Comparison of Efficacy and Safety of Glycolic Acid Peel versus Glycolic Acid Peel Combined with Micro-needling in Treatment of Acne Scars: A Quasi- Experimental Study
DOI:
https://doi.org/10.66344/jpad.v36i2.3415Keywords:
Acne scars, Glycolic acid peel, Microneedling, Atrophic scars, Combination therapyAbstract
Background Various treatment modalities for acne scars including chemical peels and microneedling, have been used to improve atrophic acne scars with varying degrees of success. Glycolic acid peel promotes skin exfoliation and collagen remodeling, while microneedling stimulates dermal collagen production. Combining these therapies may enhance treatment outcomes compared with glycolic acid peel alone.
Objective To compare the safety and effectiveness of 35% glycolic acid peel alone versus combined glycolic acid peel and micro needling in treating acne scars.
Methods Sixty patients were enrolled in the study and divided into Groups A and B, aged 18-45 years. Group A received six fortnightly sessions of microneedling using a 1.5 mm derma roller with glycolic acid peel, whereas Group B underwent six sessions of 35% glycolic acid alone. Goodman's Qualitative Acne Scar Grading System was used to assess the outcomes.
Results Boxcar scars were most common, followed by rolling scars and icepick scars with frequencies of 38.3%, 31.7%, and 30.0% respectively. Group A demonstrated better outcomes (P=.041): 60% of patients showed excellent improvement compared to 33.3% in Group B. Moderate improvement was recorded in 30% of Group A patients versus 40% in Group B, while poor response was seen in 10% versus 26.7%. Both treatment modalities were safe and well tolerated. Mild transient erythema and facial edema were the most commonly observed adverse effects, resolving spontaneously within 24-48 hours. No serious complications were observed in either group.
Conclusion Using glycolic acid with microneedling is safe and yields better results for the treatment of acne scars in comparison to the use of glycolic acid alone.
References
1. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016 Jan 19;7:13-25. doi: 10.2147/AHMT.S55832.
2. Dreno B, Amici JM, Demessant-Flavigny AL, Wright C, Taieb C, Desai SR, et al. The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach. Clin Cosmet Investig Dermatol. 2021 Jun 14;14:623-632. doi: 10.2147/CCID.S315846.
3. Fabbrocini G, Annunziata MC, D'Arco V, De Vita V, Lodi G, Mauriello MC, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;2010:893080. doi: 10.1155/2010/893080.
4. Moon J, Yoon JY, Yang JH, Kwon HH, Min S, Suh DH. Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-β1 signalling. Br J Dermatol. 2019 Dec;181(6):1226-1237. doi: 10.1111/bjd.17851.
5. Limandjaja GC, Niessen FB, Scheper RJ, Gibbs S. Hypertrophic scars and keloids: Overview of the evidence and practical guide for differentiating between these abnormal scars. Exp Dermatol. 2021 Jan;30(1):146-61. doi: 10.1111/exd.14121.
6. Kravvas G, Al-Niaimi F. A systematic review of treatments for acne scarring. Part 2: Energy-based techniques. Scars Burn Heal. 2018 Aug 16;4:2059513118793420. doi: 10.1177/2059513118793420.
7. Weissler JM, Carney MJ, Carreras Tartak JA, Bensimon RH, Percec I. The Evolution of Chemical Peeling and Modern-Day Applications. Plast Reconstr Surg. 2017 Nov;140(5):920-29. doi: 10.1097/PRS.0000000000003787.
8. Jun-Zeng, Huang TY, Wang ZZ, Gong YF, Liu XC, Zhang XM, Huang XY. Scar-reducing effects of gambogenic acid on skin wounds in rabbit ears. Int Immunopharmacol. 2021 Jan;90:107200. doi: 10.1016/j.intimp.2020.107200.
9. Rana S, Mendiratta V, Chander R. Efficacy of microneedling with 70% glycolic acid peel vs microneedling alone in treatment of atrophic acne scars-A randomized controlled trial. J Cosmet Dermatol. 2017 Dec;16(4):454-9. doi: 10.1111/jocd.12377.
10. Shukla, S.K. and Gold, M.H. (2021). Treatment of Acne and Acne Scars with Microneedling. In Microneedling (eds E.B. Houshmand and M.H. Gold). https://doi.org/10.1002/9781119431817.ch6
11. Saadawi AN, Esawy AM, Kandeel AH, El-Sayed W. Microneedling by dermapen and glycolic acid peel for the treatment of acne scars: Comparative study. J Cosmet Dermatol. 2019 Feb;18(1):107-14. doi: 10.1111/jocd.12827.
12. Ishfaq F, Shah R, Sharif S, Waqas N, Jamgochian M, Rao B. A Comparison of Microneedling versus Glycolic Acid Chemical Peel for the Treatment of Acne Scarring. J Clin Aesthet Dermatol. 2022 Jun;15(6):48-52.
13. Tobiasz, A., A. Jankowska-Konsur, and D. Nowicka, Topical Retinoids in Acne Vulgaris and Acne Scars- From Monotherapy to Combining Regimens. Pharmaceutic. 2026;19(4):620.
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