Intradermal vs. micro-needling platelet-rich plasma treatment for atrophic acne scars in Fitzpatrick Skin type 5 subjects: Two case reports
Keywords:
Acne scar, Atrophic scar, Platelet-rich plasma, Intradermal, Micro-needling, platelet rich plasma, acne scars, topical vitamin CAbstract
Introduction Atrophic scars are the most common and frequent complication of acne. The use of platelet-rich plasma (PRP) through the release of growth factors, cytokines and chemokines from α-granules may aid in the treatment of such atrophic scars. Objective To compare the effectiveness of intradermal administration of PRP with topical administration using micro-needling for treatment of atrophic acne scars. Methods Two subjects with atrophic scars were selected. Procedures were performed three times for the first subject and two times for the second subject with an interval of 3 weeks. The right side of the face was treated using intradermal PRP, while the left side was treated using micro-needling PRP. Assessments of clinical improvement were obtained by evaluating the photos of each treatment and assessment of the severity of the scar used the Global Acne Scarring Grading System and Lipper & Perez Score. Results Facial area treated using intradermal PRP in the first patient experienced an 85.71% improvement in Global Acne Scarring Grading System and 68.59% improvement in Lipper & Perez score after 9 weeks of treatment. While the second patient experienced 64.28% improvement in Global Acne Scarring Grading System and 71.35% improvement in Lipper & Perez score after 6 weeks of treatment. Furthermore, the first patient treated with micro-needling experienced 53.33% improvement in Global Acne Scarring Grading System along with 62.71% improvement in Lipper & Perez Score after 9 weeks of treatment. While the second patient experienced 61.90% improvement in Global Acne Scarring Grading System and 58.65% improvement in Lipper and Perez Score after 6 weeks of treatment. Conclusion Intradermal administration of PRP is more effective compared to topical administration using micro-needling, especially for boxcars and rolling scars. However, with notably more complications such as edema, pain, and longer downtime.References
Clark AK, Saric S, Sivamani RK. Acne Scars: How Do We Grade Them? Am J Clin Dermatol. 2018;19(2):139-44.
Connolly D, Vu HL, Mariwalla K, Saedi N. Acne Scarring-Pathogenesis, Evaluation, and Treatment Options. J Clin Aesthet Dermatol. 2017;10(9):12-23.
Bhargava S, Cunha PR, Lee J, Kroumpouzos G. Acne Scarring Management: Systematic Review and Evaluation of the Evidence. Am J Clin Dermatol. 2018;19(4):459-77.
Goodman GJ, Baron JA. Postacne scarring: a qualitative global scarring grading system. Dermatol Surg. 2006;32(12):1458-66.
Du R, Lei T. Effects of autologous platelet-rich plasma injections on facial skin rejuvenation. Exp Ther Med. 2020;19(4):3024-30.
Gulanikar A, Vidholkar R. Efficacy of platelet-rich plasma in acne scars. Clin Dermatol Rev. 2019;3(2):109-14.
Mikhael NW, Hamed AM, Malek NH. Efficacy of Platelet Rich Plasma in Treatment of Acne Scars. Benha J Appl Sci. 2021;6(3):25-7.
Pixley JN, Cook MK, Singh R, Larrondo J, McMichael AJ. A Comprehensive Review of Platelet-Rich Plasma in the Treatment of Dermatologic Disorders. J Dermatolog Treat. 2022:1-33.
Nanda S, Chauhan K, Shetty V, Dashore S, Bhatia S. Platelet-Rich Plasma in Aesthetics. Indian Dermatol Online J. 2021;12(Suppl 1):S41-s54.
Gawdat HI, Hegazy RA, Fawzy MM, Fathy M. Autologous platelet rich plasma: topical versus intradermal after fractional ablative carbon dioxide laser treatment of atrophic acne scars. Dermatol Surg. 2014;40(2):152-61.
yustin E. The Combination of Platelet Rich Plasma with Skin Needling or Subcision for Postacne Scaring: a Serial Case Study. J Stem Cell Res Tissue Eng. 2020;3(2):47-55.
Long T, Gupta A, Ma S, Hsu S. Platelet-rich plasma in noninvasive procedures for atrophic acne scars: A systematic review and meta-analysis. J Cosmet Dermatol. 2020;19(4):836-44.
Deshmukh NS, Belgaumkar VA. Platelet-Rich Plasma Augments Subcision in Atrophic Acne Scars: A Split-Face Comparative Study. Dermatol Surg. 2019;45(1):90-8.
Bhargava S, Kroumpouzos G, Varma K, Kumar U. Combination therapy using subcision, needling, and platelet-rich plasma in the management of grade 4 atrophic acne scars: A pilot study. J Cosmet Dermatol. 2019;18(4):1092-7.
Yepuri V, Venkataram M. Platelet-Rich Plasma with Microneedling in Androgenetic Alopecia: Study of Efficacy of the Treatment and the Number of Sessions Required. J Cutan Aesthet Surg. 2021;14(2):184-90.
Garg A, Chaudhary SS. Efficacy of dermaroller on morphology of acne scars: analytical and prospective study. Int J Res Dermatol. 2017;3:399-402.
