Fractional Erbium-Doped Yttrium Aluminum Garnet Laser Versus Microneedling in Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study

Summary Background Many methods have been performed to achieve a satisfying outcome in acne scars but some of them were high cost and also were associated with low results and some complications. Objectives To evaluate and compare the efficacy and safety therapy of glycolic acid (GA) peel, microneedling with dermapen and a combination of both procedures in treatment of atrophic acne scars. Patents and methods This study was conducted on 30 patients suffering from acne scars. They were randomly assigned into three groups, each group included 10 patients; group I was treated with GA peel, group II treated was with microneedling. Group III received a combination of both procedures. All patients received six sessions with 2‐week intervals. The clinical assessment was based on the qualitative global scar grading system before and after treatment, quartile grading scale, and degree of patient satisfaction. Results There was a statistically significant decrease in acne scars grade after treatment among the studied groups (P = 0.04) but it was higher in group III. There was improvement in boxcar, ice pick, and rolling scars in all groups, respectively (P = 0.03, P = 0.04, P = 0.04). Patients' satisfaction was higher in group III (P = 0.04). Conclusion The combination of dermapen and GA peel is more effective than monotherapy.

Section: Discussioncontrasting

confidence: 98%

Microneedling by dermapen and glycolic acid peel for the treatment of acne scars: Comparative study

Saadawi

Esawy

Kandeel

et al. 2018

“…Some studies in the literature indicate the considerable efficacy of microneedling in skin rejuvenation, 19,22,23 but there is only one study that compares microneedling with the fractional Er:YAG laser in the treatment of atrophic acne scar. 21 Therefore, our study seems to be distinguishing as a clinical trial used skin biomechanical evaluation along with clinical assessment to compare these modalities in facial rejuvenation. It would be better if we could perform a skin biopsy 6 months after the procedures to assess the histopathological pattern of possible neocollagenesis.…”

Section: Discussionmentioning

confidence: 99%

“…We found mild-to-moderate improvement of facial wrinkles with no significant difference between these laser systems 6,20. In a study by Osman et al about the efficacy and safety of fractional Er:YAG laser and microneedling in the treatment of atrophic acne scars, the results showed a significant clinical and histological improvement of skin lesions with both methods, but the efficacy of fractional Er:YAG laser treatment was significantly better than the microneedling technique on the acne scars.The pain score was significantly lower in the fractional Er:YAG laser, but the downtime was significantly shorter in the microneedling method 21. However, in our present study, both fractional Er:YAG laser and microneedling showed considerable improvement in facial rejuvenation with no significant difference, but microneedlingTA B L E 2 Degree of wrinkle improvement compared to baseline Moderate improvement of dyschromia and periorbital wrinkles along with mild improvement of nasolabial fold and lower face sagging after laser treatment in a 61-year-old woman: right side (microneedling) and left side (fractional Er:YAG laser).…”

mentioning

confidence: 84%

Efficacy of microneedling versus fractional Er:YAG laser in facial rejuvenation

Robati

Hamedani

Namazi

et al. 2020

Background: Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects. Aims: To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation. Patients/Methods: This study was planned as a split-face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3).Results: Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P-value < .05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling-treated side. There were no long-lasting or severe adverse effects after treatment with both methods. Conclusion:Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients. K E Y W O R D S facial rejuvenation, fractional Er:YAG laser, microneedling, wrinkle How to cite this article: Robati RM, Hamedani B, Namazi N, Niknejad N, Gheisari M. Efficacy of microneedling versus fractional Er:YAG laser in facial rejuvenation. J Cosmet

“…Subcision, needling and PRP are minimally invasive modalities and have the advantages of short downtime and low cost . The combination treatment used in the present study is effective in severe (grade 4) acne scarring and well tolerated in Fitzpatrick skin types III to V. To our knowledge, this is the first study that has combined these minimally invasive modalities.…”

Section: Discussionmentioning

confidence: 77%

Combination therapy using subcision, needling, and platelet‐rich plasma in the management of grade 4 atrophic acne scars: A pilot study

Bhargava

Kroumpouzos

Varma

et al. 2019

Summary Background Multimodality therapies including minimally invasive modalities are increasingly used in atrophic scarring. Objective To evaluate the role of platelet‐rich plasma (PRP) as adjunctive therapy to a combined subcision and needling treatment in severe (grade 4) atrophic acne scarring. Methods A total of 30 patients with grade 4 acne scars were randomly divided into two groups, 15 patients each: Group A underwent three sequential treatments of subcision and needling while Group B, three sequential treatments of subcision, needling, and topical application of PRP that were performed at 3‐week intervals. Scar grading was assessed 3 months following the final session. Participant's assessment of treatment response was registered. Results Scar improvement ≥50% was reported significantly more often by Group B than Group A patients (P = 0.025). Regarding physician‐based assessment of scar grading post‐therapy (number of patients with two grades improvement vs one grade or no improvement), there was a trend toward more improvement in Group B (P = 0.195). Physician's evaluation of acne scar improvement correlated with the patient's assessment of improvement: 60% of Group A and 66.6% of Group B patients appreciated an improvement of 25%‐49% and 50%‐74%, respectively. Mean duration of postprocedure erythema/edema was shorter among Group B than Group A patients (16.1 vs 32.9 hours, respectively). Overall, substantial improvement was noticed in rolling and boxcar scars with only a mild change in icepick scars. Conclusion Platelet‐rich plasma appears to add to the improvement of grade 4 atrophic acne scars when combined with needling and subcision. These findings require further evaluation by future studies.