PRF TREATMENT

PRF is considered the second generation of platelet concentrations—the first being platelet-rich plasma, or PRP. 

“PRP and PRF are regenerative, platelet-based treatments,” says Dr. Greenberg. “They are both harvested the same way, but treated differently afterwards.” 

First, a provider will draw your own blood from your arm. Then it will be processed in a centrifuge.

• For PRP, the blood is spun quickly in the centrifuge, along with a coagulant used to isolate the platelet-rich plasma.
• For PRF, the blood is spun more slowly, to isolate the fibrin. “The platelets become more of a gel than a serum,” says Dr. Greenberg. 

Typically, PRF is processed without any additives like anticoagulants (which some say have the potential to impair wound healing). It forms a fibrin matrix that helps confine the release of growth factors, white blood cells, and other nutrients to the treatment site, while stimulating new collagen production.  

In terms of results, PRF seems to outperform PRP. A 2023 study comparing PRF to PRP found that PRF—used both alone and alongside microneedling—led to a more significant improvement in acne scars than PRP, potentially due to the high number of growth factors. Another paper found that the results of PRF were comparable to PRP when injected into skin, but PRF results lasted a few months longer.

Pros

• PRF treatments have skin rejuvenation, hair restoration, and tissue healing benefits.
• Topical PRF has been shown to enhance the results of other cosmetic procedures and speed recovery, making it a popular add-on to laser and microneedling treatments.
• Because PRF is derived from your own blood, allergic reactions are highly unlikely.
• It’s suitable for all skin types and tones.
• There's little to no downtime associated with PRF. Side effects like soreness and bruising (if your treatment involves injections) are typically mild.

Cons

• Results are temporary, so if you want to maintain your results, you'll need to have additional treatments.
• When injected, PRF can cause inflammation and discomfort at the injection site.
• There isn’t one standardized protocol for how long or at what speed to process the blood in the centrifuge, nor is there agreement on which PRF equipment is best. Because of this, results can vary by provider and their preparation protocol.
• There aren’t yet many large-scale studies to back up the purported benefits of PRF for skin rejuvenation.

PRP treatments can cost anywhere from $300 to $2,500 per session. 

The price you pay will depend on:

• Your provider’s credentials and reputation
• Their practice location
• How many treatment sessions you have
• How the PRF is administered and whether it’s paired with other cosmetic procedures. For example, a combo of topical PRF and microneedling is less expensive than pairing injections with nanofat transfer, which must also be harvested (via liposuction) and processed.

Start with a consultation to align on your treatment plan. Then ask for a detailed cost quote that includes all related fees.

Standards and protocols for how best to prepare PRF for skin and hair rejuvenation are still being developed, but the process typically looks something like this, according to Dr. Greenberg:

• A PRF treatment begins with a blood draw from your arm, usually two vials.  
• The vial of blood is placed in a centrifuge, where it’s slowly spun for between three and 10 minutes, depending on the provider’s approach.
• While the blood is being processed, you’ll be given a numbing cream to help make your treatment more comfortable.
• The centrifuge will separate your blood into three components: platelet-poor plasma at the top of the vial (which gets discarded), red blood cells at the bottom of the tube (also discarded), and, in the middle, platelet-rich fibrin.
• Once the PRF is collected and processed, your provider will inject it into the desired treatment area or apply it topically, following a cosmetic procedure like microneedling.

Because there’s so much variability in how PRF treatments are being performed, it’s wise to have a detailed consultation prior to your session, so your provider can talk you through the details of their protocol.

For the face, Dr. Greenberg recommends a series of three treatments, spaced six to eight weeks apart for optimal results. After that, your provider may recommend one to two treatments a year to maintain your results.

For hair loss, expect to need about four monthly sessions, followed by two or three maintenance treatments annually. 

Your provider may suggest a different treatment plan, depending on your concerns, goals, and budget.

Studies on the effectiveness of PRF for hair loss and skin rejuvenation are scant, but the scientific evidence so far is promising:

• A 2023 paper in Dermatologic Therapy compared the results of PRP and PRF injected into certain areas of the face, including the canthal region (crow’s feet). PRF led to better results—in terms of smoothness and wrinkle reduction—in the eye area, with the difference being even more significant after three months. There were no differences in terms of side effects, pain, and patient satisfaction.
• In one small study published in Dermatology Practical & Conceptual, 15 participants saw an improvement in both deep wrinkles and more shallow lines, as well as hyperpigmentation, after a single PRF injection.

In one small study published in 2023, PRF under eye treatment results were still visible 3 months later. Improvements included a reduction in wrinkles and hyperpigmentation, along with a “refreshed appearance.” 

PRF results last longer when paired with other procedures. For instance, one study found that PRF treatments paired with nanofat transfer lasted at least one full year. According to the authors, “improvements were sustained for more than 12 months in the test group compared with 1 month in the control group.”

So far, PRP seems to be very safe, says Dr. Greenberg. The most common PRF side effects are minor bruising, swelling, and redness at the injection site. The under-eye area can be especially prone to swelling, which may linger for up to five days.

As with any injection, you may have some inflammation and soreness, but it should subside within a few hours.

Atsu, Nilhan, et al. “The Comparison of Platelet-Rich Plasma versus Injectable Platelet Rich Fibrin in Facial Skin Rejuvenation.” Dermatologic Therapy, Hindawi, 15 Apr. 2023.

Dashore, Shuken, et al. “Platelet-Rich Fibrin, Preparation and Use in Dermatology.” Indian Dermatology Online Journal, U.S. National Library of Medicine, 25 Nov. 2021.

Diab, Nagwa Ali Fahmy, et al. “Fluid Platelet-Rich Fibrin (PRF) versus Platelet-Rich Plasma (PRP) in the Treatment of Atrophic Acne Scars: A Comparative Study.” Archives of Dermatological Research, U.S. National Library of Medicine, July 2023.

Grecu, Alexandru Florian, et al. “Platelet-Rich Fibrin and Its Emerging Therapeutic Benefits for Musculoskeletal Injury Treatment.” Medicina (Kaunas, Lithuania), U.S. National Library of Medicine, 15 May 2019.

Hassan, Haidar, et al. “Injectable Platelet‐rich Fibrin for Facial ... - Wiley Online Library.” Wiley Online Library, 27 Aug. 2020.

Liang, Zhi-Jie, et al. “Precise Intradermal Injection of Nanofat-Derived Stromal Cells Combined with Platelet-Rich Fibrin Improves the Efficacy of Facial Skin Rejuvenation.” Karger Publishers, S. Karger AG, 11 May 2018.

Mahmoodabadi, Razieh Ahmadi, et al. “Evaluation of the Effect of Platelet-Rich Fibrin Matrix in the Correction of Periorbital Wrinkles: An Experimental Clinical Trial.” Dermatology Practical & Conceptual, U.S. National Library of Medicine, 1 Jan. 2023.

Wu, Qing-Yun, et al. “Clinical Application of Platelet-Rich Fibrin in Dermatology.” International Journal of Dermatology and Venereology, Sept. 2022.