Department of Dermatology, R.D. Gardi Medical College, Ujjain, India. Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island. Department of Dermatology, Medical School of Jundiai, Sao Paulo, Brazil. GK Dermatology, PC, South Weymouth, Massachusetts.
BACKGROUND Multimodality therapies including minimally invasive modalities are increasingly used in atrophic scarring. OBJECTIVE To evaluate the role of platelet-rich plasma (PRP) as adjunctive therapy to a combined subcision and needling treatment in severe (grade 4) atrophic acne scarring. METHODS A total of 30 patients with grade 4 acne scars were randomly divided into two groups, 15 patients each: Group
A underwent three sequential treatments of subcision and needling while Group B, three sequential treatments of subcision, needling, and topical application of PRP that were performed at 3-week intervals. Scar grading was assessed 3 months following the final session. Participant's assessment of treatment response was registered. RESULTS Scar improvement ≥50% was reported significantly more often by Group B than Group A patients (P = 0.025). Regarding physician-based assessment of scar grading post-therapy (number of patients with two grades improvement vs one grade or no improvement), there was a trend toward more improvement in Group B (P = 0.195). Physician's evaluation of acne scar improvement correlated with the patient's assessment of improvement: 60% of Group A and 66.6% of Group B patients appreciated an improvement of 25%-49% and 50%-74%, respectively. Mean duration of postprocedure erythema/edema was shorter among Group B than Group A patients (16.1 vs 32.9 hours, respectively). Overall, substantial improvement was noticed in rolling and boxcar scars with only a mild change in icepick scars. CONCLUSION Platelet-rich plasma appears to add to the improvement of grade 4 atrophic acne scars when combined with needling and subcision. These findings require further evaluation by future studies.