The Potential Role of Platelet - rich Plasma in the Treatment of Melasma

Objective: To evaluate the response of patients with melasma to intradermal injection of platelet-rich plasma. Background: Melasma is a frequently acquired disorder of hyperpigmentation, that is characterized by asymptomatic light to dark brown patches on face involving the forehead, cheeks, chin and upper lip. Inspite of several treatments for melasma such as topical agents, chemical based peeling, laser and light sourcestherapies, the treatment results are variable success with complications such as irritation, post-inflammatory hyperpigmentation or hypopigmentation. Nonetheless, platelet-rich plasma (PRP) is gettig attention in aesthetic medicinebecause of its autologous nature and mild side effects compare to other melasma treatments. Methods: the present study included 30 patients with melasma having Fitzpatrick skin type III and IV. The duration of study extended from February to November 2019.The therapeutic course consisted of 5 sessions of Platelet-rich plasma(PRP) injections with an interval of 2 weeks apart. PRP was prepared by using a double-spin method and then activated with calcium chloride. Final evaluation was analysed by percent of reduction in baseline of mMASI score. Its consider mild response when reduction of baseline mMASI was between 0-25%; 25-50% reduction consider fair response; 50- 75% reduction consider good response; >75% consider excellent response. The treatment trial was considered effective if there was reduction in mMASI score from the baseline is greater than 50%. Results: Of 30 enrolled patients, 5(16.7%) patients showed good response, 19(63.3%) patients showed fair response, and 6(20%) patients showed poor response. None of patients showed excellent response. The overall efficacy of treatment was 16.7%. Conclusion: PRP appear a promising adjuvant therapy for recalcitrant cases of melasma.