Vampire facials have been in the news a lot the past day because of a Med Spa in New Mexico. Two patients contracted the same strain of HIV after treatments there, and this is big news because contracting HIV as a result of aesthetic treatment is very serious. Also, given our knowledge about how HIV spreads, this should also be preventable. I personally do not offer the Vampire Facial, or Platelet Rich Plasma Microneedling treatments in my practice, though I do have experience with them, as I performed these during my fellowship training in Facial Plastic and Reconstructive Surgery.
What is the Vampire Facial?
The Vampire Facial involves extracting whole blood from a patient, through the same process you get labs drawn. It is then processed and then used as a part of a microneedling treatment, where it is applied to the skin before and after a microneedling device is used to create multiple “channels”, or needle paths, into the skin to “deliver” the PRP. Though “Vampire Facial” is one trade name, there are many different products that are aimed at microneedling a processed blood product into the skin, each one claiming to have a totally different process and results. “Vampire Facial” is just one product for PRP microneedling, and there are dozens of others in the same market, just as “Xerox” is used as a verb for “photocopy”, even though there are several companies that mane photocopiers.
What is Platelet Rich Plasma (PRP)?
After a given volume of blood is extracted, it is then processed by a centrifuge to remove the red blood cells, leaving the platelets and plasma to be drawn into a syringe and used for a purpose. The idea is that this “platelet-rich plasma” has healing factors and growth factors to guide your body to repair wounds and stimulate collagen production. This is the claim of the PRP microneedling treatments. The claims only escalate from there, and there are additional claims of stimulating hair growth in patients with hair loss, and cartilage growth in joints to prevent and treat arthritis.
Each PRP process is a little different, but there are a few single stage systems out, where you draw blood into a vial, allow it to centrifuge for a few minutes, and then extract the PRP directly. The amount of PRP extracted from 10cc (one vial) of blood is around 6-7cc. That means that the “magic” PRP accounts for up to 70% of the volume of blood, or that regular blood is 70% PRP and 30% blood cells. There are other processes that make claims to purify this farther, giving 1cc of their PRP per 10cc of blood. How do they compare? It’s hard to say because comparing two things like PRP head to head, especially when many people (myself included) don’t believe that any of it works at all, is like comparing the effectiveness of pixie dust from purple fairies vs green fairies.
Does PRP Microneedling, or the PRP Facial, Work?
In my opinion, no. Look up a photo of a famous person after a microneedling treatment. What does their face look like? It looks like red. Blood. Because microneedling involves making holes in the skin with tiny needles, and some of these holes are through and around blood vessels, so they bleed. PRP is actually straw colored and is not red. What this means is that microneedling alone makes blood come to the skin. What does PRP add? Well, it adds “growth factors” that were extracted from your own blood. But the blood is already getting to the area treated. Does the PRP add anything? I haven’t been convinced by several treatments that I did with my own two hands. I never saw results beyond microneedling without PRP.
Also, it does not make sense to me from a scientific level. Let’s use cars as an example. If you are using regular gas, 87 octane, and then you switch to 93 octane gas, which has a 7% higher octane rating, can you expect your car to go twice as fast? No. Your benefit can only be up to 7% higher (and I rounded up to get to 7%, it should read “6.8%”).
So why would we expect PRP, which is 70% of the volume of your own blood, to give a profound boost to your microneedling treatment? Especially when your blood is already reaching the area being treated (as evidenced by the bloody red faces on post-treatment pictures on Instagram)? Well, I think it’s because we like the idea that all we need to use is our own blood. It emotionally feels good.
The biggest reason that the PRP microneedling products like Vampire Facial can make their claims is that microneedling works. It alone works, and it works well. On all skin types. Piggybacking claims of “better results” on a proven, effective treatment is easy, as is a claim that the jockey’s blue hat made the winning horse go a little faster. Common sense would say that the horse was the reason they won, though.
Is It Possible That It Works?
Yes. And this possibility comes from biology, as our blood is more complex than gasoline, and our metabolism is more complex than a combustion engine. This “X factor” comes from biology. If the process of PRP extraction, application, and use, is switching the biology of the PRP so its activity is different, or “activated”, compared to the blood in the body, then it is possible that the effect is a million times stronger or more effective than blood alone. This would involve giving the platelets a signal to release stored growth factors or involve switching proteins or enzymes in the plasma from an inactive state to an active state.
This has never been proven, or shown, by any of the companies marketing PRP. Insurance does not pay for knee injections using PRP, because data has not shown it to work. Just look up the claims that people make about PRP. You would think that surgical knee replacements are a dying breed based on the “successes” of PRP. This is not the case. Surgical knee replacements are rising faster than ever, the only problem is when patients spend lots of money on PRP injections and don’t have enough to afford an actual knee replacement.
In my opinion, if PRP actually worked and lived up to the claims being made, then the results would speak for themselves.
Is PRP Microneedling, or the Vampire Facial, Safe?
Yes. When done using universal precautions for the handling of blood products. The two patients in New Mexico probably thought they were getting a safe treatment. As of today, HIV has no cure (though a few patients have been cured of their disease and there is a possibility on the horizon that we will be able to beat this disease in the future).
The venipuncture set used to draw blood is a single-use kit and everything you need to draw blood in a sterile kit. The blood is processed in single-use vials, and disposable single-use syringes and needles are used to extract the PRP from the vial after it was processed in a centrifuge.
The microneedling needles are single-use, disposable cartridges that attach to a handpiece that can be sterilized (some parts) or sanitized (the battery containing part) between uses. Also, the hand-pieces do not come in contact with the patient, though there is a possibility of this if proper technique is not used.
How Did Patients Get HIV From The Vampire Facial, or PRP Microneedling?
We do not know. This is being investigated, and they may very well find the cause of contamination in the process that was being used at the facility in New Mexico. They may not. They also may find that the HIV was not a result of contamination from a PRP treatment, but some other cause. I will not guess, as information is not available at the time of writing of this article.
If it was from their PRP treatments, though, you can infer that the bottom line is that there was a system in place that allowed cross-contamination of blood products from one patient to another, and then another. This is what we know so far.
Also, you rarely get caught the first time you stick your hand in the cookie jar. There may be more patients, or more diseases, such as Hepatitis B or C, that got spread because of unsafe practices.
My Experience with PRP Microneedling
I performed dozens of microneedling treatments using applied PRP from the patient, as well as injected PRP into deep scars before microneedling treatments when I was in fellowship for Facial Plastic and Reconstructive Surgery. I even used it during facelifts and after laser resurfacing procedures. There was one memorable patient that had deep acne scars, and after a half dozen treatments, I took before and after pictures, and nobody in the office could tell a difference between them. This is a single example, and acne scars are difficult to treat with anything. I also treated patients with general aging face complaints with several treatments, and never had a lasting effect that the patient or I saw that made the PRP worth the additional cost, time, and risk. They later opted for the microneedling without PRP. I never personally profited from any of the treatments I delivered during training, and have not done any since that time.
All of the views in this article are based on my personal views and experience with PRP microneedling. I have not personally used the Vampire Facial or been trained as a provider by them, though I have gone through multiple other microneedling and PRP training sessions from other vendors.