Platelet-Rich Fibrin (PRF) is a next-generation platelet concentrate, directly derived from autologous blood without anticoagulants. It is rich in platelets and leukocytes, with a slow and sustained release of growth factors, providing optimal conditions for tissue regeneration. In dermatology, PRF is emerging as a safe and effective choice for skin rejuvenation and wound healing.
Platelet-Rich Plasma (PRP) has been widely used across fields ranging from dentistry to dermatology. PRP contains a supraphysiological concentration of growth factors that significantly accelerate healing. Its simple preparation—requiring only a blood draw—helped PRP become a popular product in regenerative medicine.
However, PRP has two major limitations:
Presence of anticoagulants: The release of growth factors is closely tied to the clotting process, which is inhibited by anticoagulants. Hence, there was a need for autologous platelet concentrates without external additives.
Sudden release of growth factors: Nearly 95% of growth factors are released immediately after activation with calcium chloride or bovine thrombin.
These limitations drove the development of second-generation platelet concentrates without anticoagulants, where the fibrin matrix naturally traps platelets and growth factors, allowing their gradual release.
The original research by Dr. Joseph Choukroun and Dr. David Dohan led to PRF preparation without anticoagulants. Blood was centrifuged at 750 g for 12 minutes: red blood cells settled at the bottom, while platelets and leukocytes were trapped in the fibrin clot. This was termed PRF, and due to the essential role of leukocytes in wound healing, it was specifically called L-PRF. The three-dimensional fibrin matrix serves as a biological scaffold and a reservoir of growth factors released for up to 14 days.
Later studies showed that high centrifugal force pushed most leukocytes and platelets to the bottom, leaving fewer in the PRF layer. By reducing the centrifugation speed to 200 g (1300 rpm) and increasing spin duration, more leukocytes and platelets were retained. This was called A-PRF.
A new protocol with an 8-minute spin at the same 200 g speed created A-PRF+, yielding even higher growth factor concentrations.
In dentistry, A-PRF clots can be compressed into membranes or plugs using PRF boxes. These are useful in wound healing, and in dermatology, clots can be directly applied and compressed onto ulcers or wounds for better integration.
PRF produces a higher cumulative release of growth factors than PRP, but solid PRF membranes cannot be injected. Further research found that reducing centrifugation force and time could yield a liquid form, called Injectable PRF (I-PRF).
At 60 g for 3 minutes, blood remains liquid for 15-20 minutes before clotting. I-PRF contains higher concentrations of platelets and leukocytes than both L-PRF and A-PRF. It can be injected into the scalp, face, or mixed with bone grafts.
For clarity, it is recommended:
Mechanism of Action
Leukocytes play a key role through mesenchymal stem cells, stimulating fibroblast proliferation, exerting anti-inflammatory effects, promoting angiogenesis, and enhancing extracellular matrix remodeling (e.g., procollagen deposition).
Fibroblast migration is 350% higher in fluid PRF compared to controls, and 200% higher compared to PRP.
Fluid PRF significantly enhances cell proliferation after 5 days.
Compared with PRP, fluid PRF induces higher mRNA levels of TGF-β, collagen I, and fibronectin, leading to greater collagen synthesis.
Clinical Studies
A study of 11 healthy women receiving I-PRF injections showed significant improvement in skin spots and pores after 3 months, along with high patient satisfaction, and no serious adverse effects.
The Cleopatra Technique, combining I-PRF and A-PRF, demonstrated encouraging results in 34 patients, becoming increasingly popular.
Nanofat + PRF combinations have proven highly effective in facial rejuvenation, significantly improving hydration and long-term skin quality compared to hyaluronic acid (HA) fillers.
Contraindications
Absolute: Platelet dysfunction, critical thrombocytopenia, hemodynamic instability, septicemia, unrealistic expectations.
Relative: Heavy smoking, alcohol/drug abuse, chronic liver disease, severe systemic/metabolic disorders, hematological cancers, anemia (Hb <10 g/dL), platelet count <150,000/µL, recent fever or illness, patients on NSAIDs, corticosteroids >20 mg/day, or anticoagulants.
Procedure Notes
Conducted in a minor OT under aseptic conditions.
~40 mL blood required (only 1-1.5 mL liquid PRF per 10 mL blood).
PRF must be injected immediately (remains liquid only 15-20 minutes).
Skin numbing via topical cream, ice, or nerve blocks.
Injection depth: deep dermal or subcutaneous.
Dosage: ~3-4 mL for full face (0.1 mL per injection site, injected slowly).
Expected post-procedure: mild pain, redness, bruising.
Avoid NSAIDs for 2 weeks, ensure strict sun protection and moisturizing.
Recommended course: 3-6 sessions spaced 4-6 weeks apart. Results appear after 4-6 weeks.
PRF works at the cellular level rather than as a volumizing filler, making it suitable as monotherapy or in combination with fat transfer and HA fillers.
Second-generation platelet products like PRF show significant potential in dermatology. Despite multiple variations in preparation protocols, PRF remains underutilized. More high-quality clinical studies are required to standardize its use in practice.
PRF is not only a technical improvement over PRP but also a new approach in regenerative and aesthetic medicine. Its slow, sustained release of growth factors provides optimal tissue regeneration, overcoming PRP’s limitations such as reliance on anticoagulants and short-term effects.
The success of PRF treatment largely depends on the centrifugation process and device quality. Even small errors in speed or timing can affect yield and growth factor release.
To meet clinical demand for high-quality PRF, VATRACY PRF Isolation Tubes are specifically designed to maximize yield and growth factor concentration:
No anticoagulants, ensuring natural clot formation and a stable fibrin matrix.
Superior efficiency in retaining platelets and leukocytes, enhancing therapeutic outcomes.
Multi-application use: dermatology, dentistry, orthopedics, and reconstructive surgery.
VATRACY PRF Isolation Tubes help standardize PRF preparation, ensuring consistent results, high-quality concentrates, and improved patient satisfaction.
📩 Contact WEMBLEY MEDICAL at info@wembleymed.com.vn- Hotline: (028) 73013688 for consultation and orders.
Reference: NCBI - PMC8664174