Christopher Labos: The evidence on vampire facials is anemic

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A friend of mine recently told me that vampire facials are becoming big business. If you’ve never heard of it, a vampire facial is the process by which your own blood is centrifuged and injected into your face to make you look younger. As expected, it is not covered by Medicare and you would have to pay for it out of pocket. But you probably shouldn’t do it. There is little evidence that it works.

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Vampire facial is the colloquial term for a platelet-rich plasma (PRP) injection. Our blood is made up of red blood cells to carry oxygen to our tissues, white blood cells to fight infections, platelets to clot blood, and other proteins dissolved in water. The watery part minus the cells is called plasma. Anyone offering PRP injections will draw your blood, spin it in a centrifuge to separate the cells from the plasma, and then inject the plasma into your face. The reason is that the growth factors and cytokines in the plasma will stimulate healing and rejuvenation of the skin.

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The problem is that the evidence base is very thin. Most of the clinical research on PRP has focused on musculoskeletal problems and the treatment of hair loss. There have been quite a few studies using PRP as a treatment for osteoarthritis, but a systematic review of the evidence demonstrated some key problems. Sometimes the studies used very different protocols. Different groups spun the blood at different times and at different speeds. Some subjected the blood plasma to a second round of centrifugation and some added activators such as calcium chloride. They used different doses at different intervals, and this lack of standardization makes it difficult to assess whether there is any real benefit from this therapy. That said, in the RESTORE In a randomized trial published in JAMA, PRP joint injections did not improve pain in patients with mild to moderate osteoarthritis compared to saline injections.

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Another common refrain is that PRP can be used to speed the healing of injured muscles. For this reason, it is often used in sports-related injuries. But a moment of reflection will reveal a problem: muscle injuries are very heterogeneous. They have different causes, occur in different places, and involve different tissues. A sprained ankle and a torn hamstring are not the same thing, and lumping them all together will invariably muddy the issue. Some analyzes have suggested that PRP shortened injured athletes’ return to play by five days, but long-term injuries remained the same. In contrast to one of the largest randomized trials on the topic, the Dutch study on hamstring injection therapy, which showed no benefit for PRP when used on hamstring injuries. TO Cochrane review PRP as a treatment for tennis elbow also showed no benefit.

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While musculoskeletal studies have not been as overwhelming, other research groups have considered PRP as a hair loss treatment. Here too, studies have faced problems with small samples, different protocols and limited benefits. A study, published in the Journal of the American Academy of Dermatology, is often referred to as showing a benefit. But while the PRP treatment increased hair growth by 19 hairs per square centimeter, so did the placebo treatment. Given cheaper, well-studied alternatives such as minoxidil (Rogaine) and finasteride (Propecia), few doctors would recommend PRP for most people.

There is limited evidence on the use of PRP to treat wrinkles and rejuvenate the face. Unfortunately, because PRP is not classified as a medicine, The FDA does not require the same level of evidence before allowing clinical use. Therefore, large trials are unlikely to occur any time soon.

When it comes to wrinkles, prevention is better than cure. And since most wrinkles are caused by exposure to the sun’s ultraviolet rays, the answer is clear: the best beauty product is sunscreen.

Christopher Labos is a Montreal doctor, co-host of the show Body of Evidence Podcast and author of Does coffee cause cancer?

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