Efficacy and tolerability of using platelet-rich plasma versus chemical peeling in periorbital hyperpigmentation.

Background: Various therapeutic modalities for periorbital hyperpigmentation (POH) have been proposed.
Objective: This study was designed to compare the efficacy and tolerability of autologous platelet-rich plasma (PRP) and chemical peeling in POH.
Subjects and Methods: Forty-two patients were enrolled in this study and randomly subdivided into two groups. Group A patients were assigned to receive four sessions of chemical peeling using trichloroacetic acid and lactic acid, while group B was assigned to patients who received four sessions of PRP injection with 2 weeks of intervals. Patients were assessed by digital photographs. The degree of improvement included four degrees from poor to excellent, and side effects were reported.
Results: Females constituted 38 out of 42 patients (mean age, 28.14 ± 3.47 years). There was a significant improvement in favor of chemical peeling over PRP. Good improvement occurred in 47.6% in the group A versus 4.8% in group B (P < 0.001). None of the PRP group had excellent improvement, while 38% of chemical peeling group did. Most of group A patients reported very pleased (47.6%) to excellent (38%) degree, in contrast to group B where 52.5% were just pleased (P < 0.001). Some of group A patients experienced itching (14.3%) and redness (14.3%), while in group B, they experienced pain (23.8%) and edema (14.3%) with nonsignificant difference between both groups (P = 0.07).
Conclusions: Both PRP and chemical peeling are effective for treatment of POH; however, chemical peeling is much more effective, tolerable, and satisfying procedure than PRP.
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