The effectivity of platelet rich plasma on melasma
a systematic review and meta-analysis
DOI:
https://doi.org/10.66344/jpad.v32i1.1844Abstract
Background Melasma is an acquired hyperpigmentation in the form of light brown to dark brown macules on areas exposed to Ultraviolet (UV) radiation. Melasma accounts for 50% of aesthetic cases in Asia. Therapy of melasma depends on the type of melasma, the effectiveness of previous therapies, and the patient's expectations. Difficulties in the management of melasma include frequent recalcitrance, recurrence, side effects of therapy, long treatment and patient compliance. The latest therapy that is being used is platelet rich plasma (PRP) containing TGF-β1 which significantly suppresses melanin synthesis, thereby lowering the mMASI score of melasma patients.
Methods Searching the electronic database Medline Pubmed, Scopus, EBSCOhost, ProQuest, Cochrane library, ClinicalTrials.gov, found 5 articles included in the qualitative (n=154 subjects) and 4 articles (n=103 subjects) included in the meta-analysis.
Results The mean difference in mMASI scores before treatment in the PRP injection treatment group and the control group was negative. This value indicates a decrease in the mMASI score after PRP injection. The control group also showed the same thing. The greatest decrease in mMASI scores in the study by Gamea, 2020 with PRP injection and topical tranexamic acid treatment was
-8.5±2.76, the smallest in the study by Sirithanabadeekul, 2019 in the control group receiving normal saline injection, which was -1.42±0.93. The heterogeneity test results showed Q value=24,564, df=3; p<0.001, I2=87.787. The I2 test outcome with p<0.001 showed that the data were homogeneous. The meta-analysis results present the Q statistic value was z=-5.373 (p=<0.001). This shows that PRP can significantly reduce the mMASI score.
Conclusion The meta-analysis and systematic results show PRP intradermal injection therapy decreased in mMASI scores. The decrease in mMASI scores in the platelet rich plasma group was lower than the control group given tranexamic acid injection in melasma patients.
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