A recent trend in aesthetic medicine involves bundling different procedures that complement one another. Microneedling and platelet-rich fibrin (PRF) are separate aesthetic procedures that treat signs of aging, acne scars, and loss of volume in the skin. Since PRF comes from the patient’s blood and promotes healing and collagen production, it has been a new popular add-on to incorporate into microneedling treatments. Medical aesthetic providers can combine these two treatments into one bundled service to help patients achieve better results. But how does the treatment work, and who is the right candidate? Here’s what providers need to know about this cutting-edge treatment.
What is microneedling with PRF?
Microneedling with PRF is a minimally invasive procedure for facial rejuvenation. It involves applying the patient’s platelet-rich fibrin (PRF) to the skin and puncturing the skin with fine needles. The needling creates tiny injuries that stimulate skin renewal while the PRF speeds up recovery.
Platelet-rich fibrin is derived from the patient’s blood. It’s a mix of platelets, white blood cells, growth factors, and a clotting protein called fibrin. PRF helps stimulate wound healing and promotes collagen and elastin production.
PRF is a newer version of platelet-rich plasma (PRP) and is sometimes called a second-generation product. The medical use for these products is similar, but where PRP needs anti-clotting additives to activate growth factors, PRF does not. These additives in PRP block natural clotting and slow down the healing process, so experts consider PRF a better product. Without additives, PRF can release healing proteins over a longer time, which gives longer-lasting results.
How does microneedling with PRF work?
Microneedling treatments use a handheld needling device that creates controlled, superficial injuries that don’t damage the outer layer of a patient’s skin. The process sets off a wound-healing cascade, causing the body to release growth factors and immune cells that generate new tissue.
Cells migrate to these areas and start producing collagen fibers — a protein matrix forms and collagen deposits in the skin, leading to skin tightening. The needles don’t cause real wounds but instead trick the body into sensing an injury and setting off this cascade. Microneedles also break down tissue strands in scars and restore blood flow to the area.
Along with needling, a provider applies PRF to the patient’s skin. The PRF comes from the patient, so the provider must first draw the patient’s blood and then spin it through a centrifuge at a low speed. The machine separates the blood from the plasma, settling the heavier cells to the bottom and increasing the number of platelets and cells available.
Essentially, PRF primes the skin with the growth factors and cells it needs to heal. These cells are part of the natural healing cascade, so combining PRF with skin needling feeds the skin and the body its own natural healing ingredients, which speed up recovery time.
Compared to PRP, PRF doesn’t have any additives that block the healing process, so it steadily releases these growth factors into the skin. The effect is faster and natural healing, more significant collagen and elastin production, and longer-lasting results.
Microneedling is an intentional and controlled skin injury that triggers the body to rejuvenate and repair the skin. PRF can be applied to these micro-injuries to stimulate natural skin tissue renewal further and lead to smoother and firmer skin.
What tools do you need to perform microneedling with PRF?
Microneedling with PRF involves two separate treatments in the same appointment, so there are a few necessary tools. Since PRF is a blood product, creating a clean and safe working space is essential. Some equipment and supplies are standard across clinical settings, but others are only for microneedling and PRF.
Personal protective equipment (PPE)
PPE is, of course, a standard tool for an aesthetics practice. However, it’s always important to remember these supplies and consider them in the overhead cost of performing these procedures.
The required PPE includes:
- Hand sanitizer
- Face mask
- Eye protection
Clean lab area
The practice should have a clean lab area for processing blood products. If there is available space, it’s beneficial to set up a designated processing area in each treatment room.
Some providers offer microneedling with PRF as a concierge service, in which case disposable sterile field supplies will be necessary. Both in-practice and concierge services should have a process or an area for disinfecting and sanitizing devices and machines between patients.
The PRF step begins with blood collection. The provider cleanses the draw site, usually the arm, collects the blood, and then sets it to spin in the centrifuge. Once the spinning is complete, the PRF is applied to prepped skin.
A provider will need blood draw and PRF supplies, including:
- Alcohol sterilization pads
- Butterfly needle
- Plastic PRF tubes without additives
- Gauze and bandaids
Some lab supply companies sell FDA-approved PRF collection kits with all the supplies, which is a simpler way to purchase tools and supplies. The centrifuge will be the most significant investment.
The microneedling process has several steps, including facial cleansing, numbing, and needling. Supplies and tools include:
- Antiseptic cleansing soap
- Lidocaine numbing cream
- Alcohol cleansing pads
- Professional-grade microneedling pen
- Sterile needles in different depths or gauges
- Hyaluronic acid or other hydrating serum for slip
- Moisturizing cream
How long is the typical treatment?
A typical microneedling with PRF treatment takes about an hour. A provider should begin the appointment with a review of the procedure, the risks, the side effects to expect, and post-care instructions. Once the patient gives consent and is ready to move forward, the procedure can begin.
The most time-consuming parts of the procedure are skin numbing and microneedling. A patient should have numbing cream on the area for about 20 minutes to ensure they won’t feel any pain. The actual microneedling takes the longest at around 30 minutes.
Clinics sometimes have different scheduling procedures, so the appointment length can vary. Some clinics shorten the appointment time to 45 minutes and ask patients to come in 15 minutes early for numbing. This extra time allows for more efficient scheduling and time to clean up and prepare for the next patient.
The way providers perform microneedling with PRF can also change the length of the procedure. Some work in three separate stages where they apply PRF first, microneedle the entire face or area, and then apply the remaining PRF at the end. Others might work in sections and go back and forth between using PRF onto the skin and microneedling.
How can patients prepare for microneedling with PRF?
Providers should give patients pre-procedure instructions for the best results, efficient appointments, and an excellent overall experience. Patients should:
- Drink plenty of water for 72 hours before the procedure
- Avoid alcohol for 72 hours before the procedure
- Avoid retinol products, hydroquinone, or acids one week before the procedure
- Avoid medications, vitamins, herbs, and supplements that have blood-thinning effects for one week prior, like omegas, NSAIDs, blood thinners, vitamin E, Ginkgo Biloba
- Come to the appointment with clean skin free of makeup and creams
Patients who take prescription blood thinners, supplements, vitamins, or NSAIDs should not stop taking prescription medications without talking to their prescribing doctor. The medical aesthetics provider should also advise the patient to get clearance from their doctor before starting the procedure.
Some providers also ask patients to prep the skin for one week before the appointment with specific products, like Alastin® Skin Nectar. This preparation can help with skin health, enhance the treatment, and improve the results.
What is the recommended post-treatment care?
After a microneedling with PRF treatment, the skin will flush red and swell slightly. Then it will become quite dry and may slough off over the first few days. During this time, the skin is vulnerable to germs and sensitive to products and the sun. Post-treatment instructions should focus on gently cleansing, hydrating, and protecting the skin.
For the first 24 hours, patients should:
- Avoid all skincare products
- Avoid exercise up to 48 hours post-treatment
- Avoid all makeup
- Take only acetaminophen for pain or discomfort
- Keep hair off the face
For the first week, patients should avoid:
- Anti-inflammatory medications, like ibuprofen and naproxen
- Antihistamines, like over-the-counter allergy medications
- Steroid medications
- Blood-thinning herbs, vitamins, and supplements
- Rubbing or scrubbing the skin
Patients can start cleansing and maintaining the skin after 24 hours. Providers often recommend:
- Washing hands before touching the skin
- Using a gentle cleanser with lukewarm water and gently patting the skin dry
- Any treatment enhancing creams, if desired, like Alastin® Regenerating Skin Nectar
- Hyaluronic acid and a light moisturizer to help with dryness
- Applying makeup with clean or new brushes
- Daily sunscreen of at least 30 SPF
Who can perform this treatment?
Only licensed medical professionals can perform microneedling with PRF. The procedure involves puncturing the skin and drawing and working with blood products, so providers must have the training and the legal ability to perform these tasks. Microneedling with PRF is within the scope of practice for medical doctors, registered nurses, nurse practitioners, and physician assistants.
But providers must also have the proper certifications and insurance to be licensed to perform microneedling with PRF. Medical practices will also need to pass health inspections and have infection prevention and control protocols in place.
Who is the ideal candidate for microneedling with PRF?
Microneedling with PRF is a safe and effective procedure. While it does have some recovery time, it’s a minimally invasive treatment that can help with signs of aging. It stimulates collagen, improves scars, and the combined PRF also helps speed up recovery.
Microneedling with PRF is ideal for patients who want to improve:
- Acne scars
- Wrinkles and fine lines
- Volume and plumpness
- Facial folds and lines
Microneedling on its own is a powerful collagen stimulator, so the combined treatment is especially beneficial for people who want to restore lost collagen and lift the skin. It’s also an alternative for patients with acne scarring and hyperpigmentation who can’t have laser treatments.
Some people shouldn’t have microneedling with PRF. These include patients who have:
- Blood cancer
- HIV or AIDS
- Hepatitis C
- Skin cancer in the area being treated
- Bleeding disorder
- Low hemoglobin
- Low platelet count
Patients who are pregnant or nursing, have active acne, have had a recent illness or fever, or are taking Accutane® medications shouldn’t have this procedure performed. Anyone with a systemic or autoimmune disease should get clearance from their doctor before the procedure. Smoking can also lessen the treatment effects.
What are the benefits of microneedling with PRF?
It takes four to six weeks to appreciate the collagen production after microneedling. Fine lines should gradually disappear, and subtle changes might be seen in the weeks following the procedure. The treatment is relatively quick, with very few side effects.
It doesn’t take long to perform microneedling with PRF, and there’s very little recovery time. The skin will be red and dry, but within one to two days, this will go away. Some tenderness or discomfort is also standard, but it doesn’t usually interfere with daily life. Patients can go back to normal activities right away.
Longer lasting results
Patients will need a few treatments to get the best results, and they will be most visible between four to nine months after the procedure. Changes from microneedling tend to gradually appear rather than being dramatic and short-term, like laser treatments. Results vary by patient, though.
Restored volume and smoother texture
As the skin heals from the micro-injuries, the new collagen gives the skin a smoother texture and restores volume to the skin. The PRF enhances the natural healing process and speeds up regeneration. The result is fresher, youthful skin.
Microneedling with PRF can help a patient improve their overall skin texture and appearance with a natural product derived from their own body. If you’d like to learn more about how you can incorporate this type of treatment into your own practice, speak to a Portrait specialist today.