ORIGINAL ARTICLE NON-SURGICAL AESTHETIC Comparison of Two Anticoagulants for Pain Associated with Platelet-Rich Plasma Injections Metin Go ¨rgu ¨ 1 • Ali Go ¨kkaya 1 • Ali Dog ˘an 1 Received: 17 June 2019 / Accepted: 3 November 2019 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019 Abstract Background and Aim Platelet-rich plasma (PRP) has long been used in skin rejuvenation and hair loss treatment. Some patients require multiple intradermal injections into the face and scalp, and the way in which these patients process and experience pain differs, depending on the patient. Minimizing pain and discomfort during nonsurgi- cal procedures is essential for patient satisfaction. In our experience, the use of acid citrate dextrose-A (ACD-A) as an anticoagulant caused more patient discomfort than did sodium citrate (Na-citrate) among patients who underwent facial rejuvenation with PRP. The aim of the present study was to evaluate patient-related discomfort in PRP sessions using two different anticoagulants. Materials and Methods This clinical trial included 10 patients who received facial PRP injections for facial rejuvenation and 10 patients who received PRP injections in their scalps for hair loss. On the application area, half the surface was treated with Na-citrate PRP injections, and the other half was treated with the same amount of ACD-A PRP injections. Neither the doctors who applied the treat- ment nor the patients were given information about which anticoagulant was used in each area. Immediately after the procedure, the patients were asked to score their pain on each side of the application area on a scale of 1–10 using a visual analog scale (VAS). Results PRP injections using Na-citrate as an anticoagu- lant caused less discomfort on both the face and scalp as compared with that of ACD-A. The outcome was statisti- cally significant. Conclusion Anticoagulants used in PRP preparation affected patients’ pain perceptions during the injections. The sensation of pain with PRP prepared with Na-citrate as an anticoagulant was lower than that of PRP prepared with ACD-A. Further studies are required to evaluate the cor- relation between anticoagulants used for PRP preparation and pain feelings during injections. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords PRP Á Platelet-rich plasma Á Anticoagulant Á Pain Introduction PRP is applied in a variety of areas for treatment, as it is autologous and physiological, with no blood-related infection risks after application or side effects. PRP applications consist of multiple injections and sessions. As noted earlier, the pain felt during PRP injections may cause patient discomfort and decrease patient tolerance. In such cases, although a patient may complete the first treatment session, the patient may be reluctant to continue with subsequent sessions, despite the desire for a pleasing aes- thetic outcome. & Metin Go ¨rgu ¨ metingorgu@gmail.com Ali Go ¨kkaya dragokkaya@gmail.com Ali Dog ˘an dr.alidogan90@gmail.com 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Abant Izzet Baysal University, 14280 Go ¨lko ¨y, Bolu, Turkey 123 Aesth Plast Surg https://doi.org/10.1007/s00266-019-01541-z