| Objective:This prospective study aimed to evaluate the clinical and histological effect of dermaroller and dermaroller combined with platelet rich plasma therapy applied to facial wrinkles and to quantitatively evaluate histological changes in the skin occurring in response to the top of two treatments.Methods:From October 2015 to february 2016, a total of twenty health women (aged 43-48 years) with facial wrinkles with scores of 2-4 on the baseline facial fine wrinkle grading scale were enrolled in the this clinical study. To give information about research, the researchers implemented a single-blinded prospective trial. The left and right faces of each patient were randomly selected to choose the experimental group or the control group. Platelet-rich plasma was obtained by double-spin method, followed by the collection of 10 mL of autologous whole-blood into tubes containing anticoagulant, finally produce 1.5～2.0 mL of PRP. Local anesthetic cream (lidocaine) was applied to the face and ear back for approximately one hour before the procedure. After sterilization of the face with povidone iodine,1.5-2 mL of PRP was applied topically to the treated area, followed by needling on the one half of face. The treatment was performed by rolling the dermaroller on the one half of face and ear back 10 times in 4 directions (vertically, horizontally, and diagonally right and left) without pressing too hard. Three sitting each at 4 weeks interval were carried out of dermaroller alone on the one half face and dermaroller combined with platelet rich plasma on the another one half face. Standard photographs and skin biopsies were obtained from the treatment area at baseline, at eight weeks posttreatment. Grading of wrinkle photographs using the baseline facial fine wrinkle grading scale was carried out by a blinded observer pretreatment and posttreatment. Furthermore, all patients were rated as improved or better on the Global Aesthetic Improvement Scale (GAIS). The skin specimens were stained with Haematoxyline Eosin and Masson’s trichrome. The skin specimens stained with Haematoxylin eosin were reviewed for epidermal thickness, papillaries, pigmented epithelial cells and glands, while the skin specimens with Masson’s Trichrome were measured for dermal fibers. All microphotographs share the same power of 10X objective. Data of the cutaneous casts were analyzed by computerized image analysis. Comparisons of the treatments were analyzed using clinic, histologic findings, and patient’s satisfaction scores.Results:Of the twenty subjects enrolled, nineteen completed the study.(1) The degree of facial wrinkling was compared between the experimental group or the control group at before treatment and at 8 weeks post-treatment. At baseline, the wrinkling grade on the dermaroller combined with PRP side (3.26 ± 0.56) and the dermaroller alone side (3.21 ± 0.63) showed no significant differences (p=0.331>0.05). After 8 weeks post-treatment, the wrinkling grade on the dermaroller combined with PRP side (2.32 ± 0.82) and the dermaroller alone side (2.89 ± 0.66) showed significant differences (p=0.001<0.01).(2) GAIS scores, which were significantly lower at 8 weeks post-treatment on the two treatment sides. According to the GAIS score on the dermaroller combined with PRP side, three patients were very much improved, eight patients were much improved, six patients were improved and two patients had no change. On the dermaroller alone treatment side, one patient was very much improved, five patients were much improved, eight patients were improved and five patients had no change. The dermaroller combined with PRP side showed better improvement compared to the dermaroller alone side (P=0.047<0.05).(3) Microscopic evaluation of H&E stained sections revealed significant difference in epidermal thickness, papillaries, pigmented epithelial cells and skin glands. Epidermal thikness were 163.44±5.99μm at before treatment,235.08±31.94μm at 8 weeks post-treatment on the dermaroller combined with PRP (P= 0.000<0.01); 200.61±14.09μm at 8 weeks post-treatment on the dermaroller alone (P= 0.000<0.001)(4) Microscopic evaluation of Masson’s trichrome stained sections revealed high significant difference in dermal fibers (0.348±0.003μm at before treatment,0.502±0.025μm at 8 weeks post-treatment on the dermaroller combined with PRP (P= 0.0000＜0.01); 0.409±0.016μm at 8 weeks post-treatment on the dermaroller alone (P= 0.000＜0.001)(5) Questionnaire results that dermaroller combined with PRP side is more effective than dermaroller alone side, there were no significant improvement of sagging.Conclution:Significant changes are noted when dermaroller alone and dermaroller combined with platelet rich plasma for treatment of facial wrinkles. Hence, dermaroller combined with platelet rich plasma is more effective than dermaroller alone for treatment of facial wrinkles. Finally, combined dermaroller combined with platelet rich plasma is a novel method of facial rejuvenation. |
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