Combined treatment modalities in atrophic acne scars: a prospective study

Abstract

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

Combination Procedure for Acne Scars Revision, Is It Needed?

“…This study revealed that intense oedema post-procedure complication is seen in only one patient following subcision. 24 Based on physical examination, there are brown spots on both cheeks and static wrinkles on the forehead as signs of moderate photoaging. Chronic sun exposure was identified as a contributing factor for the patient.…”