Comparison of Efficacy and safety of Microneedling with 35% Glycolic acid peel versus Glycolic acid peel alone in the treatment of Atrophic acne scars; A Randomized Controlled Trial
Abstract
Background Acne scars are permanent textural changes and indentations that occur on the skin becauseof severe acne. Microneedling and peels have emerged as major treatment options for acne scars.Microneedling enhances the production of new collagen. Fibroblasts migrate to the point of puncturefor closure of wound and stimulate endothelial cells resulting in the formation of new microvasculature. Glycolic acid peel has anti-inflammatory, keratolytic and antioxidant action. It enhancescorneosome breakdown and reduces cohesiveness leading to desquamation. There is dearth of datacomparing the combination of these modalities to peeling alone in our population.Objective To compare the efficacy and safety of glycolic acid peel combined with microneedling versus35% glycolic acid peel alone in the treatment of acne scars.Methods This randomized controlled trial was conducted from 27th September 2021 to 28th March2022 at Outpatient Department of Dermatology, Services Hospital, Lahore. Patients of either gender,with grade 2 to grade 4 acne scars were included. After written informed consent, they were randomlydivided into two treatment groups. Group A patients were treated with 35% glycolic acid peelcombined with microneedling while Group B was treated with 35% glycolic acid peel alone. Allpatients received six treatment sessions with 2â€week interval between the sessions. They were calledfor follow-up one month after the last treatment session and treatment response was noted. ‘Treatmentresponse’ or efficacy was defined as Excellent response (reduction in two grades of scars), Goodresponse (reduction in one grade) or Poor response (no reduction in grade of scars). Safety oftreatments was assessed by side effects reported by patients and observed on examination.Results Out of 60 patients, 51 (85%) were females and 09 (15%) were males with female to male ratioof 5.7:1. They were divided equally into two treatment groups. The mean age of patients in group Awas 32.43 ± 6.91 years and in group B was 33.27 ± 7.24 years. Majority of the patients (58.33%) werebetween 31 to 45 years of age. Efficacy of Group A (glycolic acid peel 35%, combined withmicroneedling) was seen in 29 (96.67%) patients while in Group B (peeling alone) was seen in 22(73.33%) patients (p-value=0.011). Two patients in combination group reported post-inflammatoryhyperpigmentation, rest of the patients reported improvement in tone and texture of skin.Conclusion This study concluded that use of glycolic acid peel 35% combined with microneedling ismore effective treatment option in acne scars when compared to glycolic acid peel alone. Patients inboth the groups reported improvement in the tone and texture of skin with a relatively good safetyprofile.Keywords Acne scars, Glycolic acid peel 35%, Microneedling, EfficacyReferences
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