PRF or PRP. Is Platelet-Rich Fibrin the Better Treatment, or Just the Newer One

Key points

• A 2025 systematic review and meta-analysis in Dermatology and Therapy of 43 randomised controlled trials and 1,877 participants found activated PRP increased hair density and reduced recurrence compared with placebo, which is the evidence base PRF is measured against.

• A 2022 comparative study in Archives of Dermatological Research tested fluid PRF, alone or with needling, against PRP for atrophic acne scars and found both improved scarring, with PRF's slower growth factor release the theoretical advantage rather than a demonstrated one.

• A triple-blind randomised trial comparing PRF with PRP for microneedling treatment of facial photoageing, registered at Chang Gung Memorial Hospital, was not yet recruiting in 2025, which is a measure of how new the direct comparison is.

• The 2025 meta-analysis found non-activated PRP carried more adverse effects than activated PRP, and PRF is by definition non-activated, since the clot forms on its own without calcium or thrombin.

If you have been offered PRF as a better version of PRP, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will tell you what the difference would mean for your treatment.

What PRF actually is

Both products start with your own blood. PRP is drawn into a tube containing an anticoagulant, spun at a higher speed to separate the platelet-rich layer, and usually activated with calcium chloride or thrombin before injection so the platelets release their growth factors. PRF is drawn without anticoagulant and spun at a lower speed for a shorter time. Because nothing stops the blood clotting, a fibrin matrix forms during the spin, trapping platelets and white cells inside it. The result is either a solid clot used in surgery or, with a shorter spin, a liquid that stays injectable for around 15 minutes before it sets.

The argument for PRF rests on 2 points. It contains no additive, so nothing foreign is injected. And the fibrin scaffold releases growth factors gradually over several days, whereas activated PRP releases most of its growth factors within the first hour. Laboratory studies support both points. What the laboratory does not show is whether a slower release produces a better result in a scalp or a face, and that is the question the trials have to answer.

What the evidence shows for skin

The clearest comparison is a 2022 study in Archives of Dermatological Research from Zagazig University, which evaluated fluid PRF, alone or combined with needling, against PRP in the treatment of atrophic acne scars. Both improved the scars. The authors framed PRF's higher cumulative and prolonged growth factor release as the reason it might be preferable, and the study is a comparison of 3 protocols rather than a blinded randomised trial. For microneedling and PRP in acne scars more broadly, a 2022 meta-analysis in Frontiers in Medicine of 14 controlled studies and 472 patients found adding PRP to microneedling nearly tripled the odds of more than 50 percent improvement. No equivalent pooled analysis exists for PRF.

The direct randomised comparison for facial rejuvenation has been designed but not run. A triple-blind, split-face trial at Chang Gung Memorial Hospital will give each patient 3 sessions of microneedling a month apart, with PRF on one side of the face and PRP on the other, judged by blinded assessors and imaging. It was registered as not yet recruiting. When it reports, patients will have an answer. Until then, a clinic that tells you PRF is proven better for the face is ahead of the trial that would prove it.

Send us a photograph of the area you want treated on WhatsApp and a doctor will tell you which preparation the evidence supports for it.

What the evidence shows for hair

For hair loss the position is simpler and less flattering to PRF. PRP has the 2025 meta-analysis of 43 randomised trials and 1,877 participants, with a consistent increase in hair density against placebo and pooled gains of around 27 to 36 hairs per square centimetre in earlier analyses. PRF for hair has case series and small studies. There is no randomised trial comparing PRF with PRP for androgenetic alopecia that has been published with results, and no meta-analysis of PRF for hair at all.

One finding in the 2025 meta-analysis cuts against PRF in the scalp specifically. Activated PRP increased density and reduced recurrence, whereas non-activated PRP was associated with a higher frequency of adverse effects. PRF is by definition non-activated, since no calcium or thrombin is added and the clot forms on its own. That does not prove PRF is worse for hair. It means the one large dataset on preparation method points towards activation, and PRF is the preparation that omits it. A clinic offering PRF for hair as the superior option should be asked which trial supports that, and the honest answer is none.

Where PRF is the better choice

PRF has real advantages in specific settings, and a fair comparison says so. The absence of any additive matters to patients who want nothing foreign injected, and PRF's clot form is well established in oral and periodontal surgery, where it has been used for wound healing for years. For under-eye treatment PRF has become popular because its slower release and gel-like consistency are thought to give a gentler, more gradual improvement in crepey skin, and some doctors prefer it there for that reason.

The trade-off is practical. Liquid PRF must be injected within about 15 minutes of preparation, so it suits small areas treated in one sitting and does not suit a large scalp session. Its platelet concentration is generally lower than a well-prepared PRP, because the gentler spin concentrates less. And every claim of superiority currently rests on laboratory release curves rather than patient outcomes. A doctor who offers both should be choosing by area and by evidence, using PRP for the scalp where the trials are, and considering PRF for delicate facial areas where a slower release is plausibly useful and the harm of being wrong is small.

Six questions before choosing PRF over PRP

Take these to whichever clinic you see, including ours.

• What is the platelet concentration of the PRF being offered, and how does it compare with the clinic's PRP.

• For my area, which published trial shows PRF outperforming PRP. For hair the answer is none.

• Is the PRF liquid and injected within 15 minutes of preparation, or has it been left to set.

• Is PRF being offered because it suits my area, or because it is priced higher.

• If this is for hair, why is a non-activated preparation being recommended when the largest meta-analysis favoured activated PRP.

• Who is performing the treatment, and are they a GMC-registered doctor.

Our doctors put it this way. PRF is a good idea that has not yet been tested properly. For the face it is a reasonable choice. For the scalp it is the newer product with the smaller evidence, and newer is not a clinical argument.

Message us on WhatsApp with the area you want treated and any quote you have been given, and a doctor will give you a straight answer.

What PRF does not do

PRF does not have a randomised trial showing it beats PRP for hair loss, and no meta-analysis supports it for any indication. It does not concentrate platelets as highly as a well-prepared PRP, and it cannot be stored or used across a long session because it sets. It is non-activated, which the largest PRP meta-analysis associated with more adverse effects. It does not regrow hair from bald scalp, does not replace minoxidil or finasteride, and is not available on the NHS. Where a clinic charges more for PRF than PRP, the extra money is buying a theory.

What PRF and PRP cost in London

Flagship Harley Street and Mayfair clinics commonly charge £600 to £850 or more per session of hair PRP, and doctor-led under-eye work runs £400 to £850 per session or course. PRF is typically listed at a similar or higher price than PRP at the same clinic, and under-eye combinations of PRF with polynucleotides or exosomes are advertised in central London at £450 to £700 and above.

The reframing is what the price is buying. When PRF costs more than PRP at the same clinic, the difference pays for a preparation with a lower platelet count, a shorter working time and a smaller evidence base, on the strength of a laboratory release curve. For the face that may be a reasonable purchase. For hair it is paying extra to move away from the evidence.

Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship rates, with your exact figure confirmed at the free suitability review once a doctor has decided which preparation, if either, suits your area.

Ask about the cost for your treatment on WhatsApp and we will explain what the review covers.

The free suitability review

Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registered doctor assesses the area, the cause of the problem and what you want from treatment, and gives one of two answers. Either you are approved for treatment, with a named preparation and the reason for choosing it, a clear plan and realistic expectations, or you are not approved, with an honest explanation of what would serve you better.

We decline a meaningful share of the people who enquire. That is deliberate. A clinic that approves everyone is optimising for bookings, not outcomes.

Why people choose The London PRP Clinic by The Wellness

• An 87 percent patient success rate across treatments.

• A 32 percent average density increase reported in our hair restoration programme.

• More than 187 five star reviews.

• Every treatment performed by a GMC-registered doctor.

• 100 supervised treatments completed by every clinician before they treat a patient here unsupervised.

Frequently asked questions

What is the difference between PRF and PRP

PRP is spun faster with an anticoagulant and usually activated before injection, releasing growth factors quickly. PRF is spun slower without anticoagulant, forming a fibrin scaffold that releases growth factors over days. PRF has no additive and a lower platelet concentration, and must be injected within about 15 minutes.

Is PRF better than PRP for hair loss

No trial shows that. PRP has 43 randomised trials and 1,877 participants behind it in a 2025 meta-analysis. PRF for hair has small studies and no randomised comparison with PRP. The meta-analysis also favoured activated PRP, and PRF is non-activated by design.

Is PRF better than PRP for the face

Unproven either way. A 2022 comparative study found both improved acne scars, and a blinded split-face randomised trial for photoageing has been designed but had not started recruiting. Some doctors prefer PRF for delicate areas such as under the eyes because of its slower, gentler release.

Is PRF more natural than PRP

PRF contains no additive, which is its main practical advantage, whereas PRP uses an anticoagulant and usually an activator. Both come entirely from your own blood. Natural does not mean more effective, and the larger evidence base sits with PRP.

Does PRF last longer than PRP

In the laboratory PRF releases growth factors over several days rather than within the first hour. Whether that translates into longer lasting results in patients has not been shown in a randomised trial for any indication.

Should I pay more for PRF

Only if a doctor can explain why it suits your area better than PRP. For hair there is no evidence to justify a higher price. For the face it is a reasonable preference rather than a proven upgrade, and the price should reflect that.

References

• Dermatology and Therapy, 2025. Platelet-rich plasma in the management of alopecia, a systematic review and meta-analysis of 43 randomised controlled trials and 1,877 participants, including the finding on activated versus non-activated PRP. https://link.springer.com/article/10.1007/s13555-025-01542-8

• Archives of Dermatological Research, 2022. Diab et al. Fluid platelet-rich fibrin versus platelet-rich plasma in the treatment of atrophic acne scars, a comparative study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205840/

• Frontiers in Medicine, 2022. Kang and Lu. Combined effect of microneedling and platelet-rich plasma for the treatment of acne scars, a meta-analysis of 14 controlled studies and 472 patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882957/

• Clinical trials registry NCT06452667. Platelet rich fibrin versus platelet rich plasma for microneedling treatment of facial photoaging, a double-blind randomised controlled study, Chang Gung Memorial Hospital. https://clinicaltrials.gov/study/NCT06452667

• 2022. Effectiveness of platelet-rich plasma therapy in androgenic alopecia, a meta-analysis of 17 trial groups. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953144/

• 2024. Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia, a systematic review and meta-analysis of 14 studies and 431 patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551241/

• London clinic price lists for hair PRP, PRF and under-eye combinations, accessed September 2026.