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      Split Face Comparative Study of Microneedling with PRP Versus Microneedling with Vitamin C in Treating Atrophic Post Acne Scars

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          Abstract

          Introduction:

          Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients.

          Materials and Methods:

          Thirty patients with post acne atrophic facial scars attending the OPD during the period from April to October 2013 were offered four sittings of microneedling with PRP on one side and microneedling with vitamin C on other side of the face at an interval of 1 month.

          Results:

          Twenty-seven out of the total 30 patients completed the treatment schedule. Two patients were lost to follow up and one dropped out of the study due to severe PIH. Mean age of the patients was 27.5 years. Out of 30 patients, 23 achieved reduction in scarring by one or two grades. Excellent response was seen in five (18.5%) patients with platelet-rich plasma (PRP) as compared to two (7%) patients who received treatment with vitamin C according to physician's assessment. As far as up gradation by 1 score is considered, i.e., good response, it was similar in both cases. Vitamin C did not prove to be as efficacious as PRP since 10 (37%) patients had poor response in vitamin C-treated area compared to only 6 (22.2%) patients who underwent PRP therapy, but vitamin C proved to be efficacious in dealing with post inflammatory hyper-pigmentation secondary to acne. Patients were more satisfied with PRP as compared to vitamin C. The results were evaluated and statistical analysis was done using SPSS 16.0.2.

          Conclusions:

          Overall results were better with microneedling and PRP. Vitamin C combined with microneedling also showed improvement with respect to firmness and smoothness of skin; as well as post inflammatory hyper-pigmentation. Microneedling combined with PRP proved to be good in treating boxcar and rolling scars but had limited efficacy in dealing with ice pick scars.

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          Most cited references11

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          Management of acne: a report from a Global Alliance to Improve Outcomes in Acne.

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            Acne scarring: a classification system and review of treatment options.

            Acne is a common condition experienced by up to 80% of people between 11 and 30 years of age and by up to 5% of older adults. In some patients, the severe inflammatory response to Propionibacterium acnes results in permanent, disfiguring scars. Over the past several decades, numerous descriptive terms and surgical techniques have been used to diagnose the types, and improve the appearance, of scarring in those persons with acne. We propose a descriptive, simple, universally applicable acne scar classification system that includes 3 scar types: icepick, rolling, and boxcar. We also have developed an effective treatment algorithm for reconstructing and improving the appearance of acne scars including punch excision, punch elevation, subcutaneous incision (Subcision), and laser skin resurfacing. This new classification system for acne scars enables the physician to more precisely identify scar subtypes. Once the scar type has been defined, appropriate and effective treatment protocols can be developed.
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              Postacne scarring: a qualitative global scarring grading system.

              There is no global qualitative grading system for assessing the disease load and global severity of disease in a patient with postacne scarring. The purpose of this article is to provide a simple qualitative grading system that would allow better communication between practitioners of a patient's global disease severity and the most appropriate corresponding therapy for that degree of acne scarring. Four grades of postacne scarring are described, and appropriate therapeutic interventions are presented for each. Grade assignment is made by lesion morphologies and disease load as indicated by patient perception of severity (i.e., whether or not an individual can easily disguise his or her disease at social distances). A simple qualitative global acne scarring grading system is presented. The determination of disease load in terms of patient perception of severity is intrinsically imperfect due to varying subjectivity among individuals. A global acne scarring grading system is presented that is simple to use and may optimize therapeutic intervention. This system would also allow investigators, educators, and proceduralists to compare their cases more accurately and to have a more objective discussion of the efficacy of operative interventions or therapies.
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                Author and article information

                Journal
                J Cutan Aesthet Surg
                J Cutan Aesthet Surg
                JCAS
                Journal of Cutaneous and Aesthetic Surgery
                Medknow Publications & Media Pvt Ltd (India )
                0974-2077
                0974-5157
                Oct-Dec 2014
                : 7
                : 4
                : 209-212
                Affiliations
                [1]Consultant Dermatologist, Amritsar, India
                Author notes
                Address for correspondence: Dr. Simran Chawla, H. No. 118 A-block, Ranjit Avenue, Amritsar, India. E-mail: sukhwinder.c@ 123456rediffmail.com
                Article
                JCAS-7-209
                10.4103/0974-2077.150742
                4338464
                25722599
                e9b68d59-0ff7-45df-af58-6ca3243ce626
                Copyright: © Journal of Cutaneous and Aesthetic Surgery

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Surgery
                post acne scars,atrophic scarring,dermaroller,microneedling,platelet rich plasma,vitamin c
                Surgery
                post acne scars, atrophic scarring, dermaroller, microneedling, platelet rich plasma, vitamin c

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