A comparative study of efficacy of micro-needling alone versus micro-needling with autologous platelet rich plasma in facial atrophic acne scars
Abstract
Post acne scarring is a consequence of abnormal resolution or wound healing following the damage that occurs in the sebaceous follicle during acne inflammation. The present study was undertaken to compare the improvement in facial atrophic acne scars by micro-needling alone and combination of micro-needling with autologous platelet rich plasma (PRP). A prospective, observer blinded, comparative interventional study was conducted on 50 patients of facial atrophic acne scars fulfilling inclusion criteria. They were randomly divided into two group of 25 each i.e. group 'A' (micro-needling alone) and group 'B' (micro-needling with PRP). Three sessions on monthly interval were conducted and Final follow up was done at 4th month. They were evaluated by Goodman and Baron’s quantitative and qualitative grading scale, for clinical improvement and for patient's satisfaction. Although qualitative and quantitative improvement was observed in both the groups but the improvement in group 'B' was more than 'A' on Goodman and Baron’s quantitative and qualitative grading scale, however it was not statistically significant. On clinical improvement and on patient satisfaction, group 'B' had better results than group 'A' which was statistically significant (p<0.05). It was concluded that Micro-needling with autologous PRP is simple, safe and cost-effective procedure for facial atrophic acne scars. Micro-needling when combined with autologous PRP provides better overall clinical improvement. It is suggested that PRP should be considered as an adjuvant therapeutic option along with micro-needling in the management of atrophic acne scars.
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Introduction
Acne is a chronic inflammatory disease of the pilosebaceous units characterized by seborrhoea, the formation of open and closed comedones, erythematous papules, pustules nodules, deep pustules and pseudocysts. In many cases a degree of scarring will ensue.1 Abnormal resolution or wound healing following the damage that occurs in the sebaceous follicle during acne inflammation results in post acne scarring. The pathogenesis of acne is currently attributed to multiple factors, such as increased sebum production, alteration of the quality of sebum lipids, androgen activity, proliferation of Propionibacterium acnes (P. acnes) within the follicle and follicular hyperkeratinisation.2
Atrophic acne scars are more common than keloids and hypertrophic scars with a ratio 3:1.3,4 They have been sub-classified into ice pick, boxcar scar, and rolling scars. Goodman and Baron proposed a qualitative scale and then presented a quantitative scale.5,6 Dreno et al. introduced the ECCA scale (Echelle d’Evaluation Clinique des Cicatrices d’Acn´e).7
Conclusion
It was concluded from this study that Micro-needling with autologous PRP is simple, safe and costeffective procedure for facial atrophic acne scars. Micro-needling when combined with autologous PRP provides better overall clinical improvement. It is suggested that PRP should be considered as an adjuvant therapeutic option along with micro-needling in the management of atrophic acne scars.