Platelet-rich plasma versus carboxytherapy for the treatment of periocular hyperpigmentation; which approach is superior?

Periorbital hyperpigmentation (POH) is a common aesthetic condition causing people referring to dermatology clinics. Although the therapeutic approach is steeply dependent to the etiology of POH, the gold standard approach of treatment is still a question. The current study is designed to compare the use of carboxytherapy versus platelet-rich plasma (PRP) for the treatment of POH. In the current clinical trial, number of 21 patients with POH underwent carboxytherapy in one side of the face and PRP therapy on the other side. SPSS software version 22 was used with independent T-test, Chi-square, and ANOVA for analytics. Carboxytherapy was performed by intradermal injection of 5 cc carbon-dioxide gas once weekly for 6 weeks. The PRP treatment was performed by intradermal injection of PRP in periorbital space using an insulin syringe every 2 weeks for three times. The periorbital darkness was assessed using visual analogue scale preoperatively and within 8 weeks postoperatively by the patients and the dermatologists. Automatic assessments of skin vascularity and pigmentation were assessed using a digital camera. The patients represented significant darkness improvement postoperatively for both of the approaches (p value: 0.84, p value: 0.87), while the comparison of the two groups revealed insignificant postoperative changes by dermatologists assessments (p value = 0.59, p value: 0.61), the patients' assessments (p value = 0.85), the digital camera skin vascularity and pigmentation assessments (p value > 0.05). Conclusion: Although insignificant changes following both of the approaches were found, it may have occurred due to the technique, quality of material, or inadequate treatment sessions due to the type of Iranian skin; therefore, more evaluations considering particular entities such as vascularity for longer duration of follow-up and new design are strongly recommended.