: 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 with15 mL 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: PRFM produced progressive, statistically significant, clinically relevant severity reduction in periorbital wrinkles and hyperpigmentation with favorable tolerability. Larger controlled studies with longer follow-up are required to define durability and comparative efficacy.

Keywords: Platelet-rich fibrin matrix; periorbital wrinkles; periorbital hyperpigmentation; periorbital rejuvenation; autologous therapy