02 August 2018
L-R: Kim Kardashian, Bar Refaeli and Ferne McCann getting their Vampire Facials
Talking about something radical, controversial and…a little macabre all at the same time today- Vampire Facials!
If the word ‘vampire’ evokes fear like the titular villain from Brahm Stoker’s masterpiece, Dracula- the tragic and blood thirsty titular Count Dracula or perhaps the sense of romanticism like the ageless and impossibly beautiful Edward Cullen from the Twilight series; then you are in for a surprise- unlike its namesake, there is nothing gruesome about Vampire Facials.
Vampire Facials, of platelet-rich plasma (PRP) as it is more popularly known, have found fans in the likes of Kim Kardashian, Angelina Jolie, Iggy Azalea and Bar Refaeli for its purported rejuvenation and revitalisation benefits. Famous fans, gimmicky name and social media buzz aside, is there any bite to the promises of Vampire Facials?
You might remember Kim Kardashian looking like a bloody mess in an episode of Kourtney & Kim Take Miami, when blood withdrawn from her arm was spun (centrifuged) and then injected into her face. Shortly after that episode was released, Vampire Facials or Facelifts started to trend.
However, contrary to popular belief, PRP was first used as a medical treatment for patients with a blood disorder called thrombocytopenia in the 1970’s1. PRP is essentially a natural biological product processed from the patient’s own blood and is a solution that is enriched with plasma and proteins like growth factors and cytokines that initiate the body’s natural healing process2.
Besides being used in aesthetic dermatology, PRP has a long history of being used to treat a variety of conditions such as3:-
1) Orthopaedics- osteoarthritis, elbow tendonitis, Achilles tendonitis
2) Dermatology- alopecia (hair loss), chronic wounds, hair transplantation
3) Dentistry- bone grafting
Our blood compromises of red blood cells, white blood cells and platelets suspended in a fluid called plasma.
Platelets are very tiny cells that play a fundamental role in tissue repair and wound healing. Central to this regenerative role of platelets is the discovery of growth factors contained within platelets in pockets called α-granules. Growth factors are proteins that play a role in signalling cells to initiate the inflammatory cascade and healing process. Through these signalling processes, cells that produce collagen called fibroblasts are activated to synthesis collagen and elastin which is required for normal wound healing4,5.
In the presence of an injury, say a cut on your skin, platelets are activated to cause clotting to prevent life threatening blood loss. At the same time, these activated platelets also release their growth factors to kick start the skin’s natural healing process.
In PRP, blood collected from the patient is processed produce very high concentration of platelets. Before injecting this PRP mixture into the skin, the PRP is first activated by the addition of thrombin and calcium chloride to trigger the release of growth factors and other proteins from the platelets that initiate the body’s natural healing process.
As alluded to in my previous post on Rejuran Healer (here), the ideology behind using natural biological molecules represents a paradigm shift in the field of medicine. Where the conventional philosophy in medicine is to treat a problem, the concept behind PRP and stem cells is to heal and prevent the onset of a problem- hence the emerging fields of Regenerative Medicine and Anti-Aging Medicine. An analogy of this would be preventing the onset of hypertension so that you do not need medications to treat hypertension and the long-term consequences of high blood pressure.
The anti-aging and skin revitalisation properties of PRP work by harnessing the healing and regenerative property of the growth factors and proteins within the platelets. Hence, the PRP mixture needs to be activated to maximise this property.
How these growth factors work in the skin1,6,7,8
When injected into the skin and tissues, PRP accelerates skin and wound healing by the following mechanisms -
1. Involvement in different stages of wound healing process (such as chemotaxis, proliferation, differentiation, and angiogenesis) for tissue restoration 2. Collagen growth- by causing proliferation of fibroblasts cells which synthesise collagen. 3. Acts as the scaffold (fibrin framework) to support the regenerative matrix 4. Hyaluronic acid synthesis
Expected benefits in the skin after PRP treatment6,7
. Increased skin thickness due to collagen formation . Improved skin colour . Improved skin texture and firmness . Reduced wrinkles . Increased skin elasticity .Skin hydration (due to hyaluronic acid’s ability to attract and bind to water molecules) . Less sagging with improvement of the nasolabial folds
Step 1: Blood withdrawal
A small amount of blood (~20mls) is drawn from the vein of the patient
Step 2: Centrifugation
This blood is then spun to separate the platelet rich plasma from the other components of blood (red blood cells, white blood cells and platelet poor plasma)
Step 3: Activation
The platelets are activated to release their growth factors and proteins by the addition of calcium chloride
Do note that there is currently no standardised method of preparation with protocols varying across different clinics in terms of details of centrifugation and the resulting cellular composition and protein content
After the PRP mixture is prepared, the PRP can be administered to the face skin after application of numbing cream by 2 main ways
1. Microneedling- using a injector gun or via dermapen 2. Direct injection by hand into the skin and/or soft tissues
Rejuran Healer works on the same principle as PRP- using natural biological molecules to heal and repair skin damaged by aging.
A few major differences though:
1. PRP is obtained from the patient’s own blood (autologous) but Rejuran Healer is obtained from salmon DNA 2. PRP’s active ingredients are growth factors and other proteins (e.g. cytokines) released from platelets. Rejuran Healer’s active ingredients are polynucleotides from salmon DNA.
There is no study or trial that compares PRP to Rejuran Healer yet, however, when injecting biological material into your body; it seems much safer to have an autologous source compared to one from a different animal species altogether seems much safer. For PRP, there is the added advantage of no risk of immunological reactions, rejection or infections from your own blood9.
We do know that PRP is safe; with no risk of cross reactions PRP, immunological reactions or infections from an autologous source9.
As PRP has to be injected into the skin, there may be injection related reactions such as redness, swelling and bruising (just like Skinboosters and Rejuran Healer) which are temporary.
Unfortunately, PRP for dermatological purposes is banned in Singapore by the Ministry of Health. In Singapore, PRP is only permitted for the treatment of muscle, ligament and tendon injuries.
1. A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Alves, Grimalt. Skin Appendage Disord 2018;4:18–24
2. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Marx RE. Implant Dent. 2001;10:225 –228.
3. Platelet-rich plasma therapy - future or trend? Dhillon RS, Schwarz EM, Maloney MD. Arthritis Res Ther. 2012 Aug 8;14(4):219
4. Regulation of wound healing by growth factors and cytokines. Werner S, Grose R. Physiol Rev. 2003 Jul;83(3):835-70.
5. New insights into and novel applications for platelet-rich fibrin therapies. Anitua E1, Sánchez M, Nurden AT, Nurden P, Orive G, Andía I. Trends Biotechnol. 2006 May;24(5):227-34.
6. Applications of platelet-rich plasma in dermatology: A critical appraisal of the literature. Lynch MD, Bashir S. J Dermatolog Treat. 2016;27(3):285-9. doi: 10.3109/09546634.2015.1094178.
7. Platelet-rich plasma, the ultimate secret for youthful skin elixir and hair growth triggering. Elghblawi E. J Cosmet Dermatol. 2017 Sep
8. doi: 10.1111/jocd.12404. 8. Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. .El-Sharkawy H, Kantarci A, Deady J, Hasturk H, Liu H, Alshahat M, et al. J Periodontol. 2007;78:661–669.
9. Correlation of platelet concentration in platelet-rich plasma to the extraction method, age, sex, and platelet count of the donor. Weibrich G, Kleis WK, Kunz-Kostomanolakis M, Loos AH, Wagner W. Int J Oral Maxillofac Implants. 2001;16:693–699