Efficacy of vitamin C solution versus platelet-rich plasma after microneedling in treatment of periorbital hyperpigmentation: a split face clinical and three dimensional Antera camera comparative study

Background Periorbital hyperpigmentation (POH) is a prevalent dermatological issue and a matter of aesthetic significance, as it may represent the individual as sad, tired, stressed, or old. Many treatment modalities are found; however, none are satisfactory and no clear guidelines are available. We aimed at our study to compare and evaluate the therapeutic efficacy, side effects, and patient satisfaction of combining microneedling followed by vitamin C 20% solution versus microneedling followed by platelet-rich plasma (PRP) in treating patients with pigmented type of POH, in a split face comparative study. Patients and methods This prospective split-face comparative study included 30 female patients with POH. All patients were treated with microneedling over the infraorbital area, followed by PRP on the right side and vitamin C solution 20% on the left side. The procedure was carried out for four sessions 2 weeks apart then follow-up was done 2 weeks after the last treatment session. Assessment of treatment response was done by percent of improvement in darkness grade and Antera three dimensional camera changes. Also, patient satisfaction and side effects were reported. Results Our study showed that both vitamin C and PRP showed moderate improvement (25–50%) and there was no statistically significant difference between either treatment modality regarding the outcome assessed by clinical improvement, Antera camera, patient satisfaction, or pain scale. Conclusion Both vitamin C solution and PRP applied following microneedling sessions are safe, effective modalities for treatment of POH with great patient satisfaction and very few side effects.