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Background: Severe post-acne scarring has been implicated as a cause of considerable psychological distress, mainly among adolescents. Subcision and microneedling are cutting-edge treatment options available nowadays. Aim: In this study, we aimed to compare the efficacy of microneedling with platelet-rich plasma (PRP) against subcision with PRP in treating atrophic post-acne scars in a split-face study design. Materials and Methods: Fifty patients with atrophic post-acne facial scars were included in this prospective interventional study. Group A included the left side of the face managed by microneedling with PRP and group B included the right side of the face that was subjected to subcision with PRP. Results were assessed based on Goodman and Baron qualitative and quantitative grading. Results: In our study, at the end of the treatment, on the left side, 5 (10%) had 1 grade of improvement showing good response, 35 (70%) had 2 grades of improvement showing very good response, and 10 (20%) had 3 grades of improvement showing excellent response. On the right side, 1 (2%) patient had no improvement in acne grade showing poor response, 9 (18%) had 1 grade of improvement showing good response, 25 (50%) had 2 grades of improvement showing very good response, whereas 15 (30%) had 3 grades of improvement showing excellent response. Conclusion: Till date, apart from ours no other study has compared the two modalities head-to-head with adjuvant PRP in both groups. Although both modalities showed statistically significant results individually, there was no significant difference in qualitative improvement of acne scars between the two groups.
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Background: Acne scarring not only affects the aesthetic appearance of an individual but also has a detrimental effect on mental health and social life. Various treatment modalities are available for acne scars. Aim: In this study, fractional erbium-doped yttrium-aluminum-garnet (Er:YAG) laser resurfacing was compared with 20% trichloroacetic acid (TCA) peeling in terms of efficacy and safety. Materials and Methods: This prospective comparative study included 50 subjects of acne scar who were randomly divided into Groups A and B, 25 patients in each group. Group A was treated with 4 sessions of fractional Er:YAG laser and Group B with 4 session of 20% TCA application as chemical peeling, repeated every 21 days over a period of 3 months. The patients were evaluated for improvement at each visit using Goodman and Baron's qualitative and quantitative acne scar grading. Results: Statistically significant improvement in Goodman and Barron's qualitative acne scar grades was observed in both groups. At the end of therapy, that is, after 12 weeks of therapy, the mean percentage reduction in Goodman and Baron's quantitative acne scar scores was 21.69% ± 16% in Group A and 20.97% ± 8.70% in Group B. In regards of complications, both procedures were well tolerated. Conclusion: We concluded that fractional Er:YAG laser resurfacing and 20% TCA peel application in the treatment of atrophic acne scar are equally efficacious. Both procedures are safe and well tolerated by the patients.
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Background: Erbium-YAG laser has been the working horse in dermatology for years. Surprisingly, data on the efficacy and adverse effects of this novel resurfacing and ablative technique of erbium-YAG laser for superficial dermatoses in Indian skin is limited. Aim and Objective: To evaluate the efficacy and safety profile of erbium-YAG laser ablation in superficial cutaneous lesions. Materials and Methods: Two hundred and fifty patients of various superficial dermatoses, treatable by erbium-YAG laser, were recruited in the study. All the patients were subjected to erbium-YAG laser sessions. The number of laser sessions, fluence, frequency and other parameters were individualized as per the respective dermatosis. The clinical response was evaluated as grade 4 (100% lesion clearance), grade 3 (75-99%), grade 2 (50-75%) or grade 1 (<50%). Results: The overall mean age of our study group was 37.70 years. In our study, 52.38% cases of verruca plana, 36.84% cases of seborrheic keratosis, 56.4% cases of xanthelasma palpebrarum, 22% cases of acquired melanocytic nevus, 23.8% cases of plantar wart and 40% cases of sebaceous hyperplasia showed complete clearance. The most common adverse effect was post-laser erythema in 50.4% of cases, followed by pain in 36.8%. Besides this, scarring and dyspigmentation were observed in 11.6% and 12% of cases, respectively. The rate of recurrence on 3 months follow-up was 9 (23.07%) cases in xanthelasma palpebrarum, 11 (28.9%) cases in seborrheic keratosis, 10 (23.8%) cases in verruca plana and 9 (42.8%) cases in plantar warts. Conclusion: This study suggested that erbium-YAG ablation achieved good results for superficial lesions like verruca plana, seborrheic keratosis, xanthelasma palpebrarum, plantar wart, sebaceous hyperplasia and acquired melanocytic nevus. Thus, Er: YAG laser can offer a one-step procedure with better cosmetic results and a lesser rate of recurrence.