INTRADERMAL INJECTION AUTOLOGOUS PLATELET RICH PLASMA VERSUS PLATELET RICH FIBRIN IN THE TREATMENT OF MELASMA AND STRIAE DISTENSAE
This thesis investigates the comparative efficacy of Platelet-Rich Plasma (PRP) and Platelet-Rich Fibrin (PRF) in treating melasma and striae distensae, two common dermatological conditions with significant impacts on patients’ quality of life. Conducted at Mae Fah Luang University Hospital, Bangkok, this randomized, controlled, split-face, and split-abdomen trial involved 20 Thai female participants, aged 30-65 years, with Fitzpatrick skin types III to VI. Each participant received PRP on one side of the face and abdomen, and PRF on the other, thus allowing a direct comparison within the same individual. The study employed a robust methodology, utilizing a range of diagnostic tools to ensure a comprehensive evaluation of the treatment effects. The Mexameter® was used to measure melanin and erythema indices, essential in assessing melasma’s severity. The Antera 3D® system provided detailed analysis of skin texture, pigmentation, and redness, pertinent for evaluating the treatment’s impact on striae distensae. The VISIA® Complexion Analysis System was used for high-resolution, standardized facial imaging, enabling an objective evaluation of skin health and the treatment’s cosmetic outcomes. Clinical improvement was assessed using the Modified Melasma Area and Severity Index (mMASI) for melasma and the Patient and Observer Scar Assessment Scale (POSAS) for striae distensae. The study’s findings were substantial. In melasma management, PRF-treated areas exhibited a significant reduction in the mMASI score over the 12-week period, decreasing from 7.52±0.78 at baseline to 6.80±0.71 at week 12 (p=0.002). This reduction was notably greater than that observed with PRP treatment, indicating PRF’s potential superiority in managing melasma. For striae distensae, both PRP and PRF treatments led to improvements across various skin parameters. The PRF-treated areas showed slightly better results, particularly in the reduction of color, pigmentation, and texture, with statistically significant differences observed by the third visit (p≤0.040). The Mexameter® measurements corroborated these findings, indicating a more substantial reduction in melanin levels in PRF-treated areas (p=0.050). Patient satisfaction was a crucial aspect of this study. The satisfaction surveys revealed high overall contentment with both treatments for melasma and striae distensae, with a slight preference for PRF, particularly in the treatment of melasma. This suggests that while both treatments were effective and well-received, patients tended to favor PRF for its perceived superior outcomes. Ethically conducted with strict adherence to informed consent and confidentiality norms, the study’s results have important implications for clinical practice. They suggest that both PRP and PRF are viable options for patients seeking non-invasive treatments for melasma and striae distensae, with a slight edge for PRF in certain aspects. The high patient satisfaction rates also indicate that these treatments are well-accepted, which is crucial for adherence to dermatological interventions. This research makes a significant contribution to the field of cosmetic dermatology, providing empirical evidence supporting the effectiveness of PRP and PRF treatments. It opens avenues for further research, particularly regarding the long-term effects of these treatments and their impact on patients’ psychological well-being. The study emphasizes the importance of patient-centered outcomes in dermatological research and the potential of PRP and PRF to meet patient needs in non-surgical skin rejuvenation.
Keywords: Melasma, Striae Distensae, Platelet-Rich Plasma, Platelet-Rich Fibrin, Dermatology, Non-Invasive Treatment, Patient Satisfaction, Clinical Improvement, Skin Rejuvenation.