Platelet-rich plasma (PRP) therapy, used in the "vampire facial," is a regenerative medicine modality that can promote healing and regenerate senescent cells.
A vampire facial involves extracting a small amount of blood from the patient's arm and processing it to isolate the PRP, which is then reintroduced into the patient’s facial skin using microneedling or injections. The growth factors present in PRP promote tissue regeneration, collagen production, and skin rejuvenation.
Patients should be advised to receive vampire facials in a medical setting due to potential contraindications, including worsening skin issues, infections (recent HIV infections have reportedly been linked to at least one spa administering this type of facial), and more.
Humanity's quest for everlasting youth trudges ever-onward. The anti-aging industry is abuzz with innovative approaches, from unconventional-sounding therapies like snail facials and bee venom therapy to high-tech advancements like light therapy and oxygen facials. One such therapy gaining popularity is the vampire facial.
The vampire facial involves injecting or pricking facial skin to reintroduces a patient's blood into their face, so it's important to know there is a risk of blood-borne infections when administered outside the sterile confines of a hospital room. (In July 2023, NBC linked at least five HIV infections with a spa in New Mexico that offered the vampire facial.) However, when administered safely, vampire facials may help lessen the appearance of wrinkles, sun damage, or acne scars.
PRP: A regenerative powerhouse
Far from its name's association with folklore and the macabre, the vampire facial is a fairly simple procedure pioneered by Charles Runels, MD, using platelet-rich plasma (PRP) and microneedling.
PRP is prepared by extracting a small amount of blood from the patient's arm and centrifuging it to isolate the supernatant plasma, which is rich in platelets.
Research has demonstrated that PRP contains approximately 578 distinct proteins, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGFβ), and vascular endothelial growth factor (VEGF).
Investigators writing in the Indian Dermatology Online Journal note that these bioactive components can promote the regenerative processes within the skin by stimulating stem cells and causing regeneration and differentiation of epidermal and dermal cells. These proteins also activate fibroblasts and increase hyaluronic acid production in the dermis.
PRP is a regenerative therapy with significant potential in the medical field. Beyond its application in skin rejuvenation, PRP has also demonstrated potential in neuroregeneration.
Research reveals the ability of PRP to reverse nerve degeneration. It helps heal meniscal tears and alleviate pain from osteoarthritis. In senescent mice, PRP reduced signs of cognitive decline, indicating potential benefit in aging brains.
Vampire facial techniques
The wound-healing process is strikingly similar to the mechanisms that reverse or slow down intrinsic and extrinsic skin aging. Consequently, vampire facial treatments often combine PRP with microneedling, creating skin micro-wounds. The following are the most commonly used techniques:
PRP can be applied to the face with microneedling—using a 0.25 mm to 2.5 mm derma roller, derma pen, or microdermabrasion—to enhance the absorption of the plasma's proteins. Microneedling promotes angiogenesis, tissue remodeling, collagen synthesis, and wound healing, according to a review on microneedling.
PRP is injected intradermally or subdermally into the face using an insulin syringe. Injection of 3 ml to 4 ml of PRP is used for the entire face, with 1 ml for each cheek, 1 ml for the neck, and 1 ml for the chin, forehead, and nose combined. Each injection delivers 0.01 ml to 0.02 ml of PRP.
For combination therapy, the vampire facial can be combined with fractional laser resurfacing, lipofilling, or electroporation to enhance the results.
What does the research say?
Multiple studies, cited by the Indian Dermatology authors, have confirmed the efficacy of PRP in skin and neck rejuvenation. Results have shown improvements in skin color, texture, and tissue tension, and reduction in wrinkle depth.
Animal studies have demonstrated the anti-aging effects of PRP, showcasing improvements in dermal thickness, fibroblast proliferation, and collagen synthesis.
Combining microneedling with PRP significantly improves its efficacy.
Several trials have indicated that incorporating PRP with microneedling for the treatment of acne scars increased patient satisfaction, improved scarring, and reduced recovery time.
Research published in the Journal of Cosmetic Dermatology found that combining PRP and microneedling yielded a 62.20% improvement in acne scars, vs only 45.84% improvement with microneedling alone.
Citing studies from various countries, the Indian Dermatology authors noted the following findings:
A Korean study reported improved skin tone and infraorbital wrinkles after three monthly sessions.
A trial in Jordan reported significant improvement in periorbital hyperpigmentation after three sessions.
Researchers from Germany reported statistically significant improvement in lower eyelid skin firmness and elasticity with PRP.
As noted by the Indian Dermatology authors, absolute contraindications include thrombocytopenia, platelet dysfunction, septicemia, and hemodynamic instability. Additionally, microneedling is contraindicated in patients with active acne, psoriasis, eczema, keloidal tendency, or facial infections like herpes.
Risks and limitations
Adverse effects associated with vampire facial treatments are generally mild and transient, including redness, soreness, tenderness, oozing, and mild bruising, which typically resolve within 4 to 5 days.
Milia or a mild exacerbation of acne may develop during the healing process, and the authors of the review on microneedling note that patients with a history of herpes simplex infection may experience cold sore outbreaks following microneedling procedures.
Microneedling without proper sterilization risks introducing pathogens into the skin, leading to infection. LA County's Department of Public Health notes some of the dangers related to this type of procedure, including the re-use of needles, unclean equipment, or even unknowingly being injected with someone else's blood.
"Ask your provider how the instruments were cleaned before your treatment and whenever possible, ask them to open new needles, syringes, and dermarollers in front of you to ensure they are new and/or sterile," their website states.
Can your patients try a vampire facial at home?
While microneedling can be safely done at home with 0.1 mm-deep derma rollers, performing a vampire facial at home is not recommended. These procedures necessitate aseptic precautions, specialized training, equipment for blood handling, proper anesthesia, and post-treatment care. Therefore, it is best to entrust these procedures to a board-certified plastic surgeon or dermatologist.
What this means for you
PRP presents a treatment modality for improving skin texture, tone, and early signs of aging in young patients. The benefits of vampire facials accrue gradually, as collagen production takes time, and therefore the improvement may become apparent only after a few weeks. Thus, it is important to give your patients realistic expectations. Continued improvement can be expected in subsequent weeks.