A Split-Face Comparison Study between the Effects of Microneedling Combined with Topical Application of Autologous Platelet-Rich Plasma and the Effect of Microneedling Alone in the Treatment of Atrophic Post Acne Scars

Background: A permanent cosmetic disfigurement is produced due to acne scarring, which is linked to great psychological distress and low self-esteem. It is a significant cosmetic problem that poses a chief challenge to dermatologists. Skin micro puncturing technique called microneedling (MN) involves the body's self-healing mechanism to rejuvenate scars. It is believed that the different growth factors of platelet rich plasma (PRP) can stimulate wound healing and collagen regeneration. Therefore, we decided to conduct split face study to compare the efficacy of MN with PRP and MN alone. Material and Methods: This study was a split face comparative study of 30 patients with moderate to severe atrophic post-acne scars. The right half of the face was treated with MN plus topical PRP, and the left half was treated with MN alone. The treatments were given four times at monthly intervals. Final evaluation done six months from last session (9th month of treatment) by Goodman and Baron quantitative and qualitative acne scar grading scales. Photographic assessment of overall scar improvement was carried out by a blind observer, and patient self-assessment scores were recorded. The patients were followed on day 3and day 7 after the procedure and adverse effects were noted. Results: Noteworthy improvement in scar quality of both sides was detected. The qualitative grades for Goodman and Baron were both greatly lowered on each side separately and the difference between the two sides was not statistically significant at 9th month. Mean scores decreased significantly on both sides, in terms of quantitative scoring. At 9th month, there was a statistically significant scar improvement of 42.38% on the MN+PRP side (P<0.0001) and 38.08% on the MN side (P<0.000); however, there was no statistically significantly greater improvement on the MN+PRP side, as compared to the MN side (P=0.532), suggesting that MN+PRP is not superior to MN in scar reduction. There was a marked reduction in erythema and oedema on MN+PRP side than on MN side. Conclusion: Both of these modalities were successful and had similar outcomes. There was no improvement in scar improvement when PRP was combined with microneedling, while the downtime and discomfort were better with adding PRP.

Keywords: Acne, Scars, Microneedling, Platelet rich plasma.