Platelet-Rich Plasma: Advances and Controversies in Hair Restoration and Skin Rejuvenation.

BACKGROUND: Platelet-rich plasma (PRP) and its combined therapeutic modalities have catalyzed new possibilities in dermatology; however, limitations in evidence and lack of consensus remain among clinicians regarding optimal composition, protocol, technique, and application. OBJECTIVE: To provide an update and analysis of the evidence for PRP in hair restoration and skin rejuvenation through review of recent available data, highlighting controversies and expert insights to guide future studies, and stimulate discourse and innovations benefitting patients. METHODS: A structured review and expert analysis of PubMed publications before October 2023, with a focus on recent literature from January 2020 through October 2023. RESULTS AND CONCLUSION: Growing literature supports the utility and benefits of PRP and related autologous products for applications for skin and hair, with strongest evidence for androgenetic alopecia and skin rejuvenation. However, this is limited by lack of consensus regarding best practices and protocols. Randomized, controlled trials with uniform metrics comparing outcomes of various compositions of autologous blood products, preparation methods, dosimetry, and frequency of treatments are still required. This will allow the medical discourse to grow beyond the realm of expert opinion into consensus, standardization, and more wide spread adoption of best practices that will benefit patients.

The Burden of Air Pollution on Skin Health: a Brief Report and Call to Action.

INTRODUCTION: Air pollution in North America has intensified due to wildfires in recent years. In 2023, the wildfires in the Canadian province of Quebec caused a southward spread of pollutants, negatively affecting air quality and thereby aggravating certain health conditions in northeastern USA. This study examines the impact of air pollution on atopic dermatitis (AD) and skin health and how wildfires can exacerbate the burden of disease. METHODS: Carbon monoxide levels measured by the U.S. Environmental Protection Agency (EPA) in the Boston region during the months following the Canadian wildfires of 2023 were collected from the U.S. EPA Outdoor Air Quality webpage. Patient records on dermatology clinic visits for dermatitis and eczema at the Mass General Brigham (MGB) hospital system, 300 miles from the wildfires, were examined, and the data compared with data from the corresponding months in 2019-2022 for historical control. No individual patient data were collected. RESULTS: A notable rise and atypical summer peak in carbon monoxide (CO) levels in the Boston region during 2023 correlated with a spike in AD, dermatitis, and eczema-related dermatology clinic visits within the MGB hospital system, as compared with the prior 4 years. CONCLUSION: The synchronized atypical peaks of CO levels and AD-related visits during the summer of 2023 highlight the potential impact of acute air pollution events such as wildfires on air quality and the consequences for skin health. Air pollution, exacerbated by wildfires, can damage the skin through the smoke and chemicals utilized for extinguishing fires, which contain multiple potential allergens and irritants to the skin, such as CO, particulate matter (PM2.5), and ammonium phosphates, triggering airway and skin inflammation and flares of AD. This issue disproportionately affects vulnerable populations, including low-income communities and the geriatric and pediatric populations. Healthcare professionals and government agencies must work together to improve air quality and purification policies and initiatives to lower the burden of skin disease, especially for vulnerable communities.