Pravangsuk Jana, Udompataikul Montree, Cheyasak Nutjira, Kamanamool Nanticha
Drs. Pravangsuk and Udompataikul are with the Skin Center, Srinakharinwirot University in Bangkok, Thailand.
Dr. Cheyasak is with Panyanunthaphikkhu Chonprathan Medical Center, Srinakharinwirot University in Nonthaburi, Thailand.
J Clin Aesthet Dermatol. 2021 May;14(5):50-55. Epub 2021 May 1.
Acne scarring is a concerning consequence of acne with a prevalence of 11 to 14 percent after acne resolution. Needle subcision is usually used by clinicians to treat acne scars due to its safety and simplicity. Recently, normal saline injection with a pneumatic injector has shown compatible outcomes in treating acne scars. This study compared the effectiveness of acne scar treatment with a pneumatic injector and that of hypodermic needle subcision. Twenty patients with moderate to severe atrophic acne scars were voluntarily enrolled. All consecutive patients were randomly selected and treated with normal saline injection by using a pneumatic injector on one side of the face during three sessions, separated by a four-week interval. The other side of the face was treated with needle subcision at the end of the first week of the protocol. Subjective assessments were performed by self-evaluation and two blinded dermatologists. For objective assessment, the depth and volume of acne scars were estimated by an ultraviolet A light video camera and Vernier calipers at baseline and four, eight, and 12 weeks. Pain score and adverse reactions were also noted at each visit. Eighteen patients with Fitzpatrick Skin Type III or IV completed the study. Differences in the resolution in diameter and the volume of boxcar and rolling acne scars over 12 weeks of follow-up between the pneumatic injection and needle subcision groups were statistically significantly improved relative to at baseline; however, there was no statistically significant difference in the efficacy between the two modalities. Satisfaction with each modality was not statistically different. No serious adverse effects occurred. Minor reactions such as minor hematoma and subcutaneous emphysema resolved within two weeks. The efficacy of normal saline injection with a pneumatic injector is not statistically different from that of needle subcision in treating boxcar and rolling acne scars; however, less side effects were recorded. Given this advantage, the use of pneumatic injectors should be considered for treating acne scars.
痤疮瘢痕是痤疮令人担忧的后果，痤疮消退后其发生率为11%至14%。由于其安全性和简便性，临床医生通常使用皮下分离术来治疗痤疮瘢痕。最近，使用气动注射器注射生理盐水在治疗痤疮瘢痕方面显示出了相似的效果。本研究比较了气动注射器治疗痤疮瘢痕与皮下注射针分离术的有效性。20例中度至重度萎缩性痤疮瘢痕患者自愿入组。所有连续入选的患者均被随机选取，在三个疗程中使用气动注射器在面部一侧注射生理盐水进行治疗，疗程间隔为四周。在方案的第一周结束时，面部另一侧采用皮下注射针分离术治疗。主观评估通过自我评估和两名不知情的皮肤科医生进行。为了进行客观评估，在基线、4周、8周和12周时，使用紫外线A光摄像机和游标卡尺估计痤疮瘢痕的深度和体积。每次就诊时还记录疼痛评分和不良反应。18例Fitzpatrick皮肤分型为III或IV型的患者完成了研究。在12周的随访中，气动注射组和皮下注射针分离术组在冰凿样和滚轮样痤疮瘢痕直径和体积消退方面的差异相对于基线有统计学显著改善；然而，两种治疗方式在疗效上没有统计学显著差异。对每种治疗方式的满意度没有统计学差异。未发生严重不良反应。轻微血肿和皮下气肿等轻微反应在两周内消退。在治疗冰凿样和滚轮样痤疮瘢痕方面，使用气动注射器注射生理盐水的疗效与皮下注射针分离术没有统计学差异；然而，记录到的副作用较少。鉴于这一优势，在治疗痤疮瘢痕时应考虑使用气动注射器。
