PRP treatment for rosacea

What is rosacea?

Rosacea usually appears on the cheeks, nose, forehead or chin. Its presentation can differ considerably from one person to another. Today, the condition is assessed more by the features actually present than by a rigid staging system.

Possible manifestations include:

• temporary flushing and a sensation of warmth,
• persistent facial redness,
• visible superficial blood vessels,
• papules and pustules without the comedones typical of acne,
• burning, stinging, tightness or sensitive skin,
• thickened areas of skin or phymas,
• involvement of the eyes or eyelids.

Possible causes and personal triggers

The cause of rosacea is not fully understood. Several factors probably interact. These include inflammatory and neurovascular processes, genetic influences, changes in the skin barrier and an altered immune response.

Demodex mites are also being investigated as a possible contributing factor. However, they are not considered the sole cause of the condition.

Symptoms may be aggravated by factors such as:

• UV radiation, heat, cold or sudden temperature changes,
• spicy or very hot foods and drinks,
• alcohol, intense physical exertion or emotional stress,
• hot baths, steam or individually poorly tolerated cosmetic products.

Relevant triggers vary from person to person. A personal trigger diary can therefore be more useful than general lists of restrictions.

Diagnosis and established treatment approaches

Diagnosis is usually made clinically. There is no single laboratory value or specific test that can reliably confirm rosacea. It is important to distinguish it from other skin conditions such as acne, perioral dermatitis, contact dermatitis or lupus erythematosus.

Treatment is based on the symptoms present. The German S2k guideline identifies adapted skin care, consistent UV protection and avoidance of individual triggers as basic measures. Depending on the presentation, topical agents such as metronidazole, azelaic acid or ivermectin and other physician-selected procedures may be considered.

What is PRP?

PRP stands for platelet-rich plasma. It is obtained from the patient's own blood. Centrifugation separates the blood components and prepares a plasma fraction with an increased platelet concentration.

PRP is being studied in various medical specialties. Findings from one indication cannot automatically be transferred to another. Studies in orthopaedics, hair medicine or wound care therefore do not automatically prove efficacy in rosacea.

What has been studied regarding PRP and rosacea?

A clinical study published in 2021 included 40 people with rosacea. One side of each face was treated with PRP and the other with platelet-poor plasma. A total of six sessions took place over three months at two-week intervals.

According to the authors, the rosacea severity score improved more on the PRP-treated side than on the comparison side. Changes in certain inflammatory markers were also observed in tissue samples.

How robust are the findings?

The study is clinically interesting, but it is not sufficient to classify PRP as a generally effective treatment for rosacea. Important limitations include:

• the small number of 40 participants,
• comparison with platelet-poor plasma rather than an established rosacea treatment,
• a total of six invasive sessions within three months,
• the absence of robust statements on long-term effects in the abstract,
• the lack of confirmation by larger, independent and controlled studies.

Can PRP be recommended for rosacea?

Based on the limited data, PRP should not be presented as a proven or generally suitable treatment for rosacea. Its use can, at most, be considered as part of an individual medical decision.

Factors to consider include the specific presentation, inflammatory activity, comorbidities, medication, possible contraindications and previous treatments. In active or unexplained skin inflammation, specialist assessment is especially important before invasive procedures.

Technical context: professional PRP preparation

Regardless of the medical indication, PRP preparation requires a documented and reproducible workflow. This includes suitable blood collection tubes, an appropriate centrifuge and compliance with the respective manufacturer's instructions.

PRP tubes

Vi PRP-PRO

Sterile borosilicate-glass vacuum tube for professional PRP preparation. The product information specifies sodium citrate, a thixotropic separation gel and a standard protocol of 1,200 × g for seven minutes.

Blood draw volume

approximately 9 ml

Anticoagulant

0.8 ml sodium citrate

Reference value

approximately 4–4.5 ml PRP yield

Protocol

1,200 × g for 7 minutes

View Vi PRP-PRO

Medical-device centrifuge

Hettich EBA 200 MD

Compact centrifuge with an integrated eight-place fixed-angle rotor. The manufacturer specifies a maximum capacity of 8 × 10 ml, 6,000 rpm and 3,461 × g.

Rotor

8-place, fixed angle 33°

Maximum capacity

8 × 10 ml

Maximum RCF

3,461 × g

Maximum speed

6,000 rpm

View Hettich EBA 200 MD

Assessment for patients and practitioners

PRP is being studied in rosacea, but based on the sources presented it is not an established guideline treatment. The small study reports positive results, but does not allow reliable conclusions about overall success rates, optimal patient selection or the duration of any possible effect.

For patients, dermatological diagnosis, identification of personal triggers and symptom-oriented treatment in line with current medical standards remain the basis of care. PRP should not be presented as a substitute for this diagnostic and therapeutic approach.

Frequently asked questions about PRP and rosacea