Microneedle Radiofrequency Combined with Human Fibroblast Conditioned Media for Acne Scars and Skin Rejuvenation

Background: Acne vulgaris is one of the most common dermatology problems in the world. Acne scar can cause stress for sufferers. Microneedle Radiofrequency (MR) clinically has an effectiveness treating acne, acne scars and skin aging. MR acting as electrodes and directly deliver radiofrequency energy deep into the skin to induce new collagen production, dermal thickening and re epitelization. Cases: Seventeen patients (12 acne scar and 5 aging patients, 25-50 years old, Fitzpatrick skin type III-IV) with acne scars and aging skin who received three sessions of microneedle radiofrequency treatment for 2 months at 3 weeks intervalper session. Discussion: We use Goodman and Baron’s Global Acne Scarring System to assess the improvement of acne scars. It showed that by qualitative grading system from 12 patients (grade 3 and grade 4 acne scars), 58% patients showed 2 grade improvement, 33% showed1 grade improvement and 8.3% showed 3 grade improvement. Quantitative assessment showed that 58,3% of the patients had moderate improvement, 25% had good improvement and 16,6% had very good improvement. Global Aesthetic Improvement Scale (GAIS) are used to assess the improvement in skin texture, wrinkles graded by physician. It showed 60 % patients has 51 to 75% improvement and 40% patients has 26 to 50% improvement.

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Effect of Subcision and Microneedling in the Treatment of Atrophic Acne Scars in Ten Patients: A Case Series

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.30974 ◽

2021 ◽

Vol 19 (1) ◽

pp. 74-80

Author(s):

Megha Tandon

Keyword(s):

Acne Vulgaris ◽

Case Series ◽

Severe Acne ◽

Acne Scars ◽

Grading Systems ◽

Minimal Improvement ◽

Acne Scarring ◽

Good Improvement ◽

Grade 3 ◽

Facial Acne

Background: Acne vulgaris is a common condition with a prevalence of over 90% among adolescents and post- acne scarring is a well known sequelae. Different types of scars (ice pick, boxcar, and rolling scars) warrant a customized approach of treatment for each type. We propose a novel treatment of atrophic acne scars using combination of subcision and microneedling. Methods: Ten consecutive patients of skin types III - IV with moderate and severe facial acne scarring received three sequential subcision and microneedling treatments after informed consent over a period of three months with an interval of 4 weeks between each session. Goodman and Baron’s qualitative and quantitative acne scar grading systems along with side by side comparison of pre operative and post operative photographs were used for assessment at the end of three sessions of the combination procedure. Results: Estimation of improvement with Goodman and Baron’s Global qualitative acne scarring system , we found good results in patients with Grades 3 and 4 acne scars. Out of 7 patients with grade 4 scars, 29% showed improvement by 2 grades and 71% showed improvement by 1 grade and all the 3 patients with grade 3 scars showed improvement by 1 grade. Quantitative assessment showed 30% patients had minimal improvement, 50% had moderate improvement and 20% had good improvement in scars. Adverse effects were transient pain, erythema and oedema. Conclusion: Subcision and microneedling are simple and inexpensive office procedures which in combination are well tolerated and are efficacious in treatment of moderate and severe acne scars.

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The Effectiveness of Microneedling Therapy on The Severity of Acne Scars According to Goodman and Baron: A Systematic review and meta-analysis

American Journal of Dermatological Research and Reviews ◽

10.28933/ajodrr-2021-09-1305 ◽

2022 ◽

pp. 48

Author(s):

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Control Group ◽

Skin Damage ◽

Acne Scar ◽

Acne Scars ◽

Significant Difference ◽

Acne Scarring ◽

The Mean ◽

Z Value

Background: The emergence of acne scars due to skin damage in the acne healing process and causes psychological effects. The management of acne scars can be done in several methods. Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique compared to other therapeutic modalities in acne scars. The resulting wound is micro-sized, and promotes the growth of growth factors and collagen production. We aimed to assess the effectiveness of using microneedling as an acne scar treatment option. A systematic review and meta-analysis were qualitatively and quantitatively conducted from RCTs, assessing the effectiveness of microneedling in reducing the severity of acne scars according to Goodman and Baron in the treatment of acne scars. Methods: Medline Pubmed, PMC, Scopus, Google Scholar, and JDC library, eligible search. Ten studies (n=514) were analyzed qualitatively with 2 studies (n=53 subjects) and quantitatively analyzed by 2 studies (n=90 subjects). Both analyzes were included in the meta-analysis. The mean age of the participants was 40.5 years. The application of microneedling intervention as monotherapy or a combination in patients with acne scarring was followed for at least 16 weeks, the results obtained were the mean reduction in the degree of acne scarring after microneedling. Result: The combination of microneedling treatment obtained a qualitative decrease in the degree of acne scars according to Goodman and Baron with a Z value (-4.299) and P=<0.001 lower than the control (PRP) with a significant difference. The quantitative decrease in the degree of acne scars according to Goodman and Baron obtained a Z value (-4.681) and P=<0.001 lower than the control (PRP) with a significant difference. Quantitative reduction in the degree of acne scars according to Goodman and Baron on single therapy between treatment and control with a value of Z (-3.536) and P=<0.001 lower than control (fractional CO2) with a significant difference. The results of the degree of acne scars in the group treated with microneedling alone or in combination were lower than the control group. The mean before and after therapy compared to the control there was a significant difference. Conclusion. The results of a systematic review, concluded that the group treated with microneedling had a decrease in the degree of acne scarring according to Goodman and Baron with P=<0.001 compared to before treatment. The decrease was shown in the difference in Z values, which was significantly greater than the control given other therapies. Microneedling therapy can be an alternative therapy option for acne scar patients who are unresponsive to previous therapy or in conditions where there are contraindications to other therapies.

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Whole Area versus Focal Acne Scar Treatment (FAST) of Post Acne-Scars by Fractional CO2 Laser: A Comparative Study

QJM ◽

10.1093/qjmed/hcaa046.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M A Abdallah ◽

C K T Gobrial ◽

S G H Gomah

Keyword(s):

Comparative Study ◽

Co2 Laser ◽

Acne Scar ◽

Fractional Co2 Laser ◽

Acne Scars ◽

Scar Treatment ◽

Acne Scarring ◽

Facial Area ◽

The Right ◽

Split Face

Abstract Background Acne scarring is often the primary concern of a patient with acne. Acne scarring can cause depression and is a risk factor for suicide. Patients feel their appearance interferes with their relationships and chances of future employment. Acne scars can be classified into 3 different types: atrophic, hypertrophic, or keloidal. Atrophic acne scars are the most common type. Atrophic acne scars are divided into three main types: ice pick, rolling and boxcar scars. Aim of the Work To compare the results of whole facial area versus Focal Acne Scar Treatment (FAST) by factional CO2 laser in a split face study. Patients and Methods The present study is a split face comparative study which included 20 adult patients with atrophic acne scars ranged from 18 to 44 years old of both sex. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided written consent. Results Patients were asked to compare the pain, peeling and complications between the right and left sides post CO2 fractional treatment: pain was more at right side in 35% of cases and more at left side in 30% of cases and equal in the rest of cases, peeling was faster at the right side in 60% of cases, faster at the left side in 20% of cases and equal at the rest of cases, 4 of the patients had post inflammatory hyperpigmentation (1 patient at right side, 2 patients at left side and 1 patient at both sides), no other complications were recorded as secondary infection, scaring keloid and prolonged erythema. Conclusion We compared the results of whole facial area treatment in the right side of the face versus Focal Acne Scar Treatment (FAST) in the left side by factional CO2 laser. We discovered that there is a statistically highly significant relationship between the improvement of acne scars and treatment with fractional CO2 laser by the either techniques. Both techniques are preferable in treating acne scars in equal degree.

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Microneedling Radiofrequency for Acne Vulgaris and Post-Acne Scarring: A Case Report

BioScientia Medicina ◽

10.37275/bsm.v6i3.456 ◽

2022 ◽

Vol 6 (3) ◽

pp. 1443-1445

Author(s):

Vesri Yossy ◽

Wydya Yenny ◽

Lilik Norawati

Keyword(s):

Case Report ◽

Combination Therapy ◽

Acne Vulgaris ◽

Topical Therapy ◽

Skin Surface ◽

Therapeutic Modalities ◽

Dermatological Examination ◽

Acne Scars ◽

The Face ◽

Acne Scarring

Background: There are various therapeutic modalities for acne and post acne scarring, but the best option is to have a safe, effective with affordable cost such as monotherapy or combination therapy. One of the recommended combination therapy for acne vulgaris with atrophic acne scars is microneedling radiofrequency which can improve skin structure. Case report: A 25 year old male with moderate comedonal acne vulgaris and severe scarring. The patient came with complaints of uneven skin surface on both cheeks, forehead and chin which had been felt to increase since 3 years ago. The appearance of acne on the face has been felt since 12 years ago. The patient's parents and sister also had acne complaints. On dermatological examination, on the forehead, temples, cheeks, nose and chin found blackheads, whiteheads, papules, hyperpigmented macules, multiple atrophic acne scars. The treatment choice for this patient is microneedling radiofrequency in combination with topical therapy. Discussion: The combination of microneedling with radiofrequency is one of the therapeutic modalities for acne vulgaris and also post-acne scarring with minimal side effects. In the evaluation for 2 weeks after the procedure, this patient did not complaint of any adverse events.

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Clinical profile of acne vulgaris in semiurban patients

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20180120 ◽

2018 ◽

Vol 4 (1) ◽

pp. 23

Author(s):

Kshitij Saxena ◽

Yogesh M. Shah ◽

K. K. Singh ◽

Shobhit Dutt ◽

Meenal Agrawal ◽

...

Keyword(s):

Age Of Onset ◽

Acne Vulgaris ◽

Chronic Inflammatory Disease ◽

Clinical Profile ◽

Acne Lesion ◽

Dermatology Clinic ◽

Common Skin ◽

Associated Conditions ◽

Acne Scarring ◽

Grade 3

Background: Acne is a chronic inflammatory disease of the pilosebaceous unit, mainly affecting face and frequently followed by scarring. It is the most common skin disease in an urban dermatology clinic in India. Adult acne is more common in women and may be a marker of hyperandrogenism.The present study was carried out to study the clinical profile of acne vulgaris in semiurban patients.Methods: The study was conducted for 1 year on all eligible patients of acne vulgaris attending dermatology OPD of a hospital catering to semiurban patients. Data including grade of acne, markers of androgenicity and post-acne scarring was collected. Statistical analysis was done using SPSS 15 software.Results: Frequency of acne vulgaris patients in the dermatology OPD was 2.8% with 429 acne patients out of 15,322 new patients. Female to male ratio was 1.44:1. The mean age of onset in males was 16.24 and in females, 14.84 years. Grade 2 acne (66%) was commonest followed by grade 3 (5.1%) and grade 4 (3.7%). Associated conditions seen were seborrhea (60.8%), alopecia (18.9%), acanthosis (4.9%) and PCOD (2.3%). Markers of androgenicity were more frequently seen in grade 2 acne which was statistically significant. Atrophic scars were commonest including icepick scars (80.2%), rolling scars (67.4%) and box scars (57.8%). Conclusions: In our study females had an earlier onset and closed comedones were the most common acne lesion. Grade 2 acne vulgaris formed majority of patients. Grade 4 acne vulgaris was more common in males.

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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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Dermaroller: simple and effective acne scar treatment

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20163149 ◽

2016 ◽

Vol 2 (3) ◽

pp. 46 ◽

Cited By ~ 1

Author(s):

Suma Patil ◽

S. K. Patil

Keyword(s):

Minimally Invasive ◽

Acne Vulgaris ◽

Invasive Procedure ◽

Response To Treatment ◽

Grading System ◽

Minimally Invasive Procedure ◽

Acne Scar ◽

Effective Treatment Option ◽

The Mean ◽

Grade 3

Background: Scarring is particularly a distressing phenomenon. The micro-needling is a minimally invasive procedure which has recently attained popularity because of the fact that it can be used safely with minimal training.Methods: The present study was performed on 30 patients suffering from facial scarring of acne vulgaris. The patients were photographed and assessed clinically at the time of enrolment to grade the severity of scarring as per the grading system proposed by Goodman and Baron.Results: A total of 30 patients were included in the study of which females were 18 and males 12. The age of the patients ranged from 18 to 30 years with the mean age of 24 years. Overall, 20 out of the total of 28 patients (71.4%) showed an excellent response to dermaroller treatment while 7 others achieved a good response (25%). Only 1 patient (3.6%) out of the total of 28 failed to show a significant response to treatment.Conclusions: Dermaroller is a safe and effective treatment option for grade 2 and grade 3 acne scars.

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

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20210572 ◽

2021 ◽

Vol 7 (2) ◽

pp. 223

Author(s):

Neeti Kumari ◽

Arun Kumar ◽

Jitendra S. Bist ◽

Anil K. Mehta

Keyword(s):

Yttrium Aluminum Garnet ◽

Platelet Rich Plasma ◽

Acne Vulgaris ◽

Treatment Session ◽

Treatment Modalities ◽

Acne Scar ◽

Yag Laser ◽

Multiple Treatment ◽

Acne Scars ◽

Moderate Response

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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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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