tube and transferred to 5 1 ml syringes.The Prp is then ready for injections to target areas.
Results: Improvement is seen 3-4 weeks after first injection.Aside from attenuation of pigmentation,improvement of skin texture is seen.But it needs several treatments at 2-4 weeks interval for more dramatic results.
Of course, it is not a stand alone treatment.Other standard treatment options like bleaching agents, antioxidants,Vit C,Tranexamic acid,Intraceutical Oxygen facial were given either before, during or after PRP depending on the response of the patient.
Conclusion: PRP may serve as an adjunct or alternative treatment of long standing Melasma or to other skin conditions with currently no gold standard mode of therapy.
PRP is not a stand alone treatment.For optimal result, it may be combined with other treatment modalities like topicals (sunscreen, bleaching agents)micro needling,chemical peeling and lasers.
Effect of PRP on Melasma is probably secondary to the inhibition of Tyrosinase by Transforming Growth Factor-B1.
Further Studies are encouraged to substantiate the efficiency and safety of PRP.
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