A prospective interventional cohort study on the effectiveness of autologous platelet-rich plasma (PRP) as a treatment for stable vitiligo

Background: Vitiligo is a common autoimmune disease resulting in patchy depigmentation that can be cosmetically disabling. Conventional modalities often yield inconsistent results, leading to the emergence of autologous Platelet-Rich Plasma (PRP) as a safe, promising alternative. This study aimed to evaluate the effectiveness and safety of PRP as a therapeutic intervention for stable vitiligo, alongside assessing sociodemographic data, comorbidities, and patient satisfaction.
Methods: A prospective study included 22 patients with stable vitiligo (BSA ≤ 1%) at the National Hospital of Sri Lanka. Contralateral or similar lesions served as controls. Participants received intradermal PRP injections every four weeks for four sessions. Patients were monitored monthly during treatment and for three months post-therapy to evaluate repigmentation via VASI scores, lesion diameter, and side effects.
Results: The study population had a mean age of 37 years and a female preponderance (72.7%). Treated patches showed a statistically significant reduction in median diameter from 6.0 cm to 5.9 cm (P = 0.002) and median VASI score from 100 to 90 (P = 0.008). Conversely, control patches showed no significant changes. Reported complications included universal injection-site pain, with rare instances of numbness (4.5%) and bruising (4.5%). While 40% of patients were satisfied with the outcome, 59% were not. 
Conclusions: PRP is a safe, moderately effective adjuvant treatment for stable vitiligo. Although statistically significant improvements occurred in lesion size and VASI scores, clinical benefits remain modest as monotherapy. PRP may hold greater potential when combined with established therapies like NB-UVB or fractional lasers. Further large-scale randomized studies are required to optimize protocols and long-term efficacy.