top of page
Writer's pictureDr. Naheed Ali, MD, PhD

Learn All About PRP Under-Eyes Treatment

Updated: Jul 8

Investigating the efficacy of platelet-rich plasma (PRP) therapy as a novel approach in aesthetic medicine for addressing under-eye concerns is gaining interest among patients facing issues such as puffiness, dark circles, and wrinkles. Traditional methods often provide limited and temporary solutions, and while surgical options may offer more definitive results, they are associated with risks and significant recovery periods.


This article focuses on the PRP under eye treatment, a utilization of PRP therapy, which leverages the body’s innate healing mechanisms, as a potential treatment for enhancing the under-eye area. We will explore how PRP therapy, by concentrating and utilizing the patient’s own platelets, may offer a natural and personalized approach to improving under-eye aesthetics. 


Common Cosmetic Challenges


The under-eye region is a delicate area which plays a pivotal role in conveying facial expressions and emotions, yet it is particularly susceptible to a range of cosmetic challenges that can significantly affect one’s appearance. Among these issues, puffiness under the eyes is notable, often giving a swollen look due to factors such as fluid retention, allergies, or inadequate sleep. This condition can vary from day to day, presenting as a transient concern for many individuals, particularly those with thin skin. Another prevalent issue is the appearance of dark circles, which manifest as shadowy discolorations under the eyes (hollow eyes), creating the impression of fatigue or aging.


PRP under Eyes

Crow's feet, the expression lines that emerge at the outer corners of the eyes, become more pronounced with age and are often associated with repetitive facial movements such as smiling or squinting. Bags under the eyes, characterized by drooping, loose skin, and sometimes fat bulges, differ from mere puffiness by being more permanent and typically require targeted interventions to mitigate their visibility and restore a smoother under-eye appearance. [1] [2]


Most Common Causes Of These Issues


The etiology of under-eye challenges is complex, influenced by a combination of intrinsic and extrinsic factors, each playing a pivotal role in the manifestation of these cosmetic concerns.

PRP under Eyes

Aging is a primary intrinsic factor, where the natural reduction in both new collagen production and skin elasticity leads to wrinkles, sagging, and changes in skin texture and thickness. The skin naturally becomes thinner and more translucent with age, further enhancing the appearance of dark circles by making the subcutaneous blood vessels more visible. Genetics also significantly affects the propensity to develop under-eye issues like dark circles or puffiness, with very high concentrations of certain conditions being hereditary and manifesting due to familial predisposition.


Extrinsic factors, such as lifestyle choices, also play a crucial role. Sleep patterns, diet, and stress levels directly influence skin health, with inadequate rest and high stress contributing to the emergence of under-eye bags and dark circles. Poor nutrition can further accelerate signs of aging, leading to a more tired appearance. Additionally, prolonged sun exposure poses a significant risk to skin integrity, as ultraviolet (UV) radiation breaks down essential skin components, precipitating premature aging and changes in skin texture and color.


Fluid retention, influenced by dietary choices, hormonal changes, and sleeping positions, can lead to puffiness and swelling under the eyes. The adverse effects of smoking on the skin are well documented, with the habit known to expedite the aging process, encourage wrinkle formation, and reduce skin elasticity, significantly affecting the under-eye area.


Repeated facial expressions also contribute to the development of expression lines. Actions such as smiling or squinting create lines that may become permanent over time, particularly in areas where the skin is naturally thinner. [3] [4] [5]


What is Platelet-Rich Plasma Therapy?


Platelet-rich plasma therapy is an advanced medical procedure that utilizes the healing components of stem cells found circulating in an individual's own blood. By extracting a small volume of blood and processing it in a centrifuge, this technique separates platelets, which are cells known for their essential role in the healing process due to their concentration of growth factors.


After the centrifugation process, the platelet-rich plasma, now enriched with growth factors, is injected back into specific areas of the patient's body that require medical or cosmetic attention. This method is designed to enhance the body's natural healing processes, contributing to the alleviation of discomfort and improvement in the condition of treated areas. [6]

PRP under Eyes

PRP therapy is applied in a variety of medical and aesthetic contexts, offering a minimally invasive option to address a range of concerns. This includes treatments for musculoskeletal conditions and cosmetic enhancements, providing a versatile approach within the scope of contemporary medical practice. [7]


Benefits of PRP For Under-Eyes


PRP therapy represents a cutting-edge approach in the realm of dermatological and aesthetic medicine, particularly for the treatment of under-eye conditions. This method, by leveraging the body's intrinsic healing capabilities to achieve a desired outcome, offers a harmonious blend of cosmetic enhancement and biological repair, fostering a more youthful appearance and invigorated facial appearance.


At the core of PRP therapy's benefits is its capacity to stimulate the production of collagen, a crucial protein for maintaining skin firmness and elasticity. By promoting collagen production and the synthesis of new collagen, PRP therapy effectively minimizes the visibility of fine lines and wrinkles, contributing to a smoother under-eye texture. Furthermore, the growth factors present in PRP support tissue renewal, enhancing the skin's overall texture and tone, which results in a healthier and more vibrant appearance.


An additional advantage of PRP therapy is the improvement in red blood cell circulation it facilitates. Enhanced circulation not only brightens the skin tone but also mitigates issues of dullness and discoloration, including the reduction of dark circles, by targeting their underlying causes, such as thinning skin and visible blood vessels. Concurrently, PRP therapy aids in diminishing under-eye puffiness or bags through the strengthening of skin structure and acceleration of skin cells natural repair mechanisms, thereby reducing inflammation and swelling.


The increase in collagen density also plays a pivotal role in augmenting skin elasticity, which is instrumental in counteracting sagging and the formation of fine lines, hallmarks of aging skin. PRP therapy's personalized nature, utilizing the patient's own plasma, ensures a tailored treatment with minimal risk of allergic or adverse reactions.


On account of its autologous character, PRP therapy not only ensures biocompatibility but also aligns seamlessly with the body's natural healing processes, offering a holistic treatment option. The minimally invasive nature of PRP therapy, requiring only injections rather than surgical incisions, presents a less daunting alternative to more invasive surgical procedures too, appealing to those seeking effective yet non-invasive options.


PRP therapy holds the potential for long-lasting results. By addressing both the symptoms and underlying causes of under-eye concerns, it offers a durable solution to those seeking to alleviate such issues. [8] [9] [10] [11]


Comparison of PRP Therapy To Alternative Treatments


In the context of under-eye treatments, it is crucial to objectively evaluate PRP therapy in comparison with other established modalities.


Dermal fillers, utilizing substances such as hyaluronic acid, offer immediate volume enhancement and wrinkle reduction by physically filling the treated areas. Unlike PRP, which aims to utilize growth factors derived from the patient's own blood to support the skin's health, dermal fillers do not inherently affect the biological healing processes or improve the skin's texture and health over time. [12]


Microneedling involves the use of fine needles to create controlled micro-injuries in the skin, which can prompt the skin's response to injury, potentially leading to an increase in collagen and elastin production. The outcomes of microneedling are primarily based on the skin's natural response to the micro-injuries, without the direct introduction of external growth factors. [13]


Chemical peels employ acids to exfoliate the outer layer of the skin, aiming to improve the appearance of the skin by removing damaged surface layers. This contrasts with PRP therapy, where the focus is on applying a preparation derived from the patient's own blood to the targeted area without the removal of skin layers or direct exfoliation. [14]


Laser treatments use focused light energy to address skin concerns by removing skin layers or targeting specific components within the skin, such as pigmentation. This method provides controlled damage to promote skin improvement, differing from PRP therapy's approach of applying a biological substance intended to support the skin's condition. [15]


Blepharoplasty is a surgical intervention designed to correct issues with eyelids through the removal or adjustment of skin, fat, and muscle. This procedure offers a structural alteration, which is a more invasive approach compared to PRP therapy, where no surgical modifications are made to the skin's structure. [16]


Each of these treatments offers a distinct approach to addressing under-eye concerns, with varying mechanisms of action, levels of invasiveness, and types of outcomes. The choice between these options should be based on a comprehensive evaluation of the individual's specific concerns, desired outcomes, and considerations for invasiveness and potential effects.


FAQ


To facilitate an informed decision-making process, the following elaborates on common patient queries pertaining to the safety, cost, efficacy, and eligibility criteria for PRP treatment. [17]


Is PRP therapy for under-eyes safe?


PRP therapy, when applied to the periorbital region, is predominantly recognized for its safety, which is attributed to the autologous nature of the treatment, which utilizes the patient's own blood, thereby minimizing the risk of adverse reactions or rejection. The intervention is characterized by its minimal invasiveness, with the majority of recipients reporting negligible discomfort and transient side effects.


How much does PRP under-eye treatment cost?


The financial outlay for PRP therapy targeting the under-eye area is subject to variation based on geographical location, the proficiency of the administering practitioner, and the requisite number of sessions. Costs can oscillate between several hundred and a few thousand dollars per session. A consultation with a certified practitioner can provide a tailored estimate. How many treatments a patient undergoes will obviously contribute to overall cost as well.


How long do PRP under-eye results last?


The persistence of outcomes following PRP therapy in the under-eye region is variable, with effects generally observable for a span ranging from several months up to one year post-treatment. The enduring nature of these effects is influenced by factors such as the individual's skin type, lifestyle, and adherence to prescribed post-procedure care protocols. In some cases, yearly maintenance may be recommended on the treated area.


Who is a good candidate for PRP under-eye therapy?


Ideal candidates for PRP therapy aimed at addressing periorbital concerns, such as hyperpigmentation, edema, fine lines, or diminished skin turgor, include individuals in good health with realistic expectations regarding the outcomes of the therapy. Suitability for PRP therapy is optimally determined through consultation with a healthcare professional, who can assess the individual's specific condition and treatment objectives.


Potential Limitations and Risks


As PRP therapy increasingly becomes a point of consideration for addressing periorbital concerns, healthcare professionals must meticulously evaluate its current limitations and the inherent risks associated with this emerging modality. An in-depth understanding of these aspects is essential for conducting informed patient consultations regarding the application of PRP therapy in the under-eye region.


1. Limited Clinical Evidence


The utilization of PRP therapy for under-eye enhancement presents promising avenues yet is characterized by a relative paucity of robust, long-term clinical research. The evidence supporting the efficacy of PRP treatments in improving under-eye conditions, along with understanding potential adverse effects and identifying the most responsive patient demographics, remains an area under active investigation. Given the observed variability in treatment outcomes, which can be influenced by individual patient health status and specific aesthetic objectives, healthcare professionals should adopt a cautious stance. It is incumbent upon practitioners to remain informed about the latest research findings and to provide patients with a candid and comprehensive assessment of PRP therapy's capabilities and safety profile in periorbital aesthetic procedures.


2. FDA Approval


While the devices and methodologies used for preparing and administering PRP have been cleared by regulatory bodies such as the U.S. Food and Drug Administration (FDA), the specific indication of PRP therapy for under-eye rejuvenation does not yet have formal FDA approval. Given that PRP is procured from the patient's own biological material, it is not regulated as a drug, thereby granting clinicians the latitude to employ this therapy based on their professional judgment and the individual needs of patients. [18]


3. Potential for Adverse Reactions


Although the autologous nature of PRP minimizes the risk of allergic reactions or rejection, there is still a potential for adverse responses. These may include localized discomfort, pain at the injection site, the risk of infection, and other complications associated with the procedure. Therefore, it is critical for healthcare providers to thoroughly discuss these potential risks with patients, ensuring a comprehensive grasp of PRP therapy's safety considerations when applied to aesthetic enhancements in the under-eye area.


SELPHYL® Disclaimer


Instructions for the use of SELPHYL® can be found here and here.


SELPHYL® has not been approved by the FDA for subcutaneous, submucous, or intradermal injections in aesthetic medicine, and the safety and effectiveness of SELPHYL® for these conditions have not been established.


SELPHYL® is designed to be used for the safe and rapid preparation of autologous platelet-rich plasma (PRP) from a small sample of peripheral blood at the patient's point of care. The PRP is mixed with autograft and/or allograft bone prior to application to a boney defect to improve handling characteristics.


As of the time of writing, SELPHYL® has no known serious, life-threatening, or fatal risks apart from the adverse reactions described above.


SELPHYL® Limitations, Restrictions, Cautions, and Warnings


  • Prescription only.

  • Do not use the kit if the sterile packaging is damaged or compromised.

  • Follow universal safety precautions for blood collection and sharps disposal.

  • During blood draw, failure to align and properly seat tubes in the tube holder can result in a loss of vacuum and a loss of blood draw.

  • During PRP transfer, failure to align and securely seat tubes simultaneously in assembled blood transfer device tube holders can result in a loss of vacuum and the failure of PRP to transfer to the red-top PRFM tube.

  • Do not initiate the transfer of PRP into the red-top PRFM tube until the physician is ready to complete the procedure.

  • Do not reuse.


SELPHYL® Contraindications


These are not in FDA-required labeling and are part of SELPHYL®’s clinical evaluation for EU CE requirements.

  • Direct connection to a patient’s vascular system of circulating blood volume.

  • Other health conditions and diseases may also contraindicate the use of autologous PRP, including but not limited to low platelet count, sepsis, localized infection in the treatment area, anemia, malignancy with hematologic or bony involvement, and anticoagulation therapy.


Takeaway


PRP therapy, characterized by the administration of a patient-derived plasma preparation enriched with platelets, embodies a targeted approach to stimulating the body's own reparative processes in the periorbital region. This intervention aligns with the broader trend towards minimally invasive procedures in aesthetic medicine, offering a patient-centric alternative that leverages endogenous healing pathways.


For healthcare practitioners, the commitment to employing PRP treatments within a clinical setting should be underpinned by an adherence to evidence-based practices and continuous professional development. Engaging with the latest research and clinical guidelines will assist healthcare professionals in optimizing treatment protocols and patient care pathways.


About the Author


Dr. Ali is a medical journalist and copywriter employed by SELPHYL® for the writing of this article.


References


  1. Naik MN. Hills and Valleys: Understanding the Under-Eye. J Cutan Aesthet Surg. 2016;9(2):61-64.

  2. Fabi S, Alexiades M, Chatrath V, et al. Facial Aesthetic Priorities and Concerns: A Physician and Patient Perception Global Survey. Aesthet Surg J. 2022;42(4):NP218-NP229.

  3. Zhang S, Duan E. Fighting against Skin Aging: The Way from Bench to Bedside. Cell Transplant. 2018;27(5):729-738.

  4. McDaniel D, Farris P, Valacchi G. Atmospheric skin aging-Contributors and inhibitors. J Cosmet Dermatol. 2018;17(2):124-137.

  5. Parrado C, Mercado-Saenz S, Perez-Davo A, Gilaberte Y, Gonzalez S, Juarranz A. Environmental Stressors on Skin Aging. Mechanistic Insights. Front Pharmacol. 2019;10:759.

  6. Selphyl. Home of the Next Generation PRP. Selphyl. Published June 1, 2023. https://www.selphyl.com/our-science

  7. White C, Brahs A, Dorton D, Witfill K. Platelet-Rich Plasma: A Comprehensive Review of Emerging Applications in Medical and Aesthetic Dermatology. J Clin Aesthet Dermatol. 2021;14(11):44-57.

  8. Maisel-Campbell AL, Ismail A, Reynolds KA, et al. A systematic review of the safety and effectiveness of platelet-rich plasma (PRP) for skin aging. Arch Dermatol Res. 2020;312(5):301-315.

  9. Alam M, Hughart R, Champlain A, et al. Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin: A Randomized Clinical Trial. JAMA Dermatol. 2018;154(12):1447-1452.

  10. Hesseler MJ, Shyam N. Platelet-rich plasma and its utility in medical dermatology: A systematic review. J Am Acad Dermatol. 2019;81(3):834-846.

  11. Samadi P, Sheykhhasan M, Khoshinani HM. The Use of Platelet-Rich Plasma in Aesthetic and Regenerative Medicine: A Comprehensive Review. Aesthetic Plast Surg. 2019;43(3):803-814.

  12. Goel A, Sethi P. Concealing of under eye orbital fat pads with hyaluronic acid filler: A case report. J Cosmet Dermatol. 2020;19(4):820-823.

  13. Gupta M, Barman KD, Sarkar R. A Comparative Study of Microneedling Alone Versus Along with Platelet-Rich Plasma in Acne Scars. J Cutan Aesthet Surg. 2021;14(1):64-71.

  14. Mcgloin C. Chemical peels: a review of types, applications and complications. Journal of Aesthetic Nursing. 2018;7(8):422-426.

  15. Abdel Aal AM, Ibrahim IM, Sami NA, Abdel Kareem IM. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars. J Cosmet Laser Ther. 2018;20(2):106-113.

  16. Alghoul M. Blepharoplasty: Anatomy, Planning, Techniques, and Safety. Aesthet Surg J. 2019;39(1):10-28.

  17. Elghblawi E. Platelet-rich plasma, the ultimate secret for youthful skin elixir and hair growth triggering. J Cosmet Dermatol. 2018;17(3):423-430.

84 views0 comments

Comments


bottom of page