PRF injections are poised to become the next cosmetic tweakment craze, but are you better off sticking to tried-and-true injectables?
Cast your minds back to the viral vampire facial. The PRP facial, or platelet-rich plasma facial, was everywhere for a moment in time, thanks in part to Kim Kardashian’s blood-soaked selfie. Now, PRP’s younger sibling, PRF—or platelet-rich fibrin—is coming for its Twilight-worthy crown.
Injections made from a person's own blood—quite the visual!—called PRF are now being promoted as a way to regenerate skin and restore that youthful glow and bounce. But is this treatment all it’s cracked up to be—a ‘natural’ alternative to filler?
Ahead, the pros discuss this emerging treatment, and what the uptick in interest says about our relationship with injectables—and our growing ‘filler fatigue.’
- Doris Day, MD, is a board-certified dermatologist in New York City
- Ava Shamban, MD, is a board-certified dermatologist in Beverly Hills and Santa Monica
The OG, PRP (how’s that for a lot of acronyms?) has been around for a while. The technique is about 40 years old, though it became more popular in the last decade or so, and there’s some evidence to suggest it’s helpful in treating dark under-eye circles and crow’s feet, according to a study published in the journal Acta Bio-medica.
Erase them or embrace them.
In both the PRP and newer PRF treatments, a patient’s blood is drawn and separated in what is called a centrifuge—and that separation process is a key differentiator between the two. In a PRP treatment, it’s “spun at a higher speed” to achieve platelet-rich plasma, says Doris Day, MD, a board-certified dermatologist in New York City.
In a PRF treatment, it’s spun more slowly, “so some white blood cells, stem cells, and fibrin also stay in the platelet layer. But the reality is, some of those white blood cells can be inflammatory.”
Medi spas might promise that a PRF session—via injection or microneedling—will leave you with more radiant, more elastic, younger-looking skin. They might say it’s a more natural, more organic, or (perhaps especially baffling) more sustainable alternative to filler. They might even say it’ll give you a filler-like result.
Rollin', rollin', rollin'…
But the data supporting these claims just isn’t there yet. Though it’s worth noting, one small 2023 study—on 30 patients—published in the journal Archives of Dermatological Research, suggests PRF might be beneficial in treating acne scars and in improving skin texture and laxity, which, the study states, may be due to growth factors in PRF.
Dr. Day is skeptical: “I haven't seen great published data on [the benefits of PRF for skin,],” she says. “I don’t [offer PRF] for the skin, because I've been following [its use] in Europe for decades and I haven't seen much benefit. I’ve seen people unhappy with the results, and even people who have scarring from it. I really talk people out of it.”
And you might not want PRF for plumping up your nasal labial folds: “PRF is being sold as filler, but I don't think it works like filler,” says Dr. Day.
So why are more people interested in PRF? There’s a newness factor, for sure. There’s a comfort factor (whether or not it’s warranted), in something that’s derived from your own body.
And then there’s this: More “patients are looking for alternatives to filler,” says Ava Shamban, MD, a board-certified dermatologist in Beverly Hills and Santa Monica, who offers PRF treatments in her own practice. We’re living in a time of “filler fatigue”—fueled by patients who “experience sagging, heaviness, or stretched-out tissues from overfilling and improper techniques [like poor] product placement,” says Dr. Shamban.
But despite all the talk of filler fatigue, we’re also getting more injectables—fillers were up 4% in 2023, as compared to 2022, according to the American Society of Plastic Surgeons’ survey and trend report. We want to look young. But we don’t want to look filled. That makes “a more 'natural' product for skin revitalisation and rejuvenation” a tempting proposition, says Dr. Shamban.
She is more optimistic about PRF’s potential, but agrees with Dr. Day that it’s not a substitute for hyaluronic acid filler, because it doesn’t have the same strength or volumising abilities, and it breaks down faster. However, she sees a world in which it’s possible PRF could be combined with filler. It could be a helpful tool for specific patients—“as providers, we have a vast array of products, but it is about 25% the products chosen and 75% techniques and injection style that make a difference,” says Dr. Shamban.
What does the FDA have to say about using a patient’s blood to potentially regenerate their skin? According to Dr. Shamban, the FDA views PRP and PRF similarly to a tissue transfer. “They’re worried about contamination, like if [the blood] is improperly processed,” she explains, adding that the popularity of PRF and PRP treatments at medi spas versus board-certified dermatologists means there could potentially be a mix-up of patient samples.
For reference, a New Mexico spa came under fire after three people were infected with HIV after receiving PRP facials. The FDA has issued a warning letter against regenerative medicine products that include stem cells.
In the letter, the FDA cautions, “There is a lot of misleading information on the internet about these products, including statements about the conditions they can be used to treat. FDA is concerned that many patients seeking cures and remedies may be misled by information about products that are illegally marketed, have not been shown to be safe or effective, and, in some cases, may have significant safety issues that put patients at risk.”
We reached out to the FDA to ask if PRF injections would be included in this warning, and at press time, had not received confirmation
A version of this article originally appeared on Allure.
