Atrophic Acne Scars
Conditions
Keywords
Acne scarring, Atrophic acne scars, Rolling acne scars, Platelet-poor plasma gel, Plasma bio-filler
Brief summary
This randomized controlled trial compared two combined treatment approaches for atrophic acne scars. A total of 100 patients aged 15-45 years were enrolled from the Department of Dermatology, Lahore General Hospital, Lahore, and were randomly assigned to one of two treatment groups. All participants underwent subcision, a minor procedure in which fibrous bands beneath depressed acne scars were released to elevate the scarred skin. Participants in one group received platelet-rich plasma bio-filler injections after subcision. The bio-filler was prepared from each participant's own blood and was injected beneath the acne scars to provide volume and promote collagen formation. Participants in the other group received fractional carbon dioxide laser treatment after subcision. The laser created controlled microscopic skin injuries intended to stimulate collagen production and improve skin texture. Three treatment sessions were administered at 4-week intervals. Treatment outcomes were assessed using the Patient and Observer Scar Assessment Scale at baseline and during follow-up. Treatment-related adverse effects, including pain, erythema, bruising, and changes in skin pigmentation, were also recorded. Treatment efficacy was defined as a reduction of more than 50% in acne scar severity.
Interventions
BIOLOGICALPlatelet-Rich Plasma Bio-Filler With Subcision
Autologous plasma bio-filler was prepared from 20 mL of venous blood. The blood was centrifuged at 1,500 revolutions per minute for 10 minutes, followed by a second centrifugation at 3,000 revolutions per minute for 10 minutes. Approximately 4-5 mL of the upper plasma layer was collected, heated at 80-100°C for 5 minutes, and subsequently cooled at 0-6°C for 5 minutes to produce a viscous bio-filler. Following subcision, 0.1 mL of the bio-filler was injected beneath each marked scar. Three treatment sessions were provided at 4-week intervals.
DEVICEFractional Carbon Dioxide Laser With Subcision
After subcision, the treatment area received a single pass of fractional carbon dioxide laser using a pulse energy of 25 mJ, spot density of 144 spots/cm², pulse interval of 0.5 mm, and pulse duration of 0.1 milliseconds. Three treatment sessions were provided at 4-week intervals.
Sponsors
Lahore General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
15 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Patients of age 15-45 years, * both genders, * presenting with atrophic acne scars
Exclusion criteria
* Patients with photosensitive dermatosis, keloids, active acne, already taking steroidal, laser or trial treatment in last 6 months, hepatitis B or hepatitis C, hypothyroidism (TSH\>5IU), pregnant or breast feeding, skin infection or inflammatory skin disorders requiring systemic antimicrobials (on medical record). * Patients with connective tissue disorders or hypersensitivity to lidocaine, taking antiplatelet therapy, bleeding tendencies (on clinical examination)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Patient and Observer Scar Assessment Scale Score | Baseline and 4, 8, and 12 weeks after initiation of treatment. | Atrophic acne scar severity was assessed using the Patient and Observer Scar Assessment Scale. The scale was completed at baseline and at each follow-up assessment. The change in score from baseline was calculated for each participant and compared between the two treatment groups. A greater reduction from the baseline score represented greater improvement in acne scar severity. |
| Proportion of Participants Achieving Treatment Efficacy | 12 weeks after initiation of treatment. | Treatment efficacy was defined as a reduction of more than 50% in atrophic acne scar severity compared with baseline. The reduction was determined using the Patient and Observer Scar Assessment Scale. The number and percentage of participants achieving treatment efficacy were calculated for each treatment group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Treatment-Related Pain | At 4, 8, and 12 weeks after initiation of treatment. | Treatment-related pain was assessed at each follow-up visit and recorded as present or absent. The number and percentage of participants experiencing pain were compared between the two treatment groups |
| Incidence of Treatment-Related Pigmentary Changes | At 4, 8, and 12 weeks after initiation of treatment. | Hypopigmentation or hyperpigmentation occurring in the treated area was assessed by clinical examination and recorded as present or absent. The number and percentage of participants developing pigmentary changes were calculated for each treatment group. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORKainat Haq
Lahore General Hospital, Lahore
Outcome results
None listed