Microneedling combined with platelet-rich plasma or trichloroacetic acid peeling for management of acne scarring: A split-face clinical and histologic comparison

J Cosmet Dermatol. 2018 Feb;17(1):73-83. doi: 10.1111/jocd.12459. Epub 2017 Dec 10.

Abstract

Background: Minimally invasive procedures provide effective, safe, relatively long-lasting, and natural results without large damage to the skin. A combination treatment is considered an approach that includes at least 2 different and unrelated modalities.

Objectives: This study aims to evaluate the use and effectiveness of some combined minimally invasive procedures for management of acne scarring.

Patients/methods: Twenty-four volunteers with postacne atrophic scars were randomly divided into 3 equal groups according to performed procedure on each side of the face (microneedling by dermaroller alone or combined with platelet-rich plasma [PRP] or trichloroacetic acid [TCA] 15% peeling) and received 6 bi-weekly sessions of treatment. Photography and punch biopsies were taken before and after 3 months of treatment for clinical, histological, and histometrical evaluation.

Results: Combined treatment of dermaroller and PRP or dermaroller and TCA 15% showed significant improvement when compared with dermaroller alone (P = .015 and .011 respectively). Epidermal thickness showed statistically significant increase in studied groups, mainly after dermaroller and TCA 15%. Moreover, the 3 studied groups showed more organized collagen bundles and newly formed collagen formation and markedly decreased abnormal elastic fibers.

Conclusions: Based on the clinical, histometrical, and histochemical assessment, inspite that most volunteers showed significant improvement after treatment, however, the combined use of dermaroller and TCA 15% was more effective in postacne atrophic scars than the use of dermaroller and PRP or dermaroller only.

Keywords: acne scarring; collagen-induction therapy; microneedling; platelet-rich plasma; trichloroacetic acid peeling.

Publication types

  • Comparative Study

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / pathology
  • Adult
  • Ambulatory Care / methods
  • Analysis of Variance
  • Atrophy / pathology
  • Atrophy / therapy
  • Biopsy, Needle
  • Chemexfoliation / methods*
  • Cicatrix / etiology
  • Cicatrix / pathology*
  • Cicatrix / therapy*
  • Cohort Studies
  • Combined Modality Therapy
  • Esthetics
  • Female
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Immunohistochemistry
  • Male
  • Photography
  • Platelet-Rich Plasma*
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Trichloroacetic Acid / therapeutic use*
  • Young Adult

Substances

  • Trichloroacetic Acid