Marc Darrow, MD, JD

If you have Melasma, you know what it is, it is patchy brown skin discoloration that appears on your face. It is a hyperpigmentation or as it is called in the research below “Melasma is a cosmetically disfiguring disorder of facial pigmentation.” In this article, we will discuss the use of Platelet Rich Plasma therapy for the treatment of melasma.

Melasma Patches

User:Elord from Wikidocs, CC BY-SA 3.0, via Wikimedia Commons

In September 2019, researchers published these findings in the Journal of cosmetic and laser therapy (1) on the use of Platelet Rich Plasma injections for patients with Melasma, “Platelet-rich plasma (PRP) is autologous plasma containing higher than normal platelets concentrations. Recently, PRP has been used as a therapeutic modality in melasma with significant clinical improvement, possibly due to its abundant contents of growth factors such as TGF-β” (Transforming growth factor beta – a protein chemical signaler that is part of the immune repair response. TGF-β can help reduce skin hyperpigmentation.)

In this study the researchers “hypothesize that ‘injection of PRP in the lesional skin of melasma patients is associated with alterations of TGF-β protein expression.”

The study included 20 adult patients with melasma.

Autologous PRP was delivered into the lesional skin either through microneedling or as intradermal microinjections.

TGF-β protein expression was examined  before and after PRP treatment and in the healthy skins of nine volunteers (control group).

Results: TGF-β protein was expressed within the epidermis, dermal adnexal structures, vascular endothelium, nerves and arrector pili muscle fibers of the healthy skins (control group), perilesional and lesional skins of melasma patients before and after treatment with PRP.

Before treatment with PRP, the expression of TGF-β protein in the lesional and perilesional skins of melasma patients were significantly lower than that in the healthy skins. After treatment with PRP, the expression of TGF-β protein was significantly increased in the lesional skin of melasma patients.

Conclusions: “(This) study provides the first indication about increased TGF-β protein expression in skin of melasma patients after PRP treatment. The alterations of TGF-β protein in skin of melasma patients not only support its roles in the development of this condition but also have some therapeutic ramifications.”

A September 2019 study in the Journal of cosmetic dermatology (2) suggested that while “Melasma treatments have varying success and are associated with some complication,” PRP treatments may offer another option. According to the researchers this is the first randomized, placebo-controlled trial study using PRP for treatment of melasma.

Their results suggested: “PRP injection significantly improved melasma within 6 weeks of treatment in terms of mMASI (Modified Melasma Area and Severity Index) scores, patient satisfaction, and Antera® (3D camera) -assessed melanin levels. Hence, intradermal PRP injection could be used as an alternative or adjuvant therapy for melasma. However, additional trials are needed for more rigorous evaluation of its long-term efficacy and safety.”

In June 2019 a study in the The Journal of dermatological treatment (3)  evaluated the value of platelet-rich plasma (PRP) in the treatment of melasma using two different delivery techniques: microneedling using dermapen versus microinjections using mesoneedles.

• Autologous PRP was delivered into the lesional melasma skins through microneedling with dermapen on the right side of the face and intradermal microinjections using mesoneedles on the left side of the face (for each patient).
• The treatment was done regularly (three sessions, each month).
• The response to PRP therapy was measured using melasma area and severity index (MASI) and modified melasma area and severity index (mMASI) that were calculated before and after three treatment sessions.

Results: “Following PRP treatment, MASI and mMASI scores decreased significantly (showed significant improvement). A statistically significant decrease was noted in the hemi-MASI score on each side of the face following PRP treatment but there was no significant difference in comparing both sides.”

Conclusions: “(This) study provides the first indication about the value of PRP as a useful and new therapeutic option in melasma. Moreover, our study was the first to compare PRP delivery through microneedling versus microinjections.”

Treatments

Regardless of skin color, hyperpigmentation (uneven skin tone) can be tricky to treat.  It occurs when the production of melanin is excessive and causes dark spots on the skin. Common names for hyperpigmentation are sun spots, age spots, melasma, pregnancy mask and even freckles.  In our office, we use a corrective peel followed by prescribed home care.  With diligent management, hyperpigmentation can be calmed down and the results can be a smoother, more even skin tone.

Common causes of skin hyperpigmentation include:

• Sun exposure
• Hormonal changes
• Heredity
• Acne
• Botched skin treatments

Typically, hyperpigmentation is a harmless skin condition, however if moles or other possible signs of skin cancer appear, they should be checked by a dermatologist.

• Chemical peel – Chemical peels may offer diminished appearance of discoloration along with smoother texture and decreased pore size after one treatment (this is not typical for all).  Brighter, more clarified skin tone is also possible. For optimal results, a series of 4-6 treatments every 4 weeks is recommended.
• Home Care:
  • Pigment Corrector: retinol product-stimulates cell turnover
  • Sunscreen:  preferable SPF 50–Protect yourself from the sun!
  • Vitamin C:  topical anti-oxidant which protects your skin from UV light.  Our bodies do not make vitamin C and guess what, topical C is better absorbed than orally supplemented (for the skin)

Do you have questions? Ask Dr. Darrow

A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025

PHONE: (800) 300-9300 or 310-231-7000

Stem cell and PRP injections for musculoskeletal conditions are not FDA approved. We do not treat disease. We do not offer IV treatments. There are no guarantees that this treatment will help you. Prior to our treatment, seek advice from your medical physician. Neither Dr. Darrow, nor any associate, offer medical advice from this transmission. This information is offered for educational purposes only. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate. We do not guarantee the accuracy, completeness, usefulness or adequacy of any resource, information, product, or process available from this transmission. We cannot be responsible for the receipt of your email since spam filters and servers often block their receipt. If you have a medical issue, please call our office. If you have a medical emergency, please call 911.

References

1 Hofny ER, Hussein MR, Ghazally A, Ahmed AM, Abdel-Motaleb AA. Increased expression of TGF-β protein in the lesional skins of melasma patients following treatment with platelet-rich plasma. Journal of Cosmetic and Laser Therapy. 2019 Sep 26:1-8.
2 Sirithanabadeekul P, Dannarongchai A, Suwanchinda A. Platelet‐rich plasma treatment for melasma: A pilot study. Journal of Cosmetic Dermatology. 2019 Sep 30.
3 Hofny ER, Abdel-Motaleb AA, Ghazally A, Ahmed AM, Hussein MR. Platelet-rich plasma is a useful therapeutic option in melasma. Journal of Dermatological Treatment. 2019 May 19;30(4):396-401.