Question 1

I’m in New Zealand and last year did an O-Shot training with Kirshni. We have just started using the Arthrex ACP PRP

The Arthrex rep told us that no anticoagulant, we didn’t need to add calcium chloride, just checking you agreed with this. I would prefer not to use it, if possible, as it removes an extra step, but also one less ‘foreign’ thing to be injecting the patient with. But obviously, we want the procedure to be as effective as possible.

Could you please advise?

Question 2

I was watching some __ videos, he’s the medical advisor for ___ (who we get exosomes and MSCs from), and he’s very much against the use of lidocaine with PRP and human cells and tissue products.

So do you use lidocaine or the similar when doing lichen treatments?

I’ve always used either topical or usually injected lidocaine without epi when I directly inject PRP/HCTP into the lichen plaques.

I can’t imagine how someone would tolerate my laser without numbing.

Now, I’ve seen stellar results, so the lidocaine didn’t stop the PRP and HCTPs from doing their jobs, just wonder if it would have been a better outcome without the numbing.

Your thoughts?

Answers

In summary

I usually do not activate the PRP for the Vampire Facial®, Vampire Facelift®, or for Hair. I do activate when offering the O-Shot® or P-Shot® (for more complete activation and less diffusion and quicker formation of platelet rich fibrin matrix to hold exactly where injected).

There is a biological basis for concern that lidocaine (and other local anesthetics) could reduce PRP efficacy — lidocaine has been shown in vitro to impair platelet activation and viability, as well as inhibit growth factor release, potentially diminishing the regenerative benefits of PRP.

However, clinical evidence is mixed: while some laboratory studies support the inhibitory effect, several clinical trials using PRP mixed with lidocaine have still shown significant patient improvement, suggesting any negative effect may be smaller in practice or offset by other factors.

• Lab data: Strong evidence that lidocaine impairs platelet function and reduces growth factor release in PRP.
• Clinical data: PRP mixed with lidocaine still shows significant improvements in many trials, suggesting the real-world impact may be less severe.
• Best practice trend: Many regenerative medicine protocols now avoid mixing lidocaine directly with PRP; instead, local anesthetic is injected separately before PRP to avoid direct platelet exposure.

References

Question 1– Should you activate?

Question 2: Can you mix PRP with lidocaine?