What is platelet-rich plasma?

Platelet-rich plasma, or PRP, is prepared from the patient’s own blood. After collection, blood components are separated by centrifugation. The resulting plasma fraction contains a higher platelet concentration than the starting blood. Once activated, platelets can release growth factors, cytokines and other signalling molecules involved in tissue repair, cellular communication, angiogenesis and extracellular-matrix formation.

This biological rationale does not prove clinical efficacy for every dermatologic indication. Diagnosis, baseline condition, PRP composition, preparation and delivery method all influence the outcome.

Why study results and clinical outcomes differ

The term PRP covers very different preparations. Platelet concentration, leukocyte content, residual red blood cells, plasma volume, activation, centrifugation and delivery technique may all vary.

Clinical protocols are equally heterogeneous. The number and interval of sessions, injection depth, treated area, combinations with microneedling or laser and the outcome measures are often not comparable. A positive individual study therefore cannot define a universal PRP protocol.

PRP for androgenetic alopecia

Hereditary pattern hair loss in women and men currently has the broadest dermatologic evidence base. A large 2025 systematic review rated the overall evidence as moderate. The included studies mainly reported improvements in hair density, clinically perceived hair loss and patient satisfaction. Results for hair thickness and other follicular parameters were less consistent.^[1]

A 2026 meta-analysis directly compared PRP with topical minoxidil. It found no clear overall superiority of PRP for key outcomes such as hair density and terminal-hair count. Patient satisfaction and the hair-pull test sometimes favoured PRP, but heterogeneity was substantial.^[2]

PRP may be an adjunct or alternative in appropriately selected patients, but it is not a blanket replacement for established therapies. The type of hair loss must be diagnosed first.

PRP for acne scars — distinct from active acne

For atrophic acne scars, PRP is usually used as an adjunct to microneedling, fractional laser treatment or subcision. A 2024 overview of systematic reviews concluded that confidence in the available evidence was low to very low. Many studies were small and used different scar scales and protocols.^[3]

A 2025 network meta-analysis ranked laser combined with PRP relatively favourably for reducing scar severity. Such rankings are informative, but they do not replace robust standardized treatment recommendations.^[4]

Active inflammatory acne is a different condition. Claims that PRP removes bacteria, sebum or “toxins” and prevents new lesions are not supported by reliable clinical evidence. Current acne guidelines recommend established topical and systemic treatments; PRP is not a standard therapy for active acne.^[9]

Skin regeneration and signs of ageing

In aesthetic dermatology, PRP is studied for skin texture, fine lines, elasticity and perceived skin quality. It may be used alone or alongside microneedling and fractional procedures.

A 2025 systematic review found signals of improvement in wrinkles and skin texture. Interpretation remains limited by small samples, different preparation methods, variable intervals and inconsistent measurement tools.^[5]

Moderate changes in skin quality may be realistic for some patients. Claims that PRP “removes wrinkles”, “eliminates dark circles” or “erases pigmentation” are not scientifically justified.

PRP in chronic wound care

PRP has also been investigated as an adjunct in chronic wound care, with the strongest evidence involving diabetic foot ulcers. A 2025 meta-analysis of randomized trials reported a higher complete-healing rate and shorter healing time compared with conventional care.^[6]

These results cannot be generalized to every wound. Chronic wounds require assessment of perfusion, pressure, infection, neuropathy and metabolic control. PRP does not replace debridement, infection management, off-loading or treatment of the underlying disease.

Melasma, vitiligo and stretch marks

Melasma

Small studies have evaluated PRP alone or combined with microneedling and other approaches. Systematic analyses suggest possible effects but do not demonstrate stable overall superiority. PRP should therefore be described as an investigated adjunct rather than an established standard treatment.^[7]

Vitiligo

Some studies report favourable outcomes, particularly with fractional laser procedures. Sample sizes are often small and body sites and repigmentation measures differ.

Stretch marks

Clinical and histologic changes have been reported in striae distensae. The 2024 evidence overview shows a diverse treatment landscape without a reliably superior method. Complete removal should not be promised.^[8]

Risks, contraindications and hygiene

Because PRP is autologous, immune reactions to foreign blood components are less likely. Common local effects include pain, redness, swelling, tenderness, bruising and short-term bleeding. Rare but relevant complications include infection, vascular or nerve injury and harm from unsuitable delivery techniques.

Additional care is required in coagulation disorders, thrombocytopenia, anticoagulant therapy, acute infection, certain haematologic diseases and poorly controlled systemic disease.

A CDC investigation documented likely HIV transmission after PRP microneedling at an unlicensed facility with serious infection-control failures. The issue was not autologous plasma itself but unsafe handling of blood, needles and reusable equipment.^[10]

Practical interpretation of the evidence

The quality of a PRP programme also depends on a defined preparation system, appropriate centrifugation parameters, sterile technique and a documented SOP.