BIOFILLER VS PLATELET RICH PLASMA MESOTHERAPY IN THE TREATMENT OF PERI-ORBITAL HYPERPIGMENTATION IN PATIENTS PRESENTING TO OUTPATIENT DEPARTMENT OF DERMATOLOGY IN A TERTIARY CARE HOSPITAL-AN RCT

Authors

  • Sakina Sadiq Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Uzma Bashir Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Ayesha Rizwan Margalla Hospital Taxila-Pakistan
  • Ayesha Anwar Pak Emirates Military Hospital, Rawalpindi-Pakistan
  • Sibghatullah Rao CMH Hyderabad-Pakistan
  • Shyna Shahid

Keywords:

Biofillers, Platelet rich plasma therapy, Mesotherapy, Drak circles, Periorbital hyperpigmentation

Abstract

Background: Peri orbital hyperpigmentation (POH) is a common presentation in dermatological outpatient departments and has multiple causes. Finding an appropriate treatment for POH can be challenging and requires case-based approach. The objective of this research was to study the effect of Biofiller Vs Platelet rich plasma meso-therapy in the treatment of Peri-orbital hyperpigmentation. Our hypothesis was “Biofillers are better than platelet rich plasma therapy in the treatment of peri-orbital hyperpigmentation”. It was a double-blinded randomized Control Trial (IRCT20230816059168N1) carried out in the Dermatology OPD of a tertiary care hospital in Rawalpindi over 4 months, i.e., 10.07.23 to 10.10.23. Methods: Forty-two patients meeting the inclusion criteria were included in the study after taking informed consent.  Sampling was done by non-probability randomized sampling using the lottery method. 21 patients were treated with Bio fillers and another 21 by platelet rich plasma therapy (PRP). Sessions with a 2 weeks interval were done in each case and results were analyzed by peri-orbital photo-metric pigmentation scale and clinical grading improvement scale rated by a physician. Patient satisfaction and complications were also recorded. Results: Statistically significant difference in results of Group A as compared to Group B, regarding improvement in photonumeric scale, evaluation of efficacy by a blinded dermatologist and patient satisfaction i.e. p= 0.001, 0.014 and 0.001 respectively. In group A, pain was reported by 3 (14.3%), bruising by 1 (4.76%) and lumps by 2(9.5%).  PRP treated group had more side effects, i.e., 9 (42.8%) reported pain, 6 (28.6%) bruising and 4 (19%) more than one complaint (p-0.001). Conclusion: Biofillers are better than PRP in the treatment of POH.

Author Biographies

Sakina Sadiq, Pak Emirates Military Hospital, Rawalpindi-Pakistan

 

Uzma Bashir, Pak Emirates Military Hospital, Rawalpindi-Pakistan

 

Ayesha Rizwan, Margalla Hospital Taxila-Pakistan

 

Ayesha Anwar, Pak Emirates Military Hospital, Rawalpindi-Pakistan

 

Sibghatullah Rao, CMH Hyderabad-Pakistan

 

Shyna Shahid

 

References

Neinaa YME, Hodeib AAE, Morquos MM, Elgarhy LH. Platelet-poor plasma gel vs platelet-rich plasma for infraorbital rejuvenation: A clinical and dermoscopic comparative study. Dermatol Ther 2020;33(6):e14255.

Freitag FM, Cestari TF. What causes dark circles under the eyes? J Cosmet Dermatol 2007;6(3):211–5.

Gendler EC. Treatment of periorbital hyperpigmentation. Aesthet Surg J 2005;25(6):618–24.

Goodman RM, Belcher RW. Periorbital hyperpigmentation. An overlooked genetic disorder of pigmentation. Arch Dermatol 1969;100(2):169–74.

Roh MR, Chung KY. Infraorbital dark circles: Definition, causes, and treatment options. Dermatol Surg 2009;35(8):1163–71.

Ranu H, Thng S, Goh BK, Burger A, Goh CL. Periorbital hyperpigmentation in Asians: An epidemiologic study and a proposed classification. Dermatol Surg 2011;37(9):1297–303.

Sheth PB, Shah HA, Dave JN. Periorbital hyperpigmentation: a study of its prevalence, common causative factors and its association with personal habits and other disorders. Indian J Dermatol 2014;59(2):151–7.

O’Mahony MM, Sladen C, Crone M, Banner E, Newton VL, Allen A, et al. A validated photonumeric scale for infraorbital dark circles and its application in evaluating the efficacy of a cosmetic treatment product in a split‐face randomized clinical trial. Int J Cosmet Sci 2021;43(1):48–56.

Huang YL, Chang SL, Ma L, Lee MC, Hu S. Clinical analysis and classification of dark eye circle. Int J Dermatol 2014;53(2):164–70.

Mehryan P, Zartab H, Rajabi A, Pazhoohi N, Firooz A. Assessment of efficacy of platelet rich plasma (PRP) on infraorbital dark circles and crow’s feet wrinkles. J Cosmet Dermatol 2014;13(1):72–8.

Buzalaf MAR, Levy FM. Autologous platelet concentrates for facial rejuvenation. J Appl Oral Sci 2022;30:e20220020.

Sultan A. Five-minute preparation of platelet-poor plasma for routine coagulation testing. East Mediterr Health J 2010;16(2):233–6.

Sclafani AP. Safety, efficacy, and utility of platelet-rich fibrin matrix in facial plastic surgery. Arch Facial Plast Surg 2011;13(4):247–51.

Bhatt M, Jamale V, Kale M, Hussain AA, Nikam BP. Monotherapy of Biofiller for Atrophic Acne Scars: A Prospective Nonrandomized Study. J Cutan Aesthet Surg 2022;15(3):260–6.

Prashant MC, Lahoti K, Peswani KC, Mavani AK, Sharma A, Jain M. Nonsurgical Infraorbital Rejuvenation: A Study on the use of Cost-effective Autologous Biofiller. JCLMM 2023;11(1):2099–106.

Gupta S, Borde Bisht P, Kannan C. Bio-Filler: An Effective Facial Rejuvenation Tool-Easy on Pocket. J Cutan Aesthet Surg 2020;13(3):243–6.

Mahesh AR, Arumilli KPP, Kotha S, Alluri R, Lingamaneni BV, Kolalapudi SA. Clinical and Dermoscopic Evaluation of Periorbital Melanosis. J Cutan Aesthet Surg 2022;15(2):154–60.

Nayak CS, Giri AS, Zambare US. A study of clinicopathological correlation of periorbital hyperpigmentation. Indian Dermatol Online J 2018;9(4):245–9.

Mendiratta V, Rana S, Jassi R, Chander R. Study of causative factors and clinical patterns of periorbital pigmentation. Indian Dermatol Online J 2019;10(3):293–5.

Goldman A, Goldust M, Wollina U. Periorbital Hyperpigmentation—Dark Circles under the Eyes; Treatment Suggestions and Combining Procedures. Cosmetics 2021;8(2):26.

Park SR, Kim HJ, Park HK, Kim JY, Kim NS, Byun KS, et al. Classification by causes of dark circles and appropriate evaluation method of dark circles. Skin Res Technol 2016;22(3):276–283.

Fatin AM, Mathana Sundram TK, Tan SSE, Seghayat MS, Lee CK, Rehman N, et al. Classification and characteristics of periorbital hyperpigmentation. Skin Res Technol 2020;26(3):564–70.

Oh SM, Lee YE, Ko MJ, Baek JH, Shin MK. Proposal of facial pigmentary unit and facial hyperpigmentation type for Fitzpatrick skin types II-IV. Skin Res Technol 2023;29(1):e13251.

Roh MR, Kim TK, Chung KY. Treatment of infraorbital dark circles by autologous fat transplantation: a pilot study. Br J Dermatol 2009;160(5):1022–5.

Banihashemi M, Zabolinejad N, Salehi M, Hamidi Alamdari D, Nakhaizadeh S. Platelet-rich Plasma use for facial rejuvenation: a clinical trial and review of current literature. Acta Biomed 2021;92(2):e2021187.

Maslan N, Wan Abdul Halim WH, Din NM, Tang SF. Central retinal artery occlusion and optic neuropathy secondary to platelet rich plasma injection: a case report. Int J Ophthalmol 2021;14(6):945–7.

Hu XZ, Hu JY, Wu PS, Yu SB, Kikkawa DO, Lu W. Posterior ciliary artery occlusion caused by hyaluronic acid injections into the forehead: a case report. Medicine (Baltimore) 2016;95(11):e3124.

King M, Bassett S, Davies E, King S. Management of Delayed Onset Nodules. J Clin Aesthet Dermatol 2016;9(11):E1–5.

Published

2024-02-05