Combined treatment modalities in atrophic acne scars: a prospective study
Keywords:Subcision, Micro-needling, TCA CROSS, Goodman and Baron qualitative grading
Background: Atrophic acne scars are one of the sequalae that follows acne vulgaris. These scars are big cosmetic concern presenting with varied morphology like ice-pick, rolling and boxcar scars and it needs multimodal approach to treat effectively rather than a single modality. Our main aim is to study the efficacy of combination therapy using subcision, micro-needling and trichloro acetic acid chemical reconstruction of skin scars (TCA CROSS) in a sequential manner for the management of atrophic acne scars.
Methods: Total 30 patients of either sex with grade 2, 3, and 4 atrophic acne scars were graded using Goodman and Baron qualitative grading and were enrolled in the study. After single sitting of subcision, micro-needling and 50% TCA CROSS were performed alternatively at 3 weeks interval for a total of 3 sessions of each. Grading of acne scars were done by taking photographs at pre-treatment, post treatment, 1st and 3rd month after last treatment session.
Results: Out of 14 patients with grade 4 acne scars, 9 (64.3%) patients improved to grade 2 and 5 (35.7%) patients improved to Grade 3. Out of 10 patients with Grade 3 scars, 6 (60%) patients improved to grade 1, and 4 (40%) patients were improved to grade 2 at the end of study. All 5 patients with Grade 2 scars showed significant improvement from baseline.
Conclusions: Subcision, micro-needling and TCA CROSS, if they are combined and adequately done in proper manner will have excellent response in all types of atrophic acne scars.
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