Acne Scars Improve With Laser Plus Topical Treatment

Use of an anhydrous gel with tripeptide and hexapeptides pre- and postlaser resurfacing significantly decreased postprocedural transepidermal water loss (TEWL) and erythema compared with a bland moisturizer, according to findings from a study published in Clinical, Cosmetic and Investigational Dermatology. The adjuvant therapy also increased improvement in acne scars and patient satisfaction.

The prospective, randomized study included participants older than 18 years of age with grade II to III facial acne scars who received Regenerating Skin Nectar with TriHex Technology (RSN; Alastin Skincare Inc) or a bland moisturizer (Cetaphil lotion; Galderma), which was applied twice daily.

Participants had 7 study visits, which included screening and baseline 2 or more weeks before the first laser treatment, 2 laser treatment visits 1 month apart, follow-up visits after each laser treatment at day 4, and 60 days after the last laser treatment.

Assessments included TEWL, intensity of erythema, photography, Goodman and Baron qualitative scale, Global Aesthetic Improvement Scale, and patient satisfaction. A participant in each group had a 3-mm punch biopsy on the face before use of the products and 60 days after the second laser treatment. The study began in January 2020 and was completed in May 2021.

A total of 5 men and 5 women, 19 to 45 years of age, were included. Their mean age was 33.4 years, and 4 patients had skin type I, 2 had type II, 3 had type III, and 1 had type IV.

Regarding TEWL, a statistically significant difference was found in lesional skin measurements at day 4 after both laser treatments. At day 4, after laser treatment 1, the RSN group had a mean change of 6.502 vs 21.59 in the control group (P =.02). At day 4 after laser treatment 2, a greater statistical difference of P =.0001 occurred, with an RSN group mean change of 2.858 vs 39.07 in the control group. For nonlesional skin, measurements for RSN participants were reduced before the first laser treatment (-5.098), compared with an increase in the control group of 2.061.

The erythema index a* showed a consistent decrease in participants who received RSN vs the control group from day 4 after the first laser procedure through day 90 for lesional and nonlesional skin. Acne scar scores on the Goodman and Baron scale improved in the RSN group compared with the control group. The RSN arm had a mean improvement at day 30 postlaser procedure 1 of -0.33 vs -0.25 in the control group. At day 90 postlaser procedure 2, RSN participants had a mean improvement of -0.83 compared with -0.40 for control individuals.

Participants in the RSN group rated their satisfaction of improvement in acne scars greater than the control group at every visit after the first laser procedure and significantly greater at day 90.

In the patient who had a biopsy and received the bland moisturizer, elastic tissue stain at day 0 showed an absence of elastic fibers in the papillary dermis and abnormally fragmented elastic fibers in the reticular dermis. At day 90, improvement in the characteristics of the elastin fibers in the reticular dermis occurred. In the RSN participant who had a biopsy, elastic tissue stain on day 0 revealed an almost complete absence of elastic fibers in the center of the specimen in the superficial and deep dermis. On day 90, relatively normal elastic fibers were observed in the papillary dermis with additional fibers in the reticular dermis. The RSN patient also had focally abnormally thin collagen bundles on day 0 and a modest increase in normal-density collagen bundles on day 90.

Study limitations include the small sample size from 1 center.

“Use of RSN pre- and postlaser resurfacing significantly decreased postprocedural TEWL and erythema, and increased improvement in acne scars and patient satisfaction,” concluded the investigators. “In addition, biopsy results showed good regenerative effects with the RSN product.”

Disclosure: This study was supported in part by Alastin Skincare, Inc. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.