Microneedling and Subcision With Platelet-Rich Plasma More Effective in Reducing Acne Scar Severity

acne scar atrophic scar
acne scar atrophic scar
Significant improvement in the appearance of acne scars was seen with microneedling or subcision with platelet-rich plasma compared with microneedling or subcision alone.

Microneedling or subcision combined with platelet-rich plasma (PRP) is more effective than microneedling or subcision alone for reducing the severity of atrophic acne scars, according to study research published in the Journal of Cosmetic Dermatology.

The study findings were derived from a meta-analysis of 8 trials that compared microneedling or subcision with PRP vs microneedling or subcision without PRP in patients with atrophic acne scars (N=311). Trials included whole-face participants (n=153) and split-face participants (n=158). Across the 8 trials, 238 participants were treated with a combination therapy plus adjunct PRP and 239 participants were treated with a single therapy that did not use PRP.

In 35 patients in the split-face group and 55 participants in the whole-face group, topical PRP and microneedling were associated with better results in Goodman and Baron’s qualitative scale for atrophic scar severity compared with microneedling alone (mean difference [MD], -11.38; 95% CI, -12.94 to -9.82; P <.001).

A combination regimen with intradermal PRP in 40 split-face participants and 56 whole-face participants was also associated with significantly better Goodman and Baron qualitative scores (MD, -23.30; 95% CI, -25.10 to -21.50; P <.001). In a random-effects model, there was no difference between microneedling with PRP and microneedling alone in terms of patient satisfaction (MD, 0.87; 95% CI, -0.01 to 1.75; P =.05).

A limitation of these findings included the lack of generalizability across people with lighter skin types (ie, Fitzpatrick skin types <4).

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“It appears that subcision is a therapy that benefits most from the addition of intradermal PRP,” the researchers wrote, “exhibiting the largest mean difference.”

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Long T, Gupta A, Ma S, Hsu S. Platelet-rich plasma in noninvasive procedures for atrophic acne scars: a systematic review and meta-analysis [published online February 15, 2020]. J Cosmet Dermatol. doi: 10.1111/jocd.13331