What is the comparison between Platelet-rich plasma (PRP) microneedling and exosome therapy for facial skin rejuvenation?

From the Guidelines

PRP microneedling is currently the more established and cost-effective option for facial skin rejuvenation, offering reliable results for moderate concerns like fine lines and texture issues, although exosome therapy may be preferable for those with sensitive skin or targeting advanced aging concerns. Both PRP microneedling and exosome treatments are effective options for facial skin rejuvenation, but they work differently. PRP (platelet-rich plasma) microneedling uses your own blood platelets to stimulate collagen production when delivered via tiny needles that create controlled micro-injuries, as discussed in the context of regenerative medicine 1. Exosome therapy, on the other hand, is newer and typically more expensive, using cell-derived vesicles containing growth factors, proteins, and RNA that communicate with skin cells to promote repair without requiring blood drawing.

Key Considerations

• PRP microneedling is generally more cost-effective, with prices ranging from $300-700 per session 1.
• Exosome therapy may be preferable for those with sensitive skin who want to avoid the downtime of microneedling (1-3 days of redness with PRP versus minimal downtime with exosomes) or those specifically targeting advanced aging concerns.
• Both treatments require maintenance sessions every 6-12 months for sustained results.
• The ideal choice depends on your specific skin concerns, budget, and tolerance for downtime.

Evidence-Based Recommendations

• For PRP preparation, it is essential to standardize the methods for generating platelet-rich preparations and to follow evidence-based guidelines for future clinical trials, as emphasized by the Platelet Physiology Subcommittee of the ISTH 1.
• When considering exosome therapy, it is crucial to follow specific recommendations for exosome isolation and characterization, such as avoiding precipitation methods and confirming the presence of marker proteins typically enriched in exosomes 1.

Treatment Outcomes

• PRP microneedling offers reliable results for moderate concerns like fine lines and texture issues, with results developing over 2-3 months.
• Exosome therapy may offer benefits for those with sensitive skin or targeting advanced aging concerns, although more research is needed to fully understand its effects.

From the Research

Comparison of PRP Microneedling and Exosome Therapy

There are no direct comparisons between Platelet-rich plasma (PRP) microneedling and exosome therapy for facial skin rejuvenation in the provided studies. However, the following information can be gathered about PRP microneedling:

• PRP microneedling has been shown to be effective in facial rejuvenation, with studies demonstrating significant improvement in facial wrinkles and skin texture 2, 3.
• The use of PRP in combination with microneedling has been found to be more effective than microneedling alone 3.
• PRP contains concentrated levels of growth factors that help in rejuvenation by improving the migration and proliferation of keratinocytes, fibroblasts, and increased collagen synthesis 2.
• The efficacy and safety of PRP for facial rejuvenation have been reviewed, with most high-quality evidence suggesting subtle to modest clinical improvement 4, 5.
• Histologic evidence has shown that PRP can increase dermal collagen levels, resulting in improved skin rejuvenation 6.

Limitations and Future Studies

• There is a lack of standardized literature assessing the efficacy and best practice procedures for preparation of PRP for facial rejuvenation 5.
• Additional high-quality investigative work with clearly delineated methodologies is needed to better understand the role of PRP in facial rejuvenation 5.
• The available evidence is insufficient to suggest firm conclusions about the use of PRP, alone or in combination with other treatments, in promoting facial rejuvenation 4.

Key Findings

• Key findings from the studies include:
  • PRP microneedling is a safe and effective method for facial rejuvenation 2, 3.
  • The use of PRP in combination with microneedling can result in significant improvement in facial wrinkles and skin texture 3.
  • PRP can increase dermal collagen levels, resulting in improved skin rejuvenation 6.
  • Further studies are needed to evaluate the correct dose and number of sessions to get the best outcome 2.