By Alexander E. Bonato, MD — Board-Certified in Internal Medicine · Medically reviewed October 2026.
TL;DR: Platelet-rich plasma (PRP) is prepared from your own blood and used for selected skin concerns, sometimes alongside microneedling. Studies suggest possible benefits, but preparations and outcomes vary, and the overall facial-rejuvenation evidence remains uncertain. Under-eye studies report patient satisfaction and some improvement in pigmentation, with mixed wrinkle and texture results. Your own blood does not make a procedure risk-free, and PRP, PRF and PRFM should not be treated as interchangeable.
Every couple of weeks, I cook my two dogs a batch of from-scratch, all-natural meals — real ingredients, carefully portioned, the whole production. They eat, without exaggeration, better than most humans I know. There's a special irony in this, because I'm an evidence-based physician who reflexively rolls his eyes at the words “all-natural” on a product label — and yet I currently have exactly two clients on a bespoke all-natural meal plan. Both are dogs. Both are thriving. The hypocrisy is total, and I've made my peace with it.
I mention the dogs' enviable diet because it lets me segue — clumsily, as is tradition — into a treatment that genuinely is about as “all-natural” as aesthetics gets: platelet-rich plasma, or PRP. You've probably heard of it for hair (I've written about that ), but it does more. I'm a board-certified physician (internal medicine by training) at Bonato MD Aesthetics in Medford, and here's the honest evidence for PRP on your skin and under your eyes — because it's made from your own blood, which is a strong start, but “natural” and “proven” are not the same word.
What PRP Actually Is
The concept is elegantly simple. We draw a small amount of your blood, spin it in a centrifuge to separate out and concentrate the platelets — the cells packed with growth factors your body uses to heal — and then deliver that concentrated plasma back into your skin, either by injection or by pressing it in alongside microneedling. Those growth factors signal your skin to do what it does during repair: build collagen, improve blood supply, and refresh tissue. The blood comes from you, but the preparation can include an anticoagulant or other additives. At our clinic, I use Cellenis PRP and calcium-chloride activation when preparing PRFM. “Autologous” describes the source of the blood; it does not mean additive-free or risk-free.
What It's Used For on Your Skin
● Overall facial rejuvenation — a gradual improvement in texture, tone, and fine lines, aiming for “fresher,” not “done.”
● Acne scars — where it's especially useful paired with microneedling (more on that below).
● Under-eye circles and texture — the delicate infraorbital area, where studies suggest PRP may help pigmentation (those bluish-brown dark circles) and skin quality.
● A microneedling companion — added to a microneedling session to boost the result and calm the skin afterward.
The Honest Evidence (This Is the Important Part)
Here's where I have to be a good doctor rather than a good salesman. There is a lot of published research on PRP for the face — one systematic review pulled together 36 studies covering more than 3,000 patients, and the large majority reported improvement. That sounds great until you look closer: most of those studies were small and uncontrolled, used wildly different PRP preparations, and measured “success” in inconsistent ways. When researchers did the most rigorous thing — an umbrella review that grades the quality of all those reviews together — the sober conclusion was that the evidence is low-certainty and currently insufficient to draw firm conclusions.
I don’t share that to talk you out of PRP. I share it because you deserve the real picture. Some patients benefit, but the science is suggestive rather than settled. Anyone selling it as a clinically proven powerhouse is rounding way up. The preparation, treatment area and outcome being measured all matter.
Under-Eyes: Where PRP Gets Interesting
Dark circles have different causes, including pigment, visible vessels, thin skin, hollowing and shadows. A treatment aimed at one cause may do little for another.
There is a dedicated body of under-eye research—not just one small study. A 2026 systematic review included 26 PRP and PRF studies. Patient satisfaction was generally high, but improvement in pigmentation was moderate, wrinkle and texture findings were mixed, and differences in preparation limited clear conclusions.
PRP, PRF and PRFM are related preparations, not interchangeable names. The PRF preparations described in this literature differ from the calcium-chloride-activated PRFM I prepare from Cellenis PRP. Results from another preparation should not be presented as proof of the same outcome with ours.
That makes assessment more useful than a promise: what is causing the dark circles, what improvement is realistic, and does this treatment fit the problem? Durability remains uncertain, and neither complete clearance nor superiority over another treatment is established.
The Microneedling Combo (Where It Shines Most)
If there's one place the evidence and the real-world experience line up nicely, it's PRP plus microneedling. The idea is tidy: microneedling creates the tiny channels and the healing signal, and the PRP pours growth factors right into that healing process. Some studies suggest additional improvement in acne scars when PRP accompanies microneedling, but the studies use different preparations and protocols. An added benefit is possible, not guaranteed, and faster recovery should not be promised. I discuss PRP as an optional addition based on the concern being treated, its evidence and its additional cost. A topical serum is the other optional add-on, and I cover those in exosomes for skin.
If you're already considering microneedling — say, for acne scars — adding PRP is one of the more sensible upgrades on the menu.
Is It Safe?
Using your own blood does not eliminate treatment risks. Pain, bruising, swelling, redness and tenderness can occur after treatment.
Published case reports also describe infections, allergic or inflammatory reactions, and vision loss following facial PRP injections. These reports do not establish how frequently those complications occur or provide a complication rate for our clinic.
Preparation additives, sterile handling, injection technique and individual medical history all matter. A closed preparation system does not eliminate procedural risk.
Before recommending treatment, I review your history and discuss the proposed preparation, alternatives, expected recovery and relevant complications. “Natural” is a description, not a safety guarantee.
What a PRP Session Is Actually Like
The appointment is far more low-key than the “vampire facial” nickname suggests. We start with a simple blood draw — the same as any routine lab — and spin it in a centrifuge for a few minutes to separate out the platelet-rich layer. While that's happening, we numb the treatment area. Then we either inject the plasma into the target zones or apply it during microneedling, pressing those growth factors into freshly opened channels. Start to finish, it's usually under an hour. Afterward, expect some redness, minor swelling, and occasionally a little bruising — especially under the eyes, which bruise at the slightest provocation — that settles over a few days. Most people head straight back to normal life, sunscreen on.
Who It's Best For
PRP may suit someone seeking gradual improvement in selected skin concerns, provided the assessment supports that choice. Under-eye pigment, hollowing and shadowing require different considerations. Significant volume loss or a desire for dramatic change may call for another approach.
Frequently Asked Questions
Does it hurt?
There's a quick blood draw, and then either injections or microneedling — we numb the area first, and most people find it very manageable. The vampire-facial nickname is scarier than the actual appointment, which is mostly you sitting there while your own blood does the heavy lifting.
How many sessions will I need?
Typically a short series — often around three, spaced weeks apart — with occasional maintenance afterward. Like most regenerative treatments, it builds gradually rather than transforming you in one visit.
When will I see results?
Gradually, over several weeks to a few months as your skin responds and builds collagen. If you're expecting a dramatic next-day change, PRP will disappoint you; if you're expecting a natural, slow freshening, it's more likely to please.
Is it better than filler for under-eyes?
Neither is universally better. Filler is used to address selected volume deficits; PRP is studied for concerns including pigmentation and skin quality. Both involve procedural risks, and available research does not establish that PRP is always the safer or more effective option. The choice depends on the cause of the concern and your individual assessment.
Will PRP get rid of my dark circles completely?
Honestly, probably not completely — expect improvement, not erasure, and know that dark circles have several causes (pigment, thin skin, hollowing, shadows) that no single treatment fixes. I'd rather set that expectation than oversell it.
Let's Talk About Whether PRP Fits You — in Southern Oregon
PRP may be worth considering for selected concerns, with realistic expectations and a clear discussion of its evidence and risks. At Bonato MD Aesthetics, we help patients from Medford, Ashland and Grants Pass decide whether PRP, microneedling, a combination or another approach fits their goals.
See our PRP and regenerative treatments.
Book a consultation and we'll give you the honest read — including when a simpler (or different) treatment would serve you better.
References
1. Xiao H, Xu D, Mao R, Xiao M, Fang Y, Liu Y. Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Appraisal of the Available Clinical Evidence. Clin Cosmet Investig Dermatol. 2021;14:1697–1724. https://doi.org/10.2147/CCID.S340434
2. Cruciani M, Masiello F, Pati I, et al. Platelet rich plasma for facial rejuvenation: an overview of systematic reviews. Blood Transfus. 2024;22(5):429–439. https://doi.org/10.2450/BloodTransfus.730
3. Sollitto CF, Narduzzi M, Wolinsky C. A Systematic Review of Platelet-Rich Plasma Versus Platelet-Rich Fibrin for Periorbital Rejuvenation. J Cosmet Dermatol. 2025;24(11):e70524. https://doi.org/10.1111/jocd.70524
4. Tai K, Morrissette M, Li JH, et al. Platelet-Rich Plasma and Platelet-Rich Fibrin in Periorbital Esthetics: Systematic Review and Clinical Applications. Facial Plast Surg Clin North Am. 2026;34(3):365–394. https://doi.org/10.1016/j.fsc.2026.04.001
5. Arita A, Tobita M. Adverse events related to platelet-rich plasma therapy and future issues to be resolved. Regen Ther. 2024;26:496–501. https://doi.org/10.1016/j.reth.2024.07.004
