What Are PRP Injections & Acupuncture? I Tested The Integrative Treatment
There I was, with board-certified physician, integrative doctor, and certified acupuncturist Richard Firshein, D.O., sitting in front of me trying to find which arm had a better vein for drawing blood. We decided on my right. I used to be quite squeamish in the face of needles—you know, fainting spells, sweaty palms, racing heart, and the like.
But luckily, very luckily, I had grown out of that. He drew out a vial of blood, did some modern magic that I'll explain in a moment, and 20 minutes later, he was injecting it into my face followed by an acupuncture session.
And two days later, my skin was smooth and glowing.
What is PRP, and how does it work?
PRP stands for platelet-rich plasma. In the last few years, dermatologists and doctors have started utilizing it in various means and modalities to ease issues from skin concerns and joint pain to hair loss. PRP works by separating your red and white blood cells from the platelets, which contain growth-factors; these platelets are in charge of recovery and inflammation. As board-certified dermatologist Joshua Zeichner, M.D., tells me, "PRP is an all-natural treatment because it uses growth factors derived from your own blood. The growth factors act like fertilizer for your skin cells to help them behave to the best of their ability."
Firshein explains to me that when an area of the body is damaged (like the scalp that leads to hair loss, knee injury, or premature aging from environmental aggressors), that area needs more repair cells, but sometimes it's hard for the body to get those cells to said location. So that's why you inject a concentrated amount. "If you have areas of the body where the cells are damaged, like lines or scar tissue, those are harder places for the platelets to get to—but it's where you need it most. That's why we inject it, putting those platelets exactly where we want to," says Firshein.
But this isn't going to be a miracle cure for those with severe lines or skin damage. Zeichner notes that, "the best candidates are people who show early signs of aging but still have well-functioning, healthy skin."
Many in the integrative medicine and skin care space have become enamored with PRP because it offers a natural alternative to neurotoxins and fillers: What you are putting into your skin is your own blood. And it works by stimulating the body's natural recovery process and collagen production—essentially making your body perform at its best. It's not freezing your muscles or undergoing harsh, invasive procedures.
"This is regenerative medicine: It's all about, how do we repair and treat your body with what it already possesses?" says Firshein. "We're not going for superficial fixes."
What are PRP treatments like?
When you get a PRP treatment of any kind, the doctor will extract blood, which is spun in a centrifuge machine. This separates the platelets out and only takes about 15 minutes. When all is said and done, the remaining liquid should be nearly clear (Firshein tells me that earlier iterations of the centrifuge weren't as advanced and would leave some red blood cells, making it pink).
The next steps from there depend on your need. For example, it's used quite a bit in sports medicine, especially with damaged ligaments and tender joints: The PRP helps speed up the healing process. If you're experiencing hair loss, doctors can inject it at the scalp, where it reduces inflammation of the hair follicle, encouraging regrowth. For the skin, doctors can inject it into the face to target fine lines or scars. Or the dermatologist might microneedle the skin before applying the PRP like a serum (you might have heard about the "vampire facial" craze of a few years ago). There are even companies that will encapsulate your own PRP into a moisturizer—for your own, very personalized cream. (Dr. Barbara Sturm makes one, but it comes with a very hefty price tag and a trip to Germany to get it made. Yes, really.)
In my treatment, I received six injections total (two by my lips, two on my forehead, one by each of my eyes). But then Firshein also dipped acupuncture needles into the PRP before placing them on my face, focusing primarily around my lips and cheeks. This is a new use for PRP and combines the benefits of acupuncture with the healing power of platelets.
What does it feel like?
Drawing blood felt like drawing blood. And the acupuncture felt like acupuncture. No surprises for those two. As for injections, I've never done any "work" on my face before. So to say I was nervous is an understatement. Firshein slathered on numbing cream around the areas of my face he'd be injecting, let it sit for a moment, and then went in. The first injections around my mouth—where I had faint "smile" lines and a few acne scars—were quite easy since that was a bit more fleshy. A little pinch—that's it! The next spots were more painful: by my eye and my forehead, where there's less fat and muscle and thinner skin. The most painful was definitely my forehead, but it's so quick with no residual pain. If you can stand to be uncomfortable for a few seconds at a time—you'll be fine. There was very, very slight tenderness at the injection sites the rest of the day but only if I applied pressure on it. If you have moderate pain tolerance, you won't find this to be a challenge. For me, the most stressful part was the anticipation.
I have been told, however, that if you go with the microneedling route, it can be quite painful—I did not get microneedling so can't speak to that.
What changes did I see in my skin?
I had no downtime—I hopped on the subway right after, went to work, and did everything as normal. There was slight redness from the acupuncture and some puffiness around the injection sites but nothing that was too distracting or embarrassing to be seen in public. (I've heard anecdotally that women who get the microneedling version experience more redness and swelling.)
And then the next day I woke up to the best my skin has looked since, well, I can't tell you how long. I've only recently "grown out" of a decadelong struggle with acne (I still get flare-ups and breakouts), and it's left me some texture and tone issues. It's truly nothing so major that would cause me any duress, but it's something that I notice about my skin. I see it mainly around my cheeks, chin, and mouth: There's the subtlest hint of rolling scars, pigmentation issues, and slight uneven texture overall. (I will say that most outsiders probably wouldn't characterize me as having acne scars, as I have been diligent with my post-acne skin care and then blur the rest with makeup, but it still very much annoys me.) It also concerned me going forward; skin loses firmness as you get older, and any texture issue you develop when you are young tends to get worse. I was nervous that if I had these dents now, even if they were small—what would they look like in 10, 20, 30 years?
And almost overnight, these indented areas had filled out; it was the smoothest my skin had ever been since my first breakout years and years ago. To be honest, I wasn't quite prepared for it to address my acne scarring as well as it did, but board-certified dermatologist Kiera Barr, M.D., previously mentioned to me that it was being used for healing a variety of acne scar tissue types.
Weirdly, what I noticed as the biggest difference had nothing to do with appearances. When I washed my face, I could feel the texture change: It was plush and tight. The small intricacies of my skin, the ones that you only notice if you touch it day in and day out, felt smooth, and the overall quality had improved.
In the coming days, the skin only improved. Firshein tells me that results develop over time, although it will likely start to plateau eventually. The benefits can last up to 15 months.
What else should you know?
First, it's very expensive and not widely available yet. Had I not been a beauty editor, I can't say I would have gotten this—I'm glad I did, absolutely, but it just wouldn't have been first priority with my paycheck otherwise.
Because it's still relatively new, mass, large-scale studies are still needed. But many doctors and medical authorities note that it's safe and a promising field of treatment, as long as you get it from a trusted source (read: a doctor, not a day spa). And of the studies that have been done, they've primarily been of the sports medicine variety1 or hair loss, and fewer with respect to the skin. But as we enter the age of smarter aging, it could be an exciting tool in not only the integrative space but mainstream medicine as well.
Alexandra Engler is the beauty director at mindbodygreen and host of the beauty podcast Clean Beauty School. Previously, she's held beauty roles at Harper's Bazaar, Marie Claire, SELF, and Cosmopolitan; her byline has appeared in Esquire, Sports Illustrated, and Allure.com. In her current role, she covers all the latest trends in the clean and natural beauty space, as well as lifestyle topics, such as travel. She received her journalism degree from Marquette University, graduating first in the department. She lives in Brooklyn, New York.