Double-blind, randomized controlled trial comparing the use of microneedling alone vs chemical peeling alone vs a combination of microneedling and chemical peeling in the treatment of atrophic post-acne scars. An assessment of clinical effectiveness and patients’ quality-of-life

Abstract

Introduction Acne vulgaris is a common, chronic disease. One of the most commonly encountered complications of acne is permanent atrophic scarring. Treatment of atrophic scars includes fillers, dermabrasion, laser resurfacing, microneedling and peelings and it is often difficult to treat. In our double-blind randomized controlled trial (RCT), we investigated the synergistic effect of microneedling with the application of trichloroacetic acid, kojic acid and hydrogen peroxide in the treatment of atrophic acne scars. Aim To assess the clinical effectiveness and patients’ quality-of-life (HRQoL) after three types of atrophic post-acne scar treatment, namely microneedling alone (MN) vs chemical peeling alone (CP) vs. a combination of microneedling and chemical peeling (MN + CP). Material and methods A total of 120 patients were enrolled into the study following strict inclusion/exclusion criteria and randomized into the three treatment groups – MN, CP (a combination of trichloroacetic acid, kojic acid and hydrogen peroxide), and MN + CP. According to a preapproved protocol, each patient underwent four treatment sessions, each spread 20 days apart. Both pre- and post-treatment clinical status (using the Goodman-Baron scale; two expert raters blinded to the treatment used) and patients’ HRQoL (using the Dermatology Life Quality Index) were assessed. Results During the 5-month recruitment period, a total of 120 patients were approached and agreed to take part in the study (94 females – 78.3% and 26 males) (mean age of 30.14 ±3.64 years; range: 18–45 years). Only in the MN + CP group there was a statistically significant improvement according to the G-B scale post-treatment (2.87 ±0.83 vs. 2.03 ±1.16 respectively; p = 0.0005). Patients in all three treatment groups experienced a statistically significant improvement in their HRQoL post-treatment (all p ’s < 0.05). Conclusions A combination of microneedling and chemical peeling produces the best, objectively measured effects in the treatment of atrophic post-acne scars. All examined treatments, even if not producing a clinically significant treatment outcome, improve patients’ HRQoL.

Beyond the Surface: A Deeper Look at the Psychosocial Impacts of Acne Scarring

“…Early physical intervention of acne and acne scars can help prevent and ameliorate acute psychosocial distress. 53 Similarly, psychotherapy and support groups can provide additional clinical benefit to patients who are undergoing physical treatments for their acne scars. 54 While there have been few studies so far, integrated dermatological and psychiatric care for patients with post-acne scarring shows promising potential.…”

High-frequency ultrasound in anti-aging skin therapy monitoring

“…Chemical peels are applied in anti-aging therapy to smooth the surface and remove the top layer of the callous epidermis. They are claimed 20 , 21 to help eliminate pigmentary disorders, scars, and wrinkles and reduce the signs of chrono- and photo-aging. The methods for evaluating the efficacy of TCA in treating photo-aging are summarized in 21 .…”

Analysis of the efficacy of blunt separation combined with uncrosslinked sodium hyaluronate composite solution for the treatment of tear trough deformity in Asians

“…To prolong the treatment effect and reduce complications after treatment, TTD can be treated by using a blunt separation technique to repair tissue trauma. After the tissue structure is released and destroyed by blunt separation technology, many cytokines can be produced in the repair process, improving facial skin problems and achieving good results 10 . This paper describes our research team's injection method of the improved blunt separation technique combined with an uncrosslinked sodium hyaluronate composite solution to fill the deep dermis through the principles of wound repair, filling, and stimulating collagen regeneration to treat TTD.…”

“…③ We do not recommend treatment if the score is greater than 8 (assess surgery). 12 a According to the Glogau scale 10. (1) Mild-Little wrinkles, no keratosis, requires little or no makeup for coverge; (2) Moderate-Early wrinkling, sallow complexion with early actinic keratosis, requires little makeup; (3) Advanced-Persistent wrinkling, discoloration of the skin with telangiectasias and actinic keratosis, always wears makeup; (4) Severe-Severe wrinkling, photoaging, gravitational and dynamic forces affecting skin, actinic keratosis with or without cancer, wears makeup with poor coverage.…”