Comparing of the effectiveness and patients satisfaction in employing two approaches of Subcision and microneedling with Subcision and laser CO2 fractional in the treatment of acne scar
Abstract
Background Various treatments have been proposed to improve acne scars, with combination therapy sometimes required to achieve satisfactory results. This split-face, single-blind, controlled clinical trial compared subcision plus microneedling with subcision plus fractional CO2 laser in treating acne scars.  Methods Thirty patients with bilateral grade 3-4 acne scars were enrolled in this study between 2019 and 2020. All scars were treated with subcision treatment. Then, microneedling was done on the right side, and CO2 fractional laser was applied to the left. Patients were visited one month after the end of treatment. A dermatologist who was unaware of the treatment groups graded the acne scars on photographs taken before and after the intervention. The level of patient satisfaction was evaluated based on a researcher-made questionnaire. Statistical analyses were made using SPSS v.25 to compare improvements in acne scars and patient satisfaction with the different treatments.  Results According to Goodman and Baron’s scar grading scale, the overall improvement of scars was 76.66% in microneedling plus subcision (right side), 20% in fractional CO2 laser plus subcision (left side), and 3.33% on both sides (P=0.021). Patients’ satisfaction was 66.7% with microneedling plus subcision and 23.3% with CO2 fractional laser plus subcision (P<0.001).  Conclusion  Microneedling plus subcision provides promising and satisfactory outcomes after one month for patients with grade 3-4 acne scars, performing much better than CO2 fractional laser plus subcision. Further studies are required to assess long-term outcomes and side effects across repeated therapy sessions. ÂReferences
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