Microneedling in Combination With 15% Trichloroacetic Acid Peel Versus 25% Pyruvic Acid Peel in the Treatment of Acne Scars

Abstract

BACKGROUNDAcne scars are a permanent disfiguring sequel of acne.OBJECTIVETo compare the efficacy of microneedling with 15% trichloroacetic acid (TCA) peel versus microneedling with 25% pyruvic acid peel in the management of postacne scars.MATERIAL AND METHODSThirty patients with atrophic acne scars were randomized into 2 groups receiving microneedling on both sides of the face at 0,6, and 12 weeks and 15% TCA on one side and 25% pyruvic acid on other side at 3,9, and 15 weeks. Acne scar scoring performed using the Echelle D'Evaluation Clinique des Cicatrices D'Acne (ECCA) and visual analogue scales by patient and physician were used to grade improvement at all visits and at 21 weeks.RESULTSThe mean ECCA score on the TCA side declined from 151.17 ± 26.90 to 138.83 ± 30.56 and on the pyruvic side declined from 151.83 ± 27.53 to 141.33 ± 28.92 after 21 weeks (statistically significant: p-value <.05). Comparing the ECCA on the TCA and pyruvic sides at 21 weeks was not significant. VAS showed moderate-to-marked improvement after 3 months in both groups.CONCLUSIONIn our study, the combination modality showed early reduction in rolling and boxcar compared with icepick scars. These peels led to improvement in overall texture of the skin, hence more patient satisfaction. On comparing ECCA, a significant difference was not observed.

Acne microbiome: From phyla to phylotypes

“…Approximately 40% of acne sufferers develop clinically relevant scars and in darker skinned populations half or more develop pigmentary problems; 9,10 as with active lesions, these sequelae have an impact on life quality 3,4 . Further, they are often difficult to manage adequately 11 …”

“…3,4 Further, they are often difficult to manage adequately. 11 A variety of efficacious topical and systemic medical therapies for acne have been approved by regulatory bodies; however, their use can be limited by high costs, cutaneous irritation, possible teratogenicity, accessibility and efficacy-especially when patients are not able or are unwilling to use the medication for a suitable duration. Large-scale population-based studies have shown that overall medication adherence is low in acne.…”