What is the comparison between microneedling with GHK-cu (Gly-His-Lys-Copper) versus Platelet-Rich Plasma (PRP) for treating sagging skin?

Microneedling with GHK-Cu vs PRP for Sagging Skin

Microneedling with PRF (a form of PRP) appears more effective than microneedling with GHK-Cu for treating sagging skin, with studies showing superior outcomes in skin rejuvenation and elasticity improvement. 1

Mechanism of Action and Efficacy

Microneedling Base Treatment

• Microneedling stimulates the wound-healing cascade that induces rapid neocollagenesis and tissue repair, leading to improved skin texture and reduction in fine lines and wrinkles 2
• The procedure creates controlled micro-injuries that stimulate collagen types I, III, and VII production, enhancing dermal matrix remodeling 2, 3
• Multiple sessions (typically 3-6) at 2-4 week intervals are required for optimal results 2

PRP/PRF Enhancement

• When combined with microneedling, PRP/PRF shows statistically significant improvements in:

  • Skin firmness
  • Wrinkle reduction
  • Collagen bundle deposition and thickness
  • Overall facial appearance 1

• PRF (Platelet-Rich Fibrin) demonstrates superior outcomes compared to PRP:

  • One study showed 5x higher "excellent" reported outcomes with PRF injections vs PRP injections
  • 3x higher "excellent" reported scores with PRF microneedling vs PRP microneedling 1

GHK-Cu Comparison

• While GHK-Cu (Copper Peptide) is known for skin rejuvenation properties, the current evidence strongly favors PRP/PRF when combined with microneedling for sagging skin
• Comparative studies specifically examining microneedling with GHK-Cu versus PRP for sagging skin are limited, but the available evidence suggests PRF provides superior outcomes 1

Treatment Protocol

PRP/PRF Protocol

• Recommended approach: 3-4 sessions at 2-4 week intervals 1, 2
• Maintenance treatments every 6-12 months 2
• For optimal results:
  • Apply PRP/PRF prior to microneedling (not after) to allow the needling effect to push growth factors into the skin 1
  • Use small gauge needles (30G, 4mm length) with injections 5mm apart 1
  • Ensure proper preparation of PRP/PRF according to standardized protocols 1

Microneedling Technique

• Adjust microneedle depth between 0.25-2.5mm based on treatment area 2
• Ensure skin is well lubricated to avoid dry tugging sensation 2
• For sagging skin, focus on areas with more laxity with appropriate needle depth

Clinical Outcomes and Safety

Efficacy for Sagging Skin

• Studies show PRF combined with microneedling produces:

  • Significant improvement in skin elasticity
  • Increased dermal thickness
  • Enhanced collagen organization
  • Improved facial appearance measured by standardized scales 1

• One study demonstrated that PRF treatment resulted in:

  • 20-24% improvement in facial appearance at 3 months
  • 17% improvement maintained at 6 months
  • Significantly better skin elasticity compared to PRP alone 1

Safety Profile

• Both treatments are generally well-tolerated with minimal downtime (24-48 hours) 2
• Common side effects include transient erythema, mild swelling, and occasional bruising 4
• Rare complications include:
  • Post-inflammatory hyperpigmentation (more common in darker skin types)
  • Tram tracking (visible needle marks)
  • Allergic reactions 4

Important Considerations and Pitfalls

Key Considerations

• PRF has a shorter handling window (20-40 minutes before clotting) compared to PRP 1
• Results typically require multiple sessions and are not permanent
• Maintenance treatments are necessary every 6-12 months 2

Common Pitfalls to Avoid

• Applying PRP/PRF after microneedling rather than before (reduces efficacy) 1
• Using inappropriate needle depths for different facial regions
• Inadequate sun protection post-treatment (increases risk of hyperpigmentation) 2
• Treating patients with active skin infections or inflammatory conditions 2

Conclusion

For sagging skin treatment, microneedling combined with PRF appears to offer superior results compared to microneedling with GHK-Cu based on current evidence. The combination of microneedling with PRF provides significant improvements in skin elasticity, dermal thickness, and overall facial appearance, with effects lasting several months before maintenance is required.