Comparison of platelet-rich plasma efficacy with and without photoactivation in melasma: A randomized double-blind study

Background: Photoactivation has been suggested to enhance the efficacy of platelet-rich plasma (PRP) in conditions other than dermatological diseases. Aims: To evaluate the efficacy of photoactivated PRP (P-PRP) treatment for melasma by comparing it with non-photoactivated, classical PRP (C-PRP). Methods: The study consisted of 38 female patients diagnosed with melasma between April 2022 and May 2023. The patients were randomized into the P-PRP and C-PRP groups. Three sessions of P-PRP or C-PRP were applied to the patients at 2-week intervals. The Melasma Area and Severity Index (MASI) and Melasma Quality of Life Index (MELASQoL) scores were compared before and 2 weeks after treatment. Results: The median age was 38 years, and the median disease duration was 60 months. Clinically, 94.7% of the cases were centrofacial and 5.3% were malar. According to Wood's lamp examination, 55.3% of the cases were epidermal, 13.2% were dermal, and 31.6% were mixed-type. The median pre- and post-treatment scores were 14.5 and 9, respectively, for MASI and 36.5 and 17, respectively, for MELASQoL. The post-treatment MASI and MELASQoL scores of both groups significantly decreased (p < 0.001 for both). However, the intergroup difference was not significant. When all patients were evaluated together a moderate, positive, and significant relationship was detected between PRP and the pre- and post-treatment MASI and MELASQoL scores (r = 0.494 and p = 0.002). No side effects associated with PRP were observed. Conclusion: PRP is an effective and safe treatment method for melasma. Further studies are needed to evaluate the contribution of photoactivation to PRP treatment in melasma.