Don’t Fear the Vampire Facial. Just Keep It Safe

With the recent tragic revelation of more people contracting HIV from aesthetic microneedling, it seems useful to offer tips for doing the procedure safely. I invented the Vampire Facial procedure and trademarked it in 2013 but did not invent microneedling or platelet-rich plasma (PRP).

I will explain that seeming contradiction, but it will help to first review why anyone would want the procedure — and if they do, how to find a provider who can administer this treatment effectively and safely, with no risk of transmitting infections, including HIV.

The idea behind the mechanism of action of microneedling is twofold. First, hundreds of thousands of needle punctures (at depths of 0.5-2.5 mm) trigger collagenesis — like a mechanical fractional laser without the risks for scarring and burns accompanying such procedures. Also, unlike laser procedures, microneedling can be done safely with every skin type.

Second, because the skin barrier is compromised by microneedling, topical agents can be applied during and immediately after microneedling to augment the desired results. Agents studied include vitamin C serum, trichloroacetic acid, insulin, hyaluronic acid serum, and PRP.

The research regarding microneedling has accumulated over the past decade. It includes multiple papers showing benefits for acne scars, surgical scars, keloid, alopecia, and striae (postpartum, post–weight loss, or after breastfeeding) and to decrease facial wrinkles.

PRP, which is used in the vampire facial, was first studied by orthopedic surgeons and dentists looking to improve surgery outcomes on avascular tissues. For the past decade, the science of PRP has been imported into the fields of aesthetics, gynecology, urology, sports medicine, and wound care.

When I started working with PRP 14 years ago, I worried people might suffer harm; the potential for danger was great and the access to supplies easy. So, I created a group of physicians, the Cellular Medicine Association (CMA), to finance research and development of cellular-based procedures, with members agreeing to follow standards of care regarding the associated procedures.

Using a service mark (a type of trademark) allows policing of who advertises and helps patients distinguish those in our group from those who may be using similar tools but doing something different.

To become licensed to use the official Vampire Facial name in advertising, physicians documented an understanding of our safe and effective protocols and signed an agreement to not deviate from those protocols in ways that make the procedure less safe or effective.

A service mark is commonly used in business but rarely used in medicine. For example, although both may use a stove and beef, not everyone cooking a hamburger makes a McDonald’s hamburger. It would be illegal for someone to advertise a McDonald’s burger without learning the specific methods of McDonald’s and becoming licensed to put up the golden arches to help customers know where to go.

Our Vampire Facial providers are not franchisees; they are licensees who have agreed to follow safe, specific protocols, and they can lose that license to use the name should they deviate.

Because of our name’s popularity and the effectiveness of the procedure, the CMA spends over a million dollars per year on lawyers and online tools to remove the advertising of infringers (over 457 websites and social media accounts removed in 2023).

No one treated by someone in our group providing a Vampire Facial procedure has been harmed. But people who have falsely advertised the Vampire Facial and then, instead, did something dangerous that included microneedling (but not a true Vampire Facial) — they have done tremendous harm, including transmitting HIV.

Not every hamburger is a McDonald’s, nor is every microneedling procedure a Vampire Facial. To our great frustration, the attempted safety for patients afforded by our service mark has been blocked to some degree by the media’s persistent use of the term “Vampire Facial” in a generic way that equates it with microneedling.

Still, whether one provides our specific protocols or not, I am glad to list the three main guidelines that have afforded us a decade-long history of safety. 

First, microneedling devices suction blood up into the handle, so that every patient is potentially inoculated with the blood-borne pathogens carried by all the previous patients. The procedure should be performed only with devices approved by the US Food and Drug Administration (FDA), a relatively small list of brands. They are expensive but must be used. They come with disposable needles, and everything is individually packaged and sterile. Although I’m not certain, I believe the latest cases of HIV transmission probably involved using a non–FDA-approved microneedling device.

Also, the centrifuge used to process the blood to make PRP must be FDA-approved for processing blood to return to the body. That standard is not the same for processing blood for laboratory evaluation.

The FDA does not approve any medical procedures, and it does not govern body fluids, skin, or blood products. However, they do and should regulate the devices used to process PRP for reinjection, and only one of those approved devices should be used.

Finally, the person performing the procedure should be properly licensed. Licensing varies from state to state, but if a physician extender is involved, the supervising physician — or nurse practitioner where states allow — must be in the building because blood products are involved.

Physicians and nurses handle blood daily, millions of times without serious sequelae. Millions of microneedling and PRP procedures are performed safely yearly in the United States alone. Even tattoo artists use the same microneedling device used for the Vampire Facial procedure. As with many procedures, it is who holds the tool that most determines both safety and outcome — but in this case, it is also the tool.