How do Platelet-rich Plasma (PRP) and microneedling work together for skin rejuvenation?

How PRP and Microneedling Work for Skin Rejuvenation

Microneedling creates controlled microtrauma through tiny needle punctures that trigger your body's wound healing cascade, while PRP delivers concentrated growth factors directly into these microchannels to amplify collagen production and tissue regeneration—together they work synergistically to produce superior results compared to either treatment alone. 1

Mechanism of Microneedling

Creating the Regenerative Response:

• Microneedling uses 12 microneedles penetrating 0.25-2.5mm depth to create controlled microtrauma in the skin 2
• This triggers neovascularization (new blood vessel formation) and rapid neocollagenesis (new collagen production) 1
• The process is based on minimally invasive percutaneous collagen induction—essentially tricking your skin into thinking it's injured so it repairs itself 1
• Histological studies demonstrate improvements in skin thickness and hydration with microneedling alone 1, 2

Technical Delivery:

• Automated electrically powered devices deliver a vibrating, stamp-like motion creating microchannels in three directions 1
• Penetration depth is adjustable between 0.25-2.5mm depending on treatment area 1, 2
• The resulting microchannels serve as delivery pathways for topical agents like PRP 1

Mechanism of PRP (Platelet-Rich Plasma)

Growth Factor Delivery:

• PRP contains supra-physiological quantities of platelets and autologous growth factors that stimulate tissue repair and skin rejuvenation 1
• Key growth factors include PDGF (platelet-derived growth factor) and TGF-β (transforming growth factor-beta) which regulate essential processes 1
• These growth factors specifically promote: angiogenesis, cell migration, cell proliferation, and collagen deposition 1

Cellular Effects:

• PRP stimulates cell proliferation and expression of type I collagen in human dermal fibroblasts 1
• It increases MMP-1 protein and mRNA expression, which helps remodel the extracellular matrix 1
• The regenerative properties promote collagen production, improve skin texture, and reduce fine lines and wrinkles 1

Synergistic Combination: Why Together is Better

Enhanced Delivery and Efficacy:

• Microneedling creates the microchannels, then PRP is applied topically or "pushed" into these channels to specific depths 1
• This combination is "simple and effective" offering clinical benefits via a safe treatment modality 1
• Studies show microneedling with PRP demonstrates better skin structural improvements than microneedling alone 1, 3
• The combination produces significantly higher patient satisfaction and better clinical outcomes than either treatment alone 2

Evidence of Superiority:

• Combined treatment shows significant improvement compared to microneedling alone in multiple randomized controlled trials 1, 3
• One study demonstrated organized collagen bundles with newly formed collagen and markedly decreased abnormal elastic fibers were better after combined treatment 3
• PRF (platelet-rich fibrin, a newer form) may be even superior to PRP, showing 3-fold higher therapeutic response when combined with microneedling 1, 2

Clinical Protocol

Treatment Schedule:

• Optimal protocol is 4-6 sessions spaced 3-4 weeks apart 2
• Maintenance treatments every 6-12 months 2
• Some protocols use sessions every 2 weeks for six total sessions 1, 3

Procedure Steps:

1. Apply topical anesthetic for minimum 30 minutes, then completely remove before starting 2
2. Perform microneedling first to create microchannels 1
3. Immediately apply PRP topically or via intradermal injection into the microchannels 1
4. The microchannels fill with PRP, delivering growth factors to specific depths 1

Safety and Advantages

Minimal Risk Profile:

• Minimal downtime of 24-48 hours, significantly shorter than lasers or deep peels 2
• Safe for all skin types including Fitzpatrick types III-VI where lasers cannot always be safely employed 2
• Very low risk of post-inflammatory hyperpigmentation or scarring since maximum penetration is only 2.5mm 2
• PRP augments cosmetic outcomes without increasing risk for adverse events 4

Post-Treatment Care:

• Avoid sunlight for 24 hours post-procedure 2
• Avoid heavily scented facial products for 24 hours 2
• Use gentle, non-drying cleansers and non-comedogenic products during healing 2

Important Clinical Considerations

Timing with Other Modalities:

• When combining with laser therapy, always perform laser treatment first, then apply PRP immediately after—never before, as many laser wavelengths are ablative and would damage the PRP 1
• PRP can be combined with hyaluronic acid fillers (50:50 mix) showing 20-24% improvement in FACE-Q scores versus PRP or HA alone 1

Patient Selection:

• Patient age and chronicity of skin damage may negatively correlate with degree of improvement 2
• The treatment works best for photoaging, fine lines, wrinkles, and skin texture issues 1