Comparison of Two Anticoagulants for Pain Associated with Platelet-Rich Plasma Injections

  • Metin GörgüEmail author
  • Ali Gökkaya
  • Ali Doğan
Original Article Non-Surgical Aesthetic


Background and Aim

Platelet-rich plasma (PRP) has long been used in skin rejuvenation and hair loss treatment. Some patients require multiple intradermal injections into the face and scalp, and the way in which these patients process and experience pain differs, depending on the patient. Minimizing pain and discomfort during nonsurgical procedures is essential for patient satisfaction. In our experience, the use of acid citrate dextrose-A (ACD-A) as an anticoagulant caused more patient discomfort than did sodium citrate (Na-citrate) among patients who underwent facial rejuvenation with PRP. The aim of the present study was to evaluate patient-related discomfort in PRP sessions using two different anticoagulants.

Materials and Methods

This clinical trial included 10 patients who received facial PRP injections for facial rejuvenation and 10 patients who received PRP injections in their scalps for hair loss. On the application area, half the surface was treated with Na-citrate PRP injections, and the other half was treated with the same amount of ACD-A PRP injections. Neither the doctors who applied the treatment nor the patients were given information about which anticoagulant was used in each area. Immediately after the procedure, the patients were asked to score their pain on each side of the application area on a scale of 1–10 using a visual analog scale (VAS).


PRP injections using Na-citrate as an anticoagulant caused less discomfort on both the face and scalp as compared with that of ACD-A. The outcome was statistically significant.


Anticoagulants used in PRP preparation affected patients’ pain perceptions during the injections. The sensation of pain with PRP prepared with Na-citrate as an anticoagulant was lower than that of PRP prepared with ACD-A. Further studies are required to evaluate the correlation between anticoagulants used for PRP preparation and pain feelings during injections.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


PRP Platelet-rich plasma Anticoagulant Pain 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

This study has Bolu Abant Izzet Baysal University Clinical Researches Ethics Committee Approval (2019/99).

Informed Consent

All participants signed an informed consent forms for this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Department of Plastic, Reconstructive and Aesthetic SurgeryAbant Izzet Baysal UniversityGölköy, BoluTurkey

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