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 percent 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 revitalization 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 volumizing 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 medspas 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.
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