Pooja T, Gopal K V T, Rao T Narayana, Devi B Gayatri, Kumar S Ashwin
Department of Dermatology, Maharajah's Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India.
Indian Dermatol Online J. 2020 May 10;11(3):349-354. doi: 10.4103/idoj.IDOJ_370_19. eCollection 2020 May-Jun.
Acne scarring commonly seen in young adults causes marked psychological distress. Commonly used procedural treatments for post-acne scarring have limited efficacy. This prospective, randomized study was undertaken to evaluate the efficacy and adverse effects offractional CO2 laser, microneedling, and platelet-rich plasma (PRP) in post-acne scarring.
Sixty clinically diagnosed cases of post-acne scarring of both sexes were enrolled and divided into three groups of 20 patients each. The severity of scarring was graded as per the qualitative and quantitative grading system proposed by Goodman and Baron. Group A, B, and C patients were treated with fractional CO2 laser, microneedling, and PRP,respectively, at monthly intervals for foursessions. Improve men tin quantitative and qualitative grades of scars and adverse effects were noted at each session and 1 month after the final sitting. Statistical analysis was done using Student 't' test for quantitative values and Chi square test for qualitative values.
At the end of foursessions, based on mean percentage of improvement in quantitative grade, the efficacy of fractional CO2 laser is significantly greater than that of PRP ( = 0.00), while CO2 laser and microneedling did not show significant difference ( = 0.106). Based on qualitative scores, fractional CO2 laser group showed statistically higher therapeutic efficacy compared to microneedling and PRP ( = 0.00).No significant adverse effects were encountered in any groups.
Fractional CO laser resurfacing is more efficacious than microneedling and PRP. Unsatisfactory results were obtained with PRP as monotherapy in post-acne scarring.
痤疮瘢痕在年轻人中很常见，会引起明显的心理困扰。常用的痤疮后瘢痕程序性治疗效果有限。本前瞻性随机研究旨在评估分次二氧化碳激光、微针治疗和富血小板血浆（PRP）治疗痤疮后瘢痕的疗效和不良反应。
纳入60例临床诊断为痤疮后瘢痕的患者，男女不限，分为三组，每组20例。根据古德曼和巴伦提出的定性和定量分级系统对瘢痕严重程度进行分级。A组、B组和C组患者分别接受分次二氧化碳激光、微针治疗和PRP治疗，每月一次，共治疗四次。每次治疗时及最后一次治疗后1个月记录瘢痕定量和定性分级的改善情况及不良反应。对定量值采用学生t检验，对定性值采用卡方检验进行统计分析。
在四次治疗结束时，基于定量分级的平均改善百分比，分次二氧化碳激光的疗效显著高于PRP（P = 0.00），而二氧化碳激光和微针治疗之间无显著差异（P = 0.106）。基于定性评分，分次二氧化碳激光组的治疗效果在统计学上高于微针治疗组和PRP组（P = 0.00）。所有组均未出现明显不良反应。
分次二氧化碳激光换肤术比微针治疗和PRP更有效。PRP作为痤疮后瘢痕的单一疗法效果不理想。
