Fractional erbium-YAG laser vs platelet rich plasma in acne scar: a comparative study

Background: Facial acne scar is a common complication of acne vulgaris leading to social isolation, lack of self-confidence and depression that warrants multiple treatment approach. In recent years, fractional erbium-yttrium aluminum garnet (er-YAG) 2940 nm laser and platelet-rich plasma (PRP) have been used independently or in combination with other resurfacing modalities in treating acne scars with variable outcomes. The objective of this study is to compare the therapeutic responses and safety of fractional erbium-YAG 2940 nm laser and platelet-rich plasma in atrophic post acne scars.Methods: Patients were randomly divided into two groups (30 each), receiving six sittings of fractional er-YAG laser and PRP every month. Response was evaluated 4 weeks after each treatment session using Goodman and Baron qualitative acne scar grading system, photographic assessment by 2 blinded dermatologist and patients own satisfaction.Results: Both treatment modalities showed improvement of acne scars, but the improvement with fractional er-YAG laser (27% marked and 70% moderate response) treatment was higher in comparison to PRP (10% marked and 67% moderate response) in terms of acne scar grade severity (p=0.33). Similar results were obtained on photographic assessment (p=0.015 and 0.021), and patient’s own satisfaction (p=0.011), respectively. Pain and stinging score were lower in er-YAG group while down time for same was shorter in PRP.Conclusions: Both er-YAG laser and PRP showed significant improvement in atrophic acne scar while former showing slightly superior response with lesser adverse effects.

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EFFICACY OF FRACTIONAL CO2 LASER WITH TOPICAL PLATELET RICH PLASMA IN TREATMENT OF ACNE SCARS

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v4i11.706 ◽

2020 ◽

Vol 4 (11) ◽

Author(s):

Kiran Puram ◽

Rachana Laul ◽

Anand Asia

Keyword(s):

Co2 Laser ◽

Platelet Rich Plasma ◽

Acne Vulgaris ◽

Tertiary Care ◽

Acne Scar ◽

Tertiary Care Centre ◽

Self Assessment ◽

Fractional Co2 Laser ◽

Acne Scars ◽

Quantitative Score

Background: Acne scars are most distressing sequelae of acne vulgaris having a major impact on psychosocial aspect and quality of life of an individual. In spite of various therapeutic modalities available treatment of acne scars is challenging. Resurfacing techniques such as Fractional Co2 Laser is a well-established treatment option for acne scar. Platelet-Rich Plasma (PRP), an autologous preparation of growth factors helps in wound healing and tissue regeneration. Aim: To study the efficacy of Fractional CO2 Laser with Topical Platelet-Rich Plasma in Acne scars. Materials and Methods: A total of 15 patients with atrophic facial acne scar, aged 18-40 years attending Outpatient Department of Dermatology, Venereology and Leprosy at tertiary care centre during January 2019 to December 2019 were included for this interventional study after written informed consent. The patients underwent six sessions of Fractional CO2 Laser with Topical application of Platelet-Rich Plasma at monthly intervals. Pre and post treatment comparative Goodman and Baron’s quantitative global scarring grading and patients self-assessment score were used for assessment. Results: At the end of study mild reduction in Goodman and Baron’s quantitative score for acne scar was noted in 13 patients (86.6%). Mean Goodman and Baron’s quantitative score att 4 weeks after sixth sitting was 13.13 ± 4.60. On patients self-assessment moderate resolution of acne scar was noted in 8 patients (53.3%). Conclusion: Fractional CO2 Laser with Topical Platelet-Rich Plasma application has mild to moderate improvement of acne scars and shorter down time of Fractional CO2 Laser. Keywords: Acne scar, Fractional Co2 Laser, Topical Platelet-Rich Plasma

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Combined treatment modalities in atrophic acne scars: a prospective study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20190959 ◽

2019 ◽

Vol 5 (2) ◽

pp. 243

Author(s):

Saravanan Narayanan ◽

Kamalanathan Nallu ◽

Sridhar Venu ◽

Arul Raja Ganapathi

Keyword(s):

Acne Vulgaris ◽

Combined Treatment ◽

Treatment Session ◽

Treatment Modalities ◽

Multimodal Approach ◽

Acne Scars ◽

Pre Treatment ◽

Grade 3 ◽

A Prospective Study ◽

Single Modality

Background: Atrophic acne scars are one of the sequalae that follows acne vulgaris. These scars are big cosmetic concern presenting with varied morphology like ice-pick, rolling and boxcar scars and it needs multimodal approach to treat effectively rather than a single modality. Our main aim is to study the efficacy of combination therapy using subcision, micro-needling and trichloro acetic acid chemical reconstruction of skin scars (TCA CROSS) in a sequential manner for the management of atrophic acne scars.Methods: Total 30 patients of either sex with grade 2, 3, and 4 atrophic acne scars were graded using Goodman and Baron qualitative grading and were enrolled in the study. After single sitting of subcision, micro-needling and 50% TCA CROSS were performed alternatively at 3 weeks interval for a total of 3 sessions of each. Grading of acne scars were done by taking photographs at pre-treatment, post treatment, 1st and 3rd month after last treatment session.Results: Out of 14 patients with grade 4 acne scars, 9 (64.3%) patients improved to grade 2 and 5 (35.7%) patients improved to Grade 3. Out of 10 patients with Grade 3 scars, 6 (60%) patients improved to grade 1, and 4 (40%) patients were improved to grade 2 at the end of study. All 5 patients with Grade 2 scars showed significant improvement from baseline.Conclusions: Subcision, micro-needling and TCA CROSS, if they are combined and adequately done in proper manner will have excellent response in all types of atrophic acne scars.

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Management of Acne Scars with Platelet-Rich-Plasma (PRP) Therapy as a Tvaka Rasayanam

International Journal of Clinical & Experimental Dermatology ◽

10.33140/ijced/03/02/00002 ◽

2018 ◽

Vol 3 (2) ◽

Keyword(s):

Tissue Repair ◽

Platelet Rich Plasma ◽

Acne Vulgaris ◽

Acne Scar ◽

Tissue Remodelling ◽

Exclusion Criteria ◽

Double Spin ◽

Acne Scars ◽

Scar Management

Introduction: Acne vulgaris can lead to lifelong sequel in the form of atrophic or hypertrophic scars, depending on the degree of inflammation. Acne scar management remains a challenge to dermatologists. Platelet rich plasma (PRP), in which the platelets are in a highly concentrated form, has shown its effect in accelerating tissue repair and wound healing. The platelet releases a variety of growth factors which bring about tissue remodelling. Aim: To study the efficacy and safety of PRP in managing acne vulgaris as tvak rasayanam at Skin Care Unit, R.G.G.P.G. Ayurvedic College, Paprola, Kangra (H.P). Materials and Methods: Based on inclusion and exclusion criteria twenty patients were included in the study. PRP was made by double spin method. The area to be treated was cleaned with spirit and betadine, the skin was stretched and activated PRP loaded in an insulin syringe was injected into and around the scars by multiple punctures. Results: Out of 20 patients, 20% patients (4) showed marked improvement in the grading of acne scars, i.e. They improved up to grade 1 or there was an improvement by 2 grades. 50% patients (10) showed moderate improvement. In these patients grading of acne scars improved by 1. In 15% patients (3) although the grading did not changed but there was visible improvement in the appearance of the scars. In only 15% patients (3), here was no significant improvement was seen even after 4 sittings but texture of skin is mildly improved. Conclusion: Platelet- Rich-Plasma (PRP) therapy is easy to perform. Done as an outpatient procedure. It doesn’t hamper the daily activities quality of the patient. It works well for superficial acne scars, providing good results with minimal side effects like erythema and edema which subside within 2-4 hrs. PRP is thus an effective modality for treating acne scars.

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The Combination of Platelet Rich Plasma with Skin Needling or Subcision for Postacne Scaring: a Serial Case Study

Journal of Stem Cell Research and Tissue Engineering ◽

10.20473/jscrte.v3i2.20131 ◽

2020 ◽

Vol 3 (2) ◽

Author(s):

Endra Yustin

Keyword(s):

Simple Technique ◽

Platelet Rich Plasma ◽

Facial Skin ◽

Combination Therapies ◽

Acne Scar ◽

Acne Scars ◽

Small Needle ◽

Male Patients ◽

Methods Of Treatment

Scaring in acne remains a common problem and became therapeutic challenges for the clinician. Several modalities were introduced, and combination therapies are required to achieve satisfactory results. Skin needling and subcision reported as effective methods for treating acne scar. The skin needling technique involves puncturing the skin multiple times with a small needle to induce collagen growth, while subcision worked by tunneling the connective tissue and scattered the fibrosis scar. Platelet-rich plasma (PRP) influences wound-healing by stimulating an intense inflammatory response and growth factors, these increase in the production of extracellular matrix and granulation tissue occurs, with vascular in-growth, fibroblastic proliferation, and collagen production also accelerated. Three male patients enrolled in the study, with grades 2-3 acne scar. There are three different methods of treatment were used to see the effect of the treatment. The first patient used the combination of topical PRP and skin needling, and the second patient received a combination of PRP injection and subcision, while the third patient obtains combination between topical PRP and skin needling continued with PRP injection and subcision. Our study revealed that PRP and skin needling or subcision is a simple technique and has the potential for improvement of acne scars. Three weeks after treatment, all three patient had smoother facial skin and reduction of acne scar severity. The combination of PRP and skin needling or and subcision is a simple, safe and rapid method for acne scars treatment.

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Ablative Fractional CO2 Laser for Facial Atrophic Acne Scars

Facial Plastic Surgery ◽

10.1055/s-0037-1606096 ◽

2018 ◽

Vol 34 (02) ◽

pp. 205-219 ◽

Cited By ~ 11

Author(s):

Yaqin Xu ◽

Yunhua Deng

Keyword(s):

Carbon Dioxide ◽

Carbon Dioxide Laser ◽

Randomized Clinical Trials ◽

Treatment Plan ◽

Acne Vulgaris ◽

Treatment Session ◽

Efficacy And Safety ◽

Acne Scars ◽

Fractional Carbon Dioxide Laser ◽

Comprehensive Search

AbstractAblative fractional carbon dioxide laser resurfacing is a well-established treatment for acne scars. However, there are limited consensus and guidelines regarding the procedure, such as its treatment plan, efficacy, and safety. In this study, we performed a systematic review to assess the efficacy and safety of the fractional carbon dioxide laser treatment procedure, and to provide evidence-based recommendations concerning its practical use on atrophic acne scars. A comprehensive search was performed in, EMBASE, Ovid, Web of Science, and Cochrane databases, using the keywords “scar(s),” “acne vulgaris,” “carbon dioxide,” and “fraction* laser(s)” for the period from January 1987 to December 2016. The initial literature search identified 337 articles. The final selection included 30 studies: 12 retrospective studies and 18 prospective randomized clinical trials. Ablative fractional carbon dioxide laser is an effective therapy for the treatment of acne scars. The treatment session, interval, and parameters should be customized for each patient. Combination therapy should be considered for ice-pick type acne scars. The use of dermocosmetics in pre- and postoperative care may be beneficial to patients.

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The Role of Hair Transplantation for Managing Facial Trauma

Facial Plastic Surgery ◽

10.1055/s-0037-1608782 ◽

2017 ◽

Vol 33 (06) ◽

pp. 613-620

Author(s):

Gorana Kuka ◽

Jeffrey Epstein

Keyword(s):

Platelet Rich Plasma ◽

Treatment Modalities ◽

Site Formation ◽

Facial Trauma ◽

Hair Transplantation ◽

Recipient Site ◽

Facial Hair ◽

Case Examples ◽

Multiple Treatment ◽

Follicular Unit

AbstractOftentimes, multiple treatment modalities are indicated for the management of trauma to the face. When this trauma involves a hair-bearing area, such as the eyebrow, eyelid, or beard region, hair transplantation can be an effective modality. While most of these facial hair transplants are performed for elective cosmetic indications, advanced techniques of hair transplantation can assure aesthetic outcomes in the optimizing of appearance after trauma. Because hair regrowth requires a good recipient bed, adjuvant therapies to promote vascularization, such as fat transfer and platelet-rich plasma, can be applied in conjunction with hair transplantation. The authors review the indications and the essential techniques of graft harvesting by follicular unit extraction and follicular unit grafting, and recipient site formation and graft planting and management, and present different case examples illustrating these technique.

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Laser for post acne scars with or without growth factors: a comparative clinical trial

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20200601 ◽

2020 ◽

Vol 6 (2) ◽

pp. 224

Author(s):

Lakkireddygari Sujana ◽

Balachandra S. Ankad ◽

Savitha L. Beergouder

Keyword(s):

Growth Factors ◽

Platelet Rich Plasma ◽

Objective Assessment ◽

Subjective Assessment ◽

Primary Objective ◽

Treatment Modalities ◽

Acne Scars ◽

New Strategy ◽

Group A ◽

Group B

Background: Treatment of acne scars presents a considerable challenge to dermatologists. But with advent of fractional CO2 (FCO2) laser and platelet-rich plasma (PRP), new avenues can be explored. PRP provides various growth factors, so that the healing of laser-damaged skin is accelerated. The aim of this study was to assess the efficacy and safety of FCO2 laser alone and in combination with PRP in patients with post-acne scars.Methods: Eighty patients with acne scars were counseled and randomly assigned into two groups of 40 each. Group A was treated with FCO2 laser alone, while Group B was treated with FCO2 laser and PRP for 6 months. Primary objective was assessment of efficacy of both treatment modalities. Secondary objective was evaluation of safety of treatments.Results: At the end of 6 months, group A showed about 18% reduction, while group B showed about 33% reduction in acne scars on objective assessment. Patient satisfaction as assessed by subjective assessment was greater in group B than in group A. Duration of erythema, edema and crusting was lesser in group B compared to group A.Conclusions: Combination of FCO2 and PRP was found to be more efficacious as compared to FCO2 laser alone. Combining the treatment modalities can provide a new strategy for treating the post-acne scars.

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A comparative study of efficacy and safety of platelet rich plasma versus fractional co2 laser in the treatment of post acne scars

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20191760 ◽

2019 ◽

Vol 5 (2) ◽

pp. 254

Author(s):

Amita Murali Babu ◽

Vinma H. Shetty ◽

Saumya Goel ◽

Hafsa Eram

Keyword(s):

Comparative Study ◽

Platelet Rich Plasma ◽

Subjective Assessment ◽

Treatment Session ◽

Grading System ◽

Efficacy And Safety ◽

The Third ◽

Acne Scars ◽

Significant Difference ◽

Group A

Background: Facial scars prompt restorative issues and have mental impacts, for example, humiliation, poor confidence, and social isolation. This study intends to assess efficacy and safety of platelet rich plasma (PRP) versus CO2 laser in post acne scar treatment.Methods: It is an outpatient based comparative study. All patients enlisted in this study were separated into two groups, ten in each treatment group. In group A, patients received PRP month to month for 3 sittings and followed up eight weeks after the third sitting. In group B, patients received fractional CO2 laser month to month for 3 sittings and followed up eight weeks after the third sitting. Improvement of acne scars was assessed utilizing digital photographs with identical camera settings and Goodman and Baron’s qualitative grading system at beginning, after each sitting and followed up eight weeks after the third sitting. Patients subjectively evaluated clinical improvement eight weeks after the last sitting. Software (SPSS, version 16.0 statistical packages) was used.Results: Assessment using qualitative acne scars grading system prior to and after treatment as well as patient’s subjective assessment 2 months after the third treatment session showed significant improvement in both groups. The baseline scores before treatment for group A and B were similar (p=0.7678) and final scores of both treatment groups showed no significant difference (p=0.8011) after treatment.Conclusions: This study shows that PRP as well as fractional CO2 laser result in significant clinical change in the quality of post acne scars.

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The Efficacy of Autologous Nanofat Versus Enhanced Nanofat with Adipose-Derived Stem Cells Transfers in the Treatment of Atrophic Post Acne Scars

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i2430748 ◽

2020 ◽

pp. 17-31

Author(s):

Marwa Elsamongy ◽

Hashem Ayad ◽

Manal Eid ◽

Shereen Gheida ◽

Amany Abdel- Latif

Keyword(s):

Stem Cells ◽

Histopathological Examination ◽

Platelet Rich Plasma ◽

Acne Vulgaris ◽

Cost Effective ◽

Elastic Fibers ◽

Adipose Derived Stem Cells ◽

Acne Scars ◽

Significant Difference ◽

Group B

Background: Acne scarring is a visible reminder of acne vulgaris resulting from inappropriate healing of active lesions. Yet, no golden standard is present. Nanofat is an emulsified homogenous suspension of adipose tissue rich in adipose derived stem cells (ADSCs). Its application serves regenerative purposes. Objective: To evaluate efficacy of nanofat versus enhanced nanofat with adipose-derived stem cells transfer in treating atrophic acne scars. Methods and Materials: This study was carried on 40 patients with atrophic acne scars; grouped into two groups. Group A: 20 patients; treated with nanofat with platelet-rich plasma (PRP) and group B: 20 patients; treated with enhanced nanofat with ADSCs and PRP. Histopathological examination was done before and 6-months after treatment, specimens were stained by haematoxylin and eosin, Mallory trichrome and Verhoeff-Van Gieson. Results: In both groups; 70% showed excellent and very good improvement and patients’ satisfaction was 60% for both groups. Histopathological examination revealed increase in epidermal thickness, formation of new collagen and elastic fibers without significant difference between both groups. Conclusion: Nanofat transfer is easy, cost-effective, and safe for treating acne scars, compared to enhanced nanofat with ADSCs transfer which is costly and time consuming

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