Platelet-Rich Plasma Injections in Periorbital Hyperpigmentation in Skin Phototypes III and IV: Strengthening the Assessment of Treatment Outcomes

Abstract

BACKGROUND Periorbital hyperpigmentation (POH) is a therapeutic problem. Platelet-rich plasma (PRP) has been successfully used in some pigmentary disorders including POH. Proper evaluation of treatment in POH can be difficult. OBJECTIVE To assess the efficacy and safety of PRP injections for POH in skin phototypes III and IV by multiple clinical tools. METHODS A clinical trial included 30 patients with POH, skin phototypes III and IV. Three sessions of intradermal PRP injections were used in periorbital area every month. Treatment was assessed on different clinical levels 1 month after the last session by POH severity grading, blinded photographic assessment, and patient satisfaction. Adverse effects of PRP were evaluated. RESULTS A significant improvement in POH was documented by disease severity grading, patient satisfaction, and to a lesser extent by photographic evaluation. Grade II-POH showed the best improvement. More than half of the cases were satisfied and very satisfied. Lower disease grades, constitutional POH, and epidermal pigmentation showed significant improvement. Side effects were mostly tolerated. CONCLUSION The present results confirmed the beneficial role of PRP in improving POH. Multiple clinical tools are preferred for a more reliable assessment of treatment. Certain clinical types and grades of POH are suggested to respond more to PRP therapy.