This article was originally posted in the Montreal Gazette.
A friend of mine recently told me that vampire facials are becoming big business. If you’ve never heard of it, a vampire facial is the process by which your own blood is spun down and injected into your face in order to make you look younger. Unsurprisingly, it’s not covered by medicare and you would have to pay for it out of pocket. But you probably shouldn’t. There’s little evidence it works.
Vampire facial is the colloquial term for a platelet-rich plasma (PRP) injection. Our blood is made of red blood cells to carry oxygen to our tissues, white blood cells to fight infections, platelets to clot the blood and a number of other proteins dissolved in water. The watery part minus the cells is referred to as plasma. Anyone offering PRP injections will draw your blood, spin it down in a centrifuge to separate out the cells from the plasma, then inject the plasma into your face. The rationale is that the growth factors and cytokines in the plasma will stimulate healing and rejuvenation in the skin.
The problem is that the evidence base is very thin. Most of the clinical research involving PRP has centred on musculoskeletal problems and the treatment of hair loss. There have been quite a few studies using PRP as a treatment for osteoarthritis, but a systematic review of the evidence demonstrated some key problems. At times, studies used very different protocols. Different groups spun the blood for different times, at different speeds. Some submitted the blood plasma to a second round of centrifugation and some added activators like calcium chloride. They used different doses at different intervals, and this lack of standardization makes it hard to assess if there is any true benefit to this therapy. That being said, in the RESTORE randomized trial published in JAMA, PRP injections in the joints did not improve pain for patients with mild to moderate osteoarthritis when compared with saline injections.
Another common refrain is that PRP can be used to speed up the healing of injured muscles. It is often used in sports-related injuries for that reason. But a moment of reflection will reveal a problem: Muscle injuries are very heterogeneous. They have different causes, occur at different locations and involve different tissues. A sprained ankle and a torn hamstring are not the same thing, and lumping them all together will invariably muddy the issue. Some analyses have suggested PRP shortened injured athletes’ return to play by five days, but long-term injuries remained the same. Contrast that with one of the larger randomized trials on the issue, the Dutch Hamstring Injection Therapy study, which showed no benefit to PRP when used in hamstring injuries. A Cochrane review of PRP as a treatment for tennis elbow showed no benefit either.
While the musculoskeletal studies have been less than overwhelming, other research groups have looked at PRP as a treatment for hair loss. Here, too, studies have faced problems with small samples, different protocols and limited benefits. One study, published in the Journal of the American Academy of Dermatology, is often referenced as showing a benefit. But while treatment with PRP increased hair growth by 19 hairs per square centimetre, so did the placebo treatment. Given the cheaper and well-studied alternatives, like minoxidil (Rogaine) and finasteride (Propecia), few physicians would advocate for PRP for most people.
There is limited evidence about PRP being used to treat wrinkles and rejuvenate your face. Unfortunately, because PRP is not classified as medication, the FDA doesn’t require the same level of evidence before allowing its clinical use. So it’s unlikely large trials will be done any time soon.
As for wrinkles, an ounce of prevention is worth a pound of cure. And since most wrinkles are caused by exposure to the sun’s UV rays, the answer is clear: The best beauty product is sunscreen.
