Efficacy and safety of platelet-rich plasma for treatment of periorbital hyperpigmentation in patients receiving fractional CO2 laser: a parallel-group blinded randomized controlled clinical trial

Among different treatments for periorbital hyperpigmentation (POH), both semi-invasive protocols of fractional CO2 laser and platelet-rich plasma (PRP) are favored among clinicians and rarely cause complications; however, the level of patients’ satisfaction seems to differ across these methods. This randomized clinical trial was conducted on 100 patients (98 women; 2 men) between 28 to 62 years of age who complained of POH and referred to the Dermatology Clinic of Rasool Akram Medical Complex located in Tehran in 2017. The patients were randomly assigned to two groups receiving fractional CO2 laser (group C) and adding PRP treatments plus laser therapy (group CP). The outcome of both treatment protocols was followed 3 and 6 months after the last treatment by standard photography. The time for swelling after treatment in the C and CP groups was 4.58 ± 0.61 days and 2.94 ± 0.68 days, respectively, which was significantly shorter in group CP (P < 0.001). The mean time for erythema disappearance was also shorter in group CP (5.20 ± 0.76 days vs. 3.40 ± 0.76 days, P < 0.001). Regarding the trend of the change in the ΔE parameter, it fell significantly in both groups within the follow-up period (P < 0.001); however, the mean ΔE was significantly higher in the CP group when compared with the control group (P < 0.001). There were no significant or resistant side effects in either treatment group. Although both therapies are effective and safe, the concurrent use of CO2 laser and PRP can more effectively reduce the severity of POH with a shorter duration of post-treatment swelling and erythema. Hence, this combination is a superior modality for the treatment of POH as compared to laser therapy alone.