Platelet-rich plasma (PRP) is a biological preparation derived from autologous blood through centrifugation. It exhibits a platelet concentration higher than the baseline level of whole blood and is rich in various growth factors. PRP acts on the skin through multiple mechanisms, regulating local immune-inflammatory responses and promoting tissue repair and regeneration. Due to its autologous origin, high safety profile, and mild adverse effects, PRP has garnered significant attention and widespread application in the field of dermatological aesthetics and repair in recent years. This article focuses on analyzing the mechanisms of action and biological characteristics of PRP, and provides an overview of its mechanisms and the latest clinical advancements in treating facial aging, acne scars, melasma, vitiligo, and rosacea. The aim is to offer new insights for future clinical decision-making.