Topographic computer analysis for acne scar treatment on face accompanying biopsy study after dermal injection of hydrotoxin mixture

Abstract

Background: Acne during youth can leave permanent facial scarring. The depressed acne scars can be treated by injection of stabilized hyaluronic acid (S-HA) into the dermis. Due to the large number of acne scars, manual injection methods are technically difficult and bear high risk of lump formation in the dermis. Therefore, the author designed a specific injection method to solve the two abovementioned problems. Aims: This research aims to assess the effect of the intradermal injection of S-HA and aboborulinumtoxinA mixture in the treatment of all types of acne scars. Materials/Methods: A total of 102 patients who suffered from acne scars were treated with a mixture of S-HA (Restylane Vital®) and abobotulinumtoxinA (Dysport ®). Using an automatic injector, micro-droplets of the mixture (0.001 cc of S-HA and 0.125 U abobotulinumtoxinA) were delivered into 1000 intradermal sites on whole face except eyelids. This instrument radically reduced injection amounts per site (0.001 cc), lessened manual operator efforts, and ensured consistent injection depth (from 0.8 to 1.2 mm depending on individual dermal thickness) into the facial dermis. The changes in each depression site of acne scars were evaluated by topographic computer analysis (point roughness), based on the 40 magnification microscopic photographs generated. Depth measurements of each small acne scar point were taken one by one at the exact same point before and after the treatments. Global Aesthetic Improvement Scale (GAIS) was measured for improvement of acne scars at 1-and 6-month posttreatment. Additionally, serial histologic examinations of the biopsy specimens evaluated neocollagenesis, neoelastinogenesis, and longevity state of the S-HA. Results: A total of 78 patients showed improvements of depressed acne scars in physical examinations, medical photographs, and dermascopic photographs. Using topographic computer analysis, the average point roughness decreased 27.48% (at 1 month) from 29.042 ± 6.85 (baseline) to 21.05 ± 6.30 µm (P < .0001), corresponding with scar improvements observed in physical examinations, and 3.02 ± 0.66 of GAIS at 1-month posttreatment. Using an injector allowed the hydrotoxin mixture This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Needling, lasers, and Meso-Botox for hypertrophic and keloidal scars: A comprehensive review study on promising procedural treatments

“…Recently, MesoBotox has been used for some dermatological indications, including both types of depressed atrophic scars like acne scar and hypertrophic scars, as an adjuvant therapy in combination with other widely used procedures. [ 50 51 ]…”

Evaluation and comparison of the efficacy and safety of cross‐linked and non‐cross‐linked hyaluronic acid in combination with botulinum toxin type A in the treatment of atrophic acne scars: A double‐blind randomized clinical trial

“…Botulinum toxin reduces the tension of the muscles surrounding the scar. 6,12,13 One of the new methods in the treatment of atrophic acne scars, for which few studies are available, is the use of cross-linked and noncross-linked HA in combination with botulinum toxin type A. The aim of this study is to compare the efficacy and safety of the BTA injection in combination with cross-linked HA and non-cross-linked hyaluronic in the treatment of atrophic acne scar.…”

“…Or with microneedling, multiple sessions are required to treat atrophic acne scars. 6 Hyaluronic acid (HA) is a naturally occurring substance in the body that is found in high concentrations in the skin. 7 It plays an important role in maintaining skin hydration and elasticity.…”

“…In addition, the laser cannot be used to treat active acne because postinflammatory hyperpigmentation remains. Or with microneedling, multiple sessions are required to treat atrophic acne scars 6 …”

“…Another application of this toxin is the treatment and prophylaxis of atrophic acne scars. Botulinum toxin reduces the tension of the muscles surrounding the scar 6,12,13 …”