PRP and PRF on the Face: What Is Known, Mechanism, Variability

Few topics spark as much curiosity in aesthetics as using the patient's own blood as a treatment. PRP (platelet-rich plasma) and PRF (platelet-rich fibrin) show up in courses, on social media, and in protocols for skin quality, under-eye circles, and hair. For the orofacial harmonization (HOF) professional, the useful question is less "does it work?" and more "what is known, what varies, and what can I tell the patient?". This guide answers at a review level. Indications, protocols, and permissions for use are the decision of the qualified professional, according to the rules of their professional council and the health authority.

What are PRP and PRF?

PRP is obtained from a sample of the patient's own blood, processed in a centrifuge to separate components and concentrate platelets in a small volume of plasma. Using an anticoagulant at the draw keeps the product liquid until the moment of injection. PRF follows a similar logic but without an anticoagulant: when centrifuged, a fibrin matrix forms that retains platelets and leukocytes, with slower release of the factors over time.

The main difference lies in consistency and in the time over which substances are released. In practical terms:

There are a great many brand names of kits and systems, and they are not cited here. What matters is that each method produces a different product.

What is the proposed mechanism?

Platelets contain granules with growth factors and other molecules involved in wound healing. The hypothesis behind aesthetic use is that, by concentrating these factors in the skin, they would stimulate fibroblasts, matrix production, and neocollagenesis, with a possible improvement in skin quality.

Points that help read the promise critically:

1. A plausible mechanism is not a proven result. Growth factors are involved in healing, but that does not guarantee a measurable, lasting, reproducible aesthetic effect.
2. The product is not standardized. Each preparation changes the platelet concentration, the presence of leukocytes, and the final volume.
3. The response is individual. Age, smoking, conditions, and medications can influence product quality and tissue response.
4. The expected effect is usually gradual and subtle, and not volumizing.

Where do the described uses on the face appear?

Practice describes uses on several fronts, with different levels of evidence:

• Skin quality: texture, glow, and overall appearance, by superficial intradermal injection, alone or combined with microneedling.
• Periorbital area: treating under-eye circles through skin-quality mechanisms, in protocols that vary widely. See periorbital anatomy for injectables.
• Scars, including acne scars: in combination with other techniques.
• Combination with fillers or biostimulators: to improve tissue response, in combined approaches.
• Scalp use: outside the scope of this text.

As for the level of evidence, it is worth following the logic of levels of evidence in HOF and how to read a clinical trial of injectables. In general, the literature on platelet concentrates in aesthetics has heterogeneous protocols, small samples, and variable outcomes, which calls for caution when promising results.

Why is variability the central problem?

Two clinics that say they "do PRP" may be offering very different products. The variables that change the result include:

Without standardization of these items, comparing results across studies and clinics is hard. For the office, this means the protocol must be written down, be consistent, and be recorded at every session, which is different from "doing it the way the course taught."

Who can offer it, and under what conditions?

Using the patient's blood involves venous draw, handling of a blood component, and disposal of biological material. Each activity has its own rules, and permissions vary by profession, type of facility, and health regulation. It is not for this text to say who may do what. The prudent path is:

1. Check what your council's rules allow regarding drawing and using blood components.
2. Verify the local health authority's requirements for the facility. See local health authority and health license for an HOF office.
3. Have a biosafety structure: a clean area, disposal of sharps and waste. See biosafety in HOF and sharps and waste disposal (PGRSS).
4. Have registered equipment and supplies, including the centrifuge and tubes.
5. Train the team in drawing, identification, and traceability.

Which contraindications and precautions to consider?

The medical history is the foundation. In general terms, some scenarios call for caution or contraindicate the procedure:

• Coagulation disorders and significant thrombocytopenia.
• Use of anticoagulants or antiplatelets, without assessment by the responsible physician.
• Active local or systemic infection.
• Blood disorders and some active autoimmune diseases.
• Pregnancy and breastfeeding, according to the professional's guidance.
• Difficult venous access or intolerance of needle procedures.
• Expectation of a volumizing result, which the product does not provide.

See also coagulation disorders in HOF and anticoagulants and injectable procedures.

How to talk to the patient without overselling?

Realistic expectation is the biggest factor in satisfaction. Avoid terms like "total rejuvenation" and "vampire," which feed hope for a dramatic result. Prefer to talk about treating skin quality, a gradual effect, and a variable response.

How is the treatment usually organized over time?

The cadence depends on the protocol. A sketch of the reasoning, with no fixed timelines:

What should be recorded?

In the patient record, record the preparation protocol (volume drawn, centrifugation, type of product), the area, the injection technique, the lot of tubes and supplies, the identification of the material, complications, and photos. The informed consent must explain that the product comes from the patient, that the evidence is limited and variable, that there are risks from the draw and the injection, and that the result is not guaranteed.

The main point

PRP and PRF are autologous resources with a plausible mechanism, a heterogeneous literature, and poorly standardized protocols. They serve as a complement for skin quality, provided the professional is permitted to perform the procedure, has adequate facilities, a written protocol, and an honest conversation with the patient. Promising rejuvenation is the shortest path to frustration.