Fractional erbium-YAG laser vs platelet rich plasma in acne scar: a comparative study
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20210572Keywords:
Acne scars, Erbium-YAG laser, Platelet-rich plasmaAbstract
Background: Facial acne scar is a common complication of acne vulgaris leading to social isolation, lack of self-confidence and depression that warrants multiple treatment approach. In recent years, fractional erbium-yttrium aluminum garnet (er-YAG) 2940 nm laser and platelet-rich plasma (PRP) have been used independently or in combination with other resurfacing modalities in treating acne scars with variable outcomes. The objective of this study is to compare the therapeutic responses and safety of fractional erbium-YAG 2940 nm laser and platelet-rich plasma in atrophic post acne scars.
Methods: Patients were randomly divided into two groups (30 each), receiving six sittings of fractional er-YAG laser and PRP every month. Response was evaluated 4 weeks after each treatment session using Goodman and Baron qualitative acne scar grading system, photographic assessment by 2 blinded dermatologist and patients own satisfaction.
Results: Both treatment modalities showed improvement of acne scars, but the improvement with fractional er-YAG laser (27% marked and 70% moderate response) treatment was higher in comparison to PRP (10% marked and 67% moderate response) in terms of acne scar grade severity (p=0.33). Similar results were obtained on photographic assessment (p=0.015 and 0.021), and patient’s own satisfaction (p=0.011), respectively. Pain and stinging score were lower in er-YAG group while down time for same was shorter in PRP.
Conclusions: Both er-YAG laser and PRP showed significant improvement in atrophic acne scar while former showing slightly superior response with lesser adverse effects.
Metrics
References
Rook’s textbook of dermatology, 9th edition. Edited by Griffiths. Barker, Bleiker, Chalmers, Creamer, Blackwell Publishing Ltd. Cole GT. 2010;9(90):90-1.
Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L et al. New developments in our understanding of acne pathogenesis and treatment. Experim dermatol. 2009;18(10):821.
Chuah SY, Goh CL. The Impact of Post-Acne Scars on the Quality of Life Among Young Adults in Singapore. J Cutaneous Aesthetic Surg. 2015;8(3):153-8.
Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol. 2001;45(1):109-17.
Goodman GJ, Baron JA. Postacne scarring: a qualitative global scarring grading system. Dermatologic Surg. 2006;32(12):1458-66.
Loesch M, Somani AK, Kingsley MM, Travers JB, Spandau DF. skin resurfacing procedures new and emerging options. Clin Cosmetic Investig Dermatol. 2014:7(6):231-41.
Tavares Filho JM, Belerique M, Franco D, Porchat CA, Franco T. Tissue expansion in burn sequelae repair. Burns. 2007;33:246-51.
Al-Dhalimi M, Jaber A. Treatment of atrophic facial acne scars with fractional Er:Yag laser. J Cosmet Laser Ther. 2015;17(4):184-8.
Osman MA, Shokeir HA, Fawzy MM. Fractional Erbium-Doped Yttrium Aluminum Garnet Laser Versus Microneedling in Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study. Dermatol Surg. 2017;43(1):S47-56.
Thiboutot DM, Abanmi A, Araviiskaia E, Baron Cabal MI, Bettoli V. Practical management of acne for clinicians: an international consensus from the global alliance to improve outcomes in acne. J Am Acad Dermatol. 2018;2(1):1-23.
Tanzi EL, Alster TS. Single-pass carbon dioxide versus multiple pass Er:YAG laser skin resurfacing: a comparison of postoperative wound healing and side-effect rates. Dermatol Surg. 2003;29:80-4.
Manuskiatti W, Triwongwaranat D, Varothai S, Eimpunth S, Wanitphakdeedecha R. Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians. J Am Acad Dermatol. 2010;63:274-83.
Jeong JT, Park JH, Kye YC. Resurfacing of pitted facial acne scars using Er:YAG laser with ablation and coagulation mode. Aesthetic Plast Surg. 2003;27(2):130-4.
Kutlubay Z, Gokdemir G. Treatment of atrophic facial acne scars with theEr:YAG laser: a Turkish experience. J Cosmet Laser Ther. 2010;12:65-72.
Chathra N, Mysore V. Resurfacing of facial acne scars with a new variable-pulsed Er:YAG laser in Fitzpatrick skin types IV and V. J Cutan Aesthet Surg. 2018;11:20-5.
Moustafa T, Hassan I, Eisa M, Ahmed I, Aya G, Essam N. Fractional Erbium-YAG Laser and Platelet-Rich Plasma as Single or Combined Treatment for Atrophic Acne Scars: A Randomized Clinical Trial. Dermatol Therapy. 2019;9:10.
Goldust M. The efficacy and safety of Er:YAG laser for treatment of atrophic acne scars Glob Dermatol. 2014;1(2):47-50.
Nirmal B, Pai SB, Sripathi H. Efficacy and safety of erbium-doped yttrium aluminium garnet fractional resurfacing laser for treatment of facial acne scars. Indian J Dermatol Venereol Leprol. 2013;79(2):193-8.
Cenk H, Sarac G. Effectiveness and safety of 2940-nm multifractionalEr: YAG laser on acne scars. Dermatol Ther. 2020;e14270.
Gulanikar AD, Vidholkar R. Efficacy of platelet-rich plasma in acne scars. Clin Dermatol Rev. 2019;3:109-14.
Babu AM, Shettyvh Goel S, Eram H. A comparative study of efficacy and safety of platelet rich plasma versus fractional co2 laser in the treatment of post acne scars. Int j res Dermatol. 2019;5:254-8.
Lee JW, Kim BJ, Kim MN. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial. Dermatol Surg. 2011;37(7):931-8.
Chawla S. Split face comparative study of microneedling with PRP versus microneedling with vitamin C in treating atrophic post acne scars. J Cutan Aesthet Surg. 2014;7(4):209-12.
Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016;15(4):434-43.
Ibrahim MK, Ibrahim SM, Salem AM. Skin micro-needling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study. J Dermatolog Treat. 2018;29:281-6.
Ibrahim ZA, El-Ashmawy AA, Shora OA. Therapeutic effect of microneedling and autologous plateletrich plasma in the treatment of atrophic scars: a randomized study. J Cosmet Dermatol. 2017;16:388-99.
Osman MA, Shokeir HA, Fawzy MM. Fractional Erbium-Doped Yttrium Aluminum Garnet Laser Versus Microneedling in Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study. Dermatol Surg. 2017;43(1):S47-56.
Manuskiatti W, Iamphonrat T, Wanitphakdeedecha R, Eimpunth S. Comparison of fractional erbium-doped yttrium aluminum garnet and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians. Dermatol Surg. 2013;39:111-20.
Downloads
Published
How to Cite
Issue
Section
