Title : Efficacy and safety of platelet rich plasma therapy in melasma using microinjections and microneedling
Melasma is a cosmetically disfiguring acquired hyperpigmented skin disorder. Many treatment modalities are being used and many are under trials for the treatment. No single treatment option has been associated with improvement and complete cure of the disease. Frequent relapses and recurrences are common.
This study has evaluated the efficacy of Platelet Rich Plasma therapy (PRP) as an upcoming treatment modality both as an independent or as an adjuvant therapy for the treatment of recalcitrant hyper pigmentary disorder.
The objective of the study was to compare the therapeutic efficacy and safety of PRP microinjections versus PRP with microneedling in melasma.
This was a prospective, randomized, open label study with a sample size of 64. 32 patients in each treatment arms. Thirty-two patients were given microinjections of PRP in one arm, and in the other arm 32 patients underwent microneedling after topical application of PRP. The procedure was done after topical anesthesia application for 30 minutes. The session was repeated every month for a total of 3 sessions. The evaluation was done at the end of one month after the last session.
To assess the clinical response, clinical photographs were taken at the beginning of the therapy and then serially. MASI scoring, physician global assessment (PGA), and patient global assessment (PtGA) were performed at monthly intervals and any adverse events and complications were recorded.
Amongst the patients treated, there was 42.64% improvement in the MASI score in the microinjections group. In the micro needling group, the improvement seen was 63.18% at the end of third follow-up visit. No major adverse events were observed in both the treatment groups.
The study concluded has PRP can be a safer, economical and an efficient adjuvant in the treatment of melasma. The efficacy from our study was higher in the group with microneedling, probably because of the deeper penetration of the medication and delivery of plasma through the channels made with microneedling.