A bibliometric analysis of trends in the application of platelet‐rich plasma in cosmetics research between 2001 and 2022

Several studies have been conducted on using platelet‐rich plasma (PRP) to treat cosmetic issues. Nonetheless, no bibliometric analyses of publications in this field exist. Bibliometrics is an effective tool for methodically assessing the current state of research on a particular topic. This study examines the literature published in this field since 2000 and depicts the resulting network.


| INTRODUC TI ON
Platelet-rich plasma (PRP) is an autologous blood product composed of a platelet concentration recovered by centrifugation from autologous blood. 1 PRP contains nearly three times as many platelets as whole blood. 2 Platelets can release a variety of growth factors after activation, including platelet-derived growth factor (PDGF), transforming growth factor 1 (TGF 1), transforming growth factor 2 (TGF 2), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (BFGF), and epidermal growth factor (EGF). [3][4][5] Together, these growth factors and cytokines play a key role in cell proliferation, migration, differentiation, and angiogenesis.Furthermore, they stimulate the formation of collagen and extracellular matrix components, which aid in skin repair and regeneration as well as effectively improve skin barrier, immune, stress, and other physiological functions. 6,7][9][10][11][12][13] Since the first publications in this area in 2001, several researchers have discussed the benefits of PRP in clinical aesthetic treatments, but a systematic analysis of previous research and forecasting of future trends is still lacking.
Bibliometric analysis is a quantitative analysis of academic publications that identify research gaps, evaluates the quality and effect of research output, and informs strategic decision-making.To the best of our knowledge, no bibliometric research on the therapeutic application of PRP in aesthetics has been conducted.Hence, we conducted this study to examine publications from the previous 22 years in order to demonstrate research trends, highlight papers, high-impact authors, and institutions in this field, and forecast the future of PRP application in cosmetic issues.

| Exclusion criteria
(1) Due to the limitations of the analysis software, this study only included English-language literature for analysis.
(2) Taking into account the influence of literary different type on the capacity and transmission of knowledge, text types such as books, editor material were excluded.
(3) Two independent researchers review the retrieved data to ensure that no duplicate information or completely irrelevant literature is included.

| Bibliometric analysis software
(1) Microsoft Excel 2019 was employed to compute the frequencies and proportions of published materials, and the results were recorded in a spreadsheet.
(2) A visual examination of bibliometric networks was conducted utilizing VOSviewer (version 1.6.18)and CiteSpace (6.1R6).In accordance with the software user manuals, the analysis was performed on bibliographic data, specifically focusing on co-occurrence analysis of "authors", "organizations", and "countries".
(3) Citation metrics and the temporal distribution of publications were assessed using RStudio, with a primary focus on data analysis and visualization facilitated by the R-tool "bibliometrix" (https:// www.bibli ometr ix.org).

| Trends in global publications
After removing books, editorials, a total of 306 articles remained (Table .1).In 2001, the first paper on the use of PRP in cosmetic treatments was published.The number of articles in this subject has steadily increased over the subsequent 22 years.(Figure 2).PRP is gaining popularity among researchers, and several basic scientific studies and clinical trials are currently underway.From 2001 to 2010, fewer than 10 papers per year were published on the subject, as shown in Figure 2, after; 2018, the yearly production increased to more than 30.The annual growth rate is approximately 15.87%; this increase may be attributed to the discovery of PRP's potential for tissue regeneration, which shifted the focus of research from fundamental scientific study to cosmetic therapy.2019 was the first yearly publishing production peak with 38 items.Despite a slight decrease over the previous 2 years, it remained extremely high.

| Analysis of authors and cited authors
In total, 1363 writers contributed to the 306 articles.Except for 12 articles written by a single author, the rest of the publications were the result of collaboration among many writers.There are an average of 4.77 authors per manuscript, indicating that collaboration is the norm in scientific research.The most prolific writers were Saedi Nazanin, Gentile Pietro, Sclafani Anthony P, Wang Jordan V, and Wang Jordan V. (Table .2).Gentile Pietro (University of Cagliari, Italy) proposed that PRP combined with adipose tissue transplant could improve fat survival and aesthetic results.
The 306 registered articles have been referenced 8348 times.
Among the top five corresponding writers, Alan T. Nurden (990), Barry L. Eppley (718), Isabel Anda (355), Francesco Cairo (305), and Man.D (293) had the most citations (Figure 3).Alan T. Nurden and Barry L. Eppley found that PRP was efficient in promoting wound healing.These are considered pioneering works in this field and were published in different journals the same year.Of course, these two articles are each ranked among the top two most cited in this field.Table 3 shows that additional highly cited aesthetics papers focused on novel research and systematic reviews of PRP.

| Distribution of countries and institutions
All 306 publications had authors from 45 different countries (Figure 4).Table 4 and Figure 5 show the top five nations in terms of production and cooperation.The United States (US) published 88 articles, accounting for 27.94% of the total, far outnumbering any other country.
The United States, like most fields of medical research, continues to lead the world in PRP cosmetic applications, both in terms of publications and citations.This is due to advanced research conducted by US researchers on PRP and its numerous innovative applications in the cosmetic field.Italy and Germany, which came in second and third place, were the most productive nations in this category.There were found a total of 117 nodes and 345 linkages in the network of institutional cooperation in this field (Figure 6).Despite the fact that 499 institutions from 46 countries have participated in this field's research, the proportion of cooperation remains low  (23.4%).Fourth Mil Med Univ, Univ Calif San Diego, Univ Groningen, Hosp Quemados Arturo U Ill., and Alexandria University were the top five institutions cited in the article (Table 5).These institutions excelled in scientific innovation but lacked connections with each other, indicating a lack of collaboration (Figure 7).

| Distribution of journals
The top 10 journals on the use of PRP in cosmetic treatment are listed in Table 6.These journals have published 131 papers on PRP aesthetic therapy, accounting for 41.58% of all publications in the field, with Journal of Cosmetic Dermatology publishing the most articles, accounting for 10.8% of total literature (Figure 8).Plastic And Reconstructive Surgery had the greatest impact factor and is the most prominent journal in the plastics field (5.169).
Plastic And Reconstructive Surgery ranked first in terms of total citations (1371) and average citations (97.93).According to one of the most frequently cited publications in this journal, PRP contains growth factors that may improve wound healing.The number of platelets and growth factors released from PRP was quantified in this study.They found that the concentration of platelets increased eight fold and that the concentration of growth factors increased with the number of platelets.In addition, they discovered that PRP contains potentially therapeutic growth factors that can promote wound healing.

F I G U R E 2
The trend of annual production of platelet-rich plasma in cosmetics.

TA B L E 2
The top 10 authors were ranked by publications and citations.

| Analysis of keywords
Keywords are effective summaries of literature studies, and it is possible to summarize research hotspots and predict future trends by analyzing keyword clustering and brust (Figure 9; Figure 10).Table 7 displays the keywords with the highest frequency and centrality.

| DISCUSS ION
Since the first paper on PRP-treated cosmetic problems was published in 2001, the number of articles in this field has increased on an annual basis.We also looked for 45 publications in 2022 whose coverage was incomplete as of the retrieval date.Furthermore, we believe this topic is still hot due to the delay in collecting and updating some publications and networks.Not only is the use of PRP in the aesthetic sector a popular topic for scientific research, but it also gives physicians more options and has received a positive response.
Hence, research in this area remains worthwhile and promising.
The United States continues to be the most productive and cited country, demonstrating its dominance in the field.Furthermore, the United States has the most co-authored publications, which results in higher levels of research and extension.China, which published its first paper on the subject in 2008, has the second-highest number of publications but at a rapid growth rate.The significant increase in China's publication rate was directly attributable to the government's medical and academic investments.The vast market of beauty seekers in China has stimulated the application of PRP in the field of aesthetics, which requires more effective, minimally invasive, and widely applicable technologies.PRP is an ideal solution that meets these requirements.It is not surprising that China's rapid growth in this field in recent years.Therefore, it is not surprising that China has experienced rapid growth in this field in recent years.However, Italy and India had higher average citations than China, reflecting their greater academic importance (10.75 vs. 29.04 vs. 30.12).It demonstrated that the relationship between the research impact and the volume of publications is not linear.Hence, any country or location would be required to strengthen academic administration.
The prevalence of collaboration and co-authorship in PRP aesthetic therapy demonstrates the importance of collaborative and The network of authors published in platelet-rich plasma in cosmetics.

TA B L E 3
The top 10 cited paper.[16] The top 10 plastic surgery and dermatology publications reveal that the majority of researchers interested in PRP aesthetic applications are plastic surgeons and dermatologists. 17,18 employing cluster analysis and burst analysis of keywords in relevant studies, research trends can be easily identified.Currently, growth factors and innovative applications in PRP have emerged as the most active research topics.Notably, a close relationship between adipose tissue and PRP has been discovered, wherein adipose tissue is often utilized in conjunction with subsequent SVF to enhance treatment efficacy. 19,20Besides, we present a comprehensive overview of the prominent applications of PRP as reported in the extant literature.

| Mechanism of PRP promoting a cosmetic issue
In the published literature, we have seen several encouraging improvements in cosmetic issues.The majority of these effects are The network of country.

TA B L E 4
The top 10 countries based on publications and citations.

F I G U R E 5
The rank of publication and international collaboration of country in platelet-rich plasma applied in cosmetics.

F I G U R E 6
An overview of the institution network in platelet-rich plasma applied in cosmetics.

F I G U R E 7
The collaboration network of top institution in platelet-rich plasma applied in cosmetics.

| Expansion of cosmetic application
However, PRP has demonstrated significant potential in a variety of cosmetic settings over the last 20 years.Yet there are still plenty of aesthetic problems that need to be fixed.As dermatology or plastic surgery subspecialties develop, the demand for cosmetic enhancement grows.More cosmetic issues that PRP or associated products can treat are expected in the future.

TA B L E 6
The top 10 Author keywords and Keywords-plus.
The cite network of journal in platelet-rich plasma applied in cosmetics.

F I G U R E 9
The author's keywords are visualized in a network map.Keywords with similar colors form a cluster.
F I G U R E 1 0 Keyword brust.

TA B L E 7
The top 5 most productive and highest link strength institutions.

| The importance of combination treatment
Increasing research indicates that PRP is analogous to a broad-spectrum promoter.In addition to having therapeutic potential on its own, it may have a surprising effect when combined with other therapies such as fat grafting, hyaluronic acid, and adipose-derived stem cells.[23] More research efforts could be made to develop more effective PRP combo therapies.
The field of PRP applications in aesthetics continues to show immense promise.Through an extensive review of the literature, coupled with personal experience and the findings of bibliometric studies, we have identified some topic of interest that hold significant potential for future research in this domain.This integration aims to enhance the regenerative potential of PRP by promoting cell proliferation, angiogenesis, and extracellular matrix remodeling.The inclusion of these additional components holds promise for amplifying the therapeutic efficacy of PRP.
Furthermore, there is a potential for developing tailored PRP formulations to address specific cosmetic concerns such as hyperpigmentation or skin laxity.This customization could be achieved by meticulously customizing the growth factor profiles or concentrations within the PRP formulations.By adopting a personalized approach to PRP formulation, practitioners can offer targeted and precise treatments based on genetic profiles or skin characteristics.
This tailored approach has the potential to optimize the regenerative potential of PRP and improve therapeutic outcomes in cosmetic applications, opening up new possibilities for more effective and efficient cosmetic treatments.

| PRP in tissue engineering
The integration of PRP into tissue engineering approaches repre- Furthermore, our search strategy may potentially miss some relevant articles.The field of cosmetics is continuously evolving and diversifying, which means that terms and keywords are also constantly evolving.Exhaustively listing all relevant keywords seems impossible.Therefore, we are focusing our attention on the application of PRP in cosmetics.For areas not covered in this study, we will conduct further research.Finally, non-English writing studies were excluded, which means that certain advances may not receive adequate attention and may be cited less frequently.

. 1 | 2 . 3 .
Data collection 2.1.1 | Inclusion criteria 1.The information was retrieved from the Web of Science Core Collection.To avoid data discrepancies caused by daily database upgrades, the literature data for this study was last updated on February 21, 2023.The search formula is TS = (PRP * OR PRP) ANDTS = (cosmetic * OR aesthetic*) AND PY = (2000-2023) (Figure 1 depicts the flow chart of our search strategy).

F I G U R E 1
Schematic diagram of the flow of this study.TA B L E 1 Categories of publication in PRP aesthetic application.
attributed to the abundance of growth factors such as PDGF, TGF 1, TGF 2, VEGF, and others.However, which pathways or downstream signaling are those growth factors activating or suppressing in a specific cosmetic problem?Do any further unknowable factors have an impact?These questions remain unanswered and are currently a focus of research.TA B L E 5 The top 10 journals are based on publications and citations.

4. 3 . 1 |
Advanced PRP formulations and personalized PRP treatmentsFuture research endeavors in the field of PRP are anticipated to focus on refining and optimizing PRP formulations through the integration of supplementary growth factors, cytokines, or bioactive molecules.

5 |
sents an exciting area of exploration in regenerative medicine, with significant implications for cosmetic applications.By incorporating PRP into tissue engineering constructs, the development of bioactive scaffolds and biodegradable materials can be optimized to facilitate the growth and regeneration of new tissues.PRP, enriched with growth factors and cytokines, offers the potential to stimulate cellular proliferation, angiogenesis, and extracellular matrix synthesis.This unique regenerative potential makes PRP an attractive candidate for enhancing tissue engineering strategies.The integration of PRP has the potential to lead to the creation of advanced cosmetic implants, grafts, or artificial skin with improved integration and healing properties.By harnessing the regenerative capabilities of PRP, damaged or aged tissues can be regenerated, ultimately resulting in improved aesthetic outcomes in cosmetic interventions.Further research is necessary to determine the optimal methods for incorporating PRP into scaffold materials, including the ideal concentration, and timing of PRP application.Additionally, long-term performance and biocompatibility studies are essential to assess the efficacy and safety of PRP-incorporated constructs.The integration of PRP into tissue engineering holds great promise in advancing the field of cosmetic regenerative medicine, offering the potential for sophisticated constructs that promote enhanced tissue integration, healing, and overall aesthetic outcomes.4.3.3 | Non-invasive delivery systemsThe future of PRP delivery systems in cosmetic applications holds great potential with the development of non-invasive modalities, such as transdermal patches or iontophoresis devices.Transdermal patches are emerging as a promising approach, providing a controlled release of PRP components through the skin barrier.These patches offer convenience, ease of application, and customizable compositions, allowing for the gradual permeation of therapeutic factors into target tissues.Additionally, iontophoresis devices utilize low-level electrical currents to facilitate the transdermal transportation of PRP components, eliminating the need for injections and enhancing patient comfort.These innovative approaches have the potential to replace invasive injection methods, reducing discomfort, downtime, and associated risks.Transdermal patches and iontophoresis devices provide accessible and needle-free options, enhancing treatment compliance and improving patient experiences.However, further research is needed to optimize these delivery systems, including the design of effective transdermal patches, refinement of iontophoresis parameters, and comprehensive evaluation of their safety, efficacy, and long-term outcomes in cosmetic regenerative medicine.LI M ITATI O N S Inclusion of only the Web of Science database in our research may have caused the loss of data from other relevant databases.
To our knowledge, this is first bibliometric analysis on PRP's cosmetic applications.The technology has been applied to skin rejuvenation, alopecia treatment and scar management.Utilizing bibliometric analysis, we elucidated trends, collaborations, and research foci, with the United States and Fourth Military Medical University emerging as major contributors.Leading scholarly journals, such as the Journal of Cosmetic Dermatology and Plastic and Reconstructive Surgery, have undeniably occupied central positions within scholarly discourse.The forthcoming landscape warrants comprehensive randomized clinical trials of considerable scale and quality, as a requisite for establishing robust evidence to underpin clinical practice.As we anticipate future directions, research is poised to delve into "Advanced PRP Formulations and Personalized Treatments," "PRP in Tissue Engineering," and "Non-Invasive Delivery Systems."This macroscopic analysis offers valuable insights for researchers navigating cosmetic medicine's evolving landscape.