Fractional Erbium-YAG Laser and Platelet-Rich Plasma as Single or Combined Treatment for Atrophic Acne Scars: A Randomized Clinical Trial

Abstract

IntroductionAcne scarring is a common undesirable complication of acne vulgaris. Fractional erbium-yttrium aluminum garnet (YAG) 2940 nm laser and platelet-rich plasma have been used in treating acne scars with variable outcomes. The objective of this study is to assess the efficacy of fractional erbium-YAG 2940 nm laser and platelet-rich plasma as a single line of treatment in comparison with combined treatment in atrophic postacne scars.MethodsSeventy-five patients were included in this trial and randomized into three equal groups (25 each). Group A was subjected to six sessions of erbium-YAG laser for 6 months, group B was treated with 12 sessions of platelet-rich plasma over the same period, and group C was subjected to six sessions of erbium-YAG laser plus 12 sessions of platelet-rich plasma over the same period. Each subject was evaluated by acne scar grading, photography, and subjective evaluation.ResultsBoth treatment modalities showed improvement of acne scars, but the improvement with combined treatment was better than that with erbium-YAG laser or platelet-rich plasma alone regarding scar grade improvement (P = 0.007 and 0.001), clinical improvement (P = 0.001 and 0.001), and patient satisfaction (P = 0.005 and 0.001), respectively.ConclusionsThe combination of platelet-rich plasma plus erbium-YAG laser is superior to either treatment alone for acne scars, with trivial side effects for all treatment modalities.Trial RegistrationClinicalTrials.gov identifier; NCT03933033.

Prospective and randomized comparative study of calcium hydroxylapatite vs calcium hydroxylapatite plus HIFU in treatment of moderate‐to‐severe acne scars

“…Managing acne scars is a challenge, 7‐10 and therapies are divided into nonsurgical and surgical. The former includes anti‐acne agents, 11,12 chemical peels, 13 microneedling, 14‐17 and ablative 18 and nonablative fractional 19‐22 and nonfractional 23 lasers, as well as autologous growth factors 24‐27 . The latter include subcision, 28‐30 autologous cell regeneration, 31 and autologous adipose‐derived stem cells 32 …”

Efecto del plasma rico en plaquetas en el tratamiento de las cicatrices por acné: revisión sistemática y metaanálisis

“…A partir de dicha selección, descartamos 195 registros por no cumplir con los criterios de elegibilidad. Analizamos 23 artículos, de los cuales 14 cumplieron los requerimientos para ser incluidos en el análisis del estudio (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50).…”

“…El resumen del procedimiento de selección de estudios lo hemos descrito en el diagrama de flujo de acuerdo con las guías PRISMA (Figura 1). (38,41,50).…”

“…Finalmente, seis estudios describieron la intensidad de los efectos adversos observados (37,(41)(42)(43)49,50). Entre las escalas usadas se encuentran la Escala Visual Análoga (EVA), la Escala de Evaluación Clínica del Eritema (CEA), dos escalas de tres y cuatro grados de severidad de eritema y edema y un dispositivo medidor del color de la piel (Chromameter CR-400, Minolta Co., Tokyo, Japan 4A).…”

“…Por el contrario, los restantes publicaron los resultados en forma global sin separar al grupo de intervención del control(37,49).4.2.2 Seguridad del PRPEvaluamos la seguridad en forma de presencia/ausencia, tiempo de duración e intensidad de efectos adversos. Nueve estudios reportaron la presencia o ausencia de los siguientes efectos adversos: eritema, edema, dolor, hiperpigmentación postinflamatoria, erupción acneiforme, infección, sangrado, quemaduras, formación de costra, equimosis y reacciones alérgicas(37,38,(40)(41)(42)(43)46,47,50). Este reporte fue realizado por un evaluador o dermatólogo luego de cada sesión de tratamiento y fue descrito en frecuencias.…”