Microneedling to Treat Acne Scars in Patients With Dark Skin Color
In patients with darker skin color, acne scarring is further complicated by hyperpigmentation.
Microneedling has been shown to be an effective treatment for both acne scars and the associated hyperpigmentation observed in patients with dark skin color, according to the results of a study conducted in the Department of Dermatology at the Jordan University of Science and Technology in Irbid, Jordan, and published in the Journal of Cosmetic Dermatology.
The primary objective of the study was to evaluate the improvement in pigmentation linked to acne scarring in patients with dark skin achieved by the use of microneedling. Secondary objectives included assessment of postacne scarring improvement and the safety of microneedling in pigmented skin.
A total of 39 patients who had darker skin colors (Fitzpatrick skin types 3, 4, and 5) completed the study. Two scoring tools — the Postacne Hyperpigmentation Index (PAHPI) and the Goodman-Baron (GB) scar scale — were used for baseline assessment of both acne scars and pigmentation, and to evaluate patients' response to microneedling with respect to scar improvement and associated hyperpigmentation. Baseline photographs were taken of all participants.
Average patient age was 26.8 years (range, 18 to 43 years). Skin colors of the participants ranged from type 3 to type 5, with most of the patients (n=27) having type 4. All patients were seen 2 weeks after the initial treatment and then after at least 4 weeks from the initial assessment.
Change in PAHPI scores from baseline to posttreatment was statistically significant
(P =.0035). Comparison between baseline and posttreatment scores on the GB scar scale also revealed a statistically significant improvement (P =.008). None of the other variables evaluated (skin type, gender, age, and hematoma) demonstrated any statistically significant changes in either PAHPI scores or GB scores.
The most common postprocedural side effects included transient erythema, mild dryness, and formation of small hematomas. Regarding patients' opinions about final improvement from baseline with the use of microneedling, 79% (31 of 39) of patients were satisfied with the treatment (Visual Analog Scale [VAS] score of 1 to 3), whereas 21% (8 of 39) of participants did not consider the results of the microneedling treatment to be satisfactory.
The investigators concluded that additional studies focused on postacne scarring with hyperpigmentation are warranted, along with assessment tools designed for this particular patient population.
Al Qarqaz F, Al-Yousef A. Skin microneedling for acne scars associated with pigmentation in patients with dark skin [published online March 15, 2018]. J Cosmet Dermatol.