Platelet Rich Plasma

Platelet Rich Plasma Therapy or PRP is an emerging treatment in health care to rejuvenate your skin by stimulating collagen, the main component of connective tissue. The therapy improves lines, wrinkles and texture with a gradual natural change. The therapy is also helpful for treating skin conditions and for general skin reconditioning. The most dramatic results so far have been seen with improvement of crepe skin problems in areas such as the neck, under the eyes and décolletage areas.

Platelet-Rich Plasma Therapy is done in the office under ultrasound guidance to ensure accurate placement of the injections. The treatment involves drawing blood from you just in the same way as it is taken for a blood test and then it is spun for around eight minutes in a centrifuge to produce the platelet rich plasma (PRP). The PRP is then drawn into a small syringe and a small amount of calcium chloride is added to it to stimulate the process. The mixture is then injected into clean, anaesthetized skin. For better results, the PRP is injected into the same areas over three sessions which are usually spaced around a month apart.

There are almost no complications of this therapy. However, as with every kind of injection, there is the possibility of slight bruising and appearance of pinkness or redness of the skin, which usually fades away after a week or so.

Understanding Platelet-Rich Plasma (PRP): Types, Applications, and Our Systems

What Is Platelet-Rich Plasma (PRP)?

PRP is a treatment made from your own blood. A small sample of blood is drawn from your arm, placed in a special device, and spun in a centrifuge. This spinning process separates the blood into layers and concentrates the platelets - tiny blood cells that contain natural growth factors and healing proteins. The concentrated platelets are then injected into the injured area to help reduce pain, decrease inflammation, and support your body’s natural healing process.

Because PRP comes from your own blood, the risk of allergic reaction or rejection is extremely low.

How Does the Spinning Process Work?

The centrifuge spins your blood at high speed, separating it into layers based on weight:

• The top layer is plasma (the liquid part of blood).
• The middle layer (called the “buffy coat”) contains platelets and white blood cells.
• The bottom layer contains red blood cells.

There are two main approaches:

• Single spin: The blood is spun once. This is faster and simpler. It produces a moderate concentration of platelets (typically 1.5–3× your baseline blood levels) and tends to collect fewer white blood cells. The final product is usually a larger volume of less concentrated PRP.
• Double spin: The blood is spun twice - first to separate the red blood cells, then again to further concentrate the platelets. This produces a higher platelet concentration (typically 3–7× baseline) but may also concentrate more white blood cells. The final product is a smaller volume of more highly concentrated PRP.

Research suggests that higher platelet concentrations (generally above 3× baseline) may lead to better outcomes, particularly for joint conditions like arthritis. Your doctor will choose the method best suited to your specific condition.

What Are Leukocytes, and Why Do They Matter?

Leukocytes are white blood cells - part of your immune system. PRP preparations are classified as either:

• Leukocyte-Poor PRP (LP-PRP): Contains very few white blood cells. This formulation has lower levels of inflammatory molecules and is generally gentler on tissues. It may cause less soreness after injection.
• Leukocyte-Rich PRP (LR-PRP): Contains a higher concentration of white blood cells. This formulation delivers more growth factors overall but also contains more inflammatory signals. It may cause more short-term soreness or swelling after injection.

Which Type of PRP Is Used for Different Conditions?

The type of PRP your doctor recommends depends on where it is being injected and what condition is being treated:

For Joints (Intra-articular Injections) - Arthritis, Cartilage Injuries:

Leukocyte-poor PRP is generally preferred for joint injections. The joint lining (cartilage) is sensitive to inflammation, and the inflammatory molecules found in white blood cells (such as certain enzymes) may be harmful to cartilage cells. Leukocyte-poor PRP provides the healing benefits of concentrated platelets while minimizing the risk of increased inflammation inside the joint. That said, clinical studies have shown that both types can improve symptoms, and the differences in outcomes between the two are often small.

For Tendons and Ligaments - Tendinitis, Partial Tears, Sprains:

Leukocyte-rich PRP is often preferred for tendon and ligament injuries. Tendons and ligaments have a limited blood supply and heal slowly. The additional white blood cells and growth factors in leukocyte-rich PRP may help “jump-start” the healing process by creating a controlled inflammatory response that recruits your body’s repair cells to the area. Research has shown that leukocyte-rich PRP, injected directly into the tendon under ultrasound guidance, tends to produce the best results for conditions like tennis elbow, Achilles tendinitis, and patellar tendinitis.

The Three PRP Systems Used in Our Practice

Our practice uses three different PRP preparation systems. Each has unique strengths, and your doctor will select the one best suited to your condition.

1. Arthrex ACP (Autologous Conditioned Plasma) System

• How it works: Uses a specially designed double-syringe system with a single spin. About 15 mL (roughly 1 tablespoon) of blood is drawn directly into the device and spun once for about 5 minutes.
• What it produces: A leukocyte-poor PRP with a moderate platelet concentration (approximately 2× baseline). White blood cells are reduced to very low levels. Produces about 4–6 mL of PRP.
• Strengths: Quick and simple preparation. Minimal inflammatory molecules. Low risk of post-injection soreness or swelling.
• Best suited for: Joint injections (knee, hip, shoulder, ankle arthritis), situations where a gentler, anti-inflammatory PRP is desired, and when a quick in-office preparation is preferred.

2. Stryker RegenKit (RegenLab) System

• How it works: Uses a specialized tube containing a separating gel. About 8–10 mL of blood is drawn into the tube and spun once. The gel acts as a barrier to separate the red blood cells from the platelet-rich layer.
• What it produces: A leukocyte-rich PRP with a moderate-to-high platelet concentration (approximately 1.6–3× baseline). The gel traps most red blood cells below but allows white blood cells - particularly monocytes - to pass into the PRP layer. Produces about 4–5 mL of PRP.
• Strengths: Consistent preparation with the separating gel technology. Contains a mix of platelets and beneficial white blood cells. Moderate inflammatory profile.
• Best suited for: Tendon and ligament injuries (tennis elbow, rotator cuff tendinitis, patellar tendinitis), and situations where a moderate level of white blood cells may support healing.

3. Arthrex Angel System

• How it works:A more advanced, automated system that processes a larger volume of blood - typically 40–180 mL. It uses a continuous-flow centrifuge with adjustable settings that allow the doctor to customize the final product.
• What it produces: A highly concentrated PRP with platelet levels approximately 5× baseline or higher. The system allows the doctor to adjust the hematocrit (red blood cell) setting to control the white blood cell content. Even at the lowest settings, it tends to produce a leukocyte-rich product, but with a favorable white blood cell profile (predominantly lymphocytes rather than the more inflammatory neutrophils). Produces about 3–10 mL of PRP depending on settings.
• Strengths: Highest platelet concentration of the three systems. Customizable output. Ability to process larger blood volumes for higher total platelet doses. Ideal when maximum platelet delivery is needed.
• Best suited for: Larger joints or more advanced arthritis where a high platelet dose is important, tendon and ligament injuries that may benefit from a more concentrated product, surgical applications (such as augmenting rotator cuff repairs), and cases where the doctor wants to maximize the total number of platelets delivered.

Quick Comparison of Our Three Systems

What to Expect After Your PRP Injection

• Mild soreness, swelling, or stiffness at the injection site is normal and usually lasts 2–5 days.
• Leukocyte-rich PRP may cause slightly more soreness than leukocyte-poor PRP - this is expected and not a sign of a problem.
• Avoid anti-inflammatory medications (such as ibuprofen or naproxen) for at least 1–2 weeks after the injection, as these can interfere with the healing process. Acetaminophen (Tylenol) and ice may be used for comfort.
• Most patients begin to notice improvement within 4–6 weeks, with continued improvement over 3–6 months.
• Depending on your condition, your doctor may recommend a series of 1–3 injections spaced several weeks apart.

Important Notes

• PRP is not a “cure” - it is a treatment designed to reduce pain and support healing. Results vary from person to person.
• PRP works best for mild-to-moderate conditions. Severe arthritis or complete tendon tears may require other treatments.
• Because PRP is made from your own blood, it is very safe. Serious side effects are rare.
• PRP is generally not covered by insurance. Your doctor’s office can provide information about costs.

If you have questions about which PRP system is right for you, please ask your doctor. The choice depends on your specific diagnosis, the location of your injury, and your treatment goals.

The procedure for platelet rich plasma administration is demonstrated in this video:

Photography courtesy of Dr. Tyler Williamson – Perfect Circles Photography – for more information or to purchase prints please visit – https://perfectcirclesphotography.com/