Clinical Response and Safety of Platelet-Rich Fibrin Matrix in Periorbital Wrinkles and Hyperpigmentation: A Prospective Longitudinal Study

Abstract

Introduction: Periorbital wrinkles and hyperpigmentation are frequent aesthetic concerns with multifactorial pathogenesis and variable response to conventional therapy. Platelet-rich fibrin matrix (PRFM) is an autologous platelet concentrate with a fibrin scaffold that may support dermal remodeling.
Methods: A prospective longitudinal interventional study was conducted in 35 recruited patients aged more than 30 years with visible periorbital wrinkles and/or hyperpigmentation. PRFM was prepared from 15 mL of venous blood by immediate centrifugation at 700 rpm for 5 minutes and injected into the subdermal periorbital plane. Four monthly sittings were administered, followed by final assessment 3 months after the last sitting. Serial clinical grading, baseline-final scores, categorical improvement, complete clearance, and side effects were recorded. Friedman and Wilcoxon signed-rank tests were applied.
Results: At baseline, wrinkles were moderate in 18 (51.43%) and severe in 17 (48.57%) patients, while hyperpigmentation was moderate in 16 (45.71%) and severe in 19 (54.29%) patients. Median wrinkle score improved from 2 (IQR, 2-3) to 1 (IQR, 1-2), and median hyperpigmentation score improved from 3 (IQR, 2-3) to 2 (IQR, 1-2) at final follow-up (both p < 0.001). All patients showed one-grade improvement, but complete clearance was not observed. Adverse effects were mild and transient.
Conclusion: In this uncontrolled cohort, PRFM was associated with progressive one-grade reductions in the ordinal severity of periorbital wrinkles and hyperpigmentation, with only mild, transient adverse effects. Controlled studies incorporating blinded, objective outcome assessment are required to establish comparative efficacy and durability.