Punch Elevation and Microneedling in Treatment of Atrophic Acne Scars
Condition: Acne Scars
MeSH terms: Acne Vulgaris; Atrophy
Study type: Interventional

Summary: 
      The ultimate goal of this study was to compare punch elevation and micro needling with PRP
      versus micro needling and PRP only in treatment of post acne scars, in an attempt to achieve
      better management of such condition.

      This is a prospective study that was carried out on 15 patients (their ages ranged from 19 to
      32 years with a mean of 23 years. They are 6 males and 7 females, 7 patients were of skin
      photo type III, and 10 were rural residents), they presented with post acne facial scars, and
      attending the Dermatology and Andrology outpatient clinic of Al-Azhar University Hospital in
      (Assiut), between April 2021 and March 2022. Left side of face of the lesion of each patient
      will be treated by punch elevation two weeks before microneeedling with platlets rich plasma
      (PRP),the right side will be treated by microneedling with (PRP) only from the start, three
      sessions of microneedling will be done with 4 weeks interval.

      Each patient had punch elevation for scars in left side at first session then dressing
      removed after 7 days after three weeks all patents received treatment on both sides of the
      face by micro needling with PRP.

      During each session, topical anesthesia was applied over the area of interest on face and
      removed after 20 mints. Patients were placed in supine position with head stable, the skin
      was stretched and micro needling was carried out in vertical, horizontal and both diagonal
      directions for about 4-5 times. PRP (2 ml) were applied on the face. A total of three
      sessions of microneedling were performed at monthly intervals.

      Follow-up of the patients was done before and after treatment by clinical examination and
      photography by comparing the photographs before and after therapy; Evolution of clinical
      response included extent of improvement and possible adverse effects including bleeding, and
      erythema. And PIH Clinical photos of the lesions had been taken before the first session and
      one month after the last session and assessed clinically to grade the severity of scarring
      proposed by Goodman and Baron's quantitative scale for acne scars at the baseline and the end
      of study. Patients' satisfaction had been done by using a quartile grading system (1 poorly
      satisfied, 2 satisfied or 3 very satisfied).

      As regard efficacy of the procedures, we found significant improvement of atrophic acne
      scars, with significant reduction in number of acne scars as well as significant reduction in
      goodman score after treatment by punch elevation and micro needling with PRP, most of
      patients were satisfied after treatment, the side treated with punch elevation have
      statistically significant reduction in the number of the scar when compared to the right
      side.
    


Intervention name(s): Punch insturment
Intervention type(s): Procedure
Intervention description(s): surgical and dermatological tool used mainly for skin biopsy and therapeutic skin disorders
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment