Treating Atrophic Acne Scars

It’s estimated that four out of ten people with acne will develop scars on their face. Atrophic or depressed acne scars are the most common scars and are most amenable to treatment. They include boxcar (deeply depressed box shaped), icepick scars (like an icepick makes in ice), and rolling scars (where the scars seem to undulate across the skin surface). Each is caused by a loss of tissue at the site of the pimple or cyst and have a negative psychological effect.

Cosmeceuticals containing antioxidants such as vitamin C are popular remedies to lighten red acne marks; but what are the options for people with scarring who have tried these products and are not completely satisfied with the results?

One option is microneedling with tiny needles that create tiny holes in the skin. This process stimulates the skin’s natural ability to heal. It’s a simple and in-office procedure, with little downtime.

In the study summarized here, microneedling was combined with either vitamin C or platelet rich plasma (PRP). Before going further, it’s important to understand that PRP is made by taking a small amount of a patient’s own blood, which is then spun in a centrifuge. A small amount of this fluid containing concentrated platelets and growth factors is then removed. Nothing else is added, so there’s no risk of allergy, reaction, or rejection. Platelet rich plasma therapy is a purely natural process using the body’s own healing factors.

Here’s what they did.

Young adults (average age: 27.5 years) with post acne atrophic facial scars were offered microneedling with PRP on the right side of their face and microneedling with vitamin C on the left side of their face. They had four treatments on each side of the face. Each was given at monthly intervals.

The patients and the physicians used a 4-point scale to compare their appearance after final treatment to photographs taken before treatment. An improvement by 2 grades was excellent, 1 grade was good, and no change was a poor response.

Here’s what they found.

Among 30 people participating in the study, 23 achieved a reduction in scarring by one or two grades.

Based on the physician evaluation, an excellent response was seen in five (18.5%) patients with microneedling plus PRP. This compared to an excellent response in two (7%) patients who received microneedling with vitamin C.

The ability to achieve a “good” response was similar with both treatments. However, vitamin C was not considered as effective as PRP because 10 (37%) patients had poor response in the vitamin C-treated area compared to 6 (22.2%) patients who received PRP therapy.

Vitamin C was effective in dealing with post inflammatory skin discoloration secondary to acne. However, patients reported greater overall satisfaction when PRP was used with microneedling.

The bottom line.

Microneedling when used by a qualified aesthetic dermatologist is an important option for treating atrophic acne scars. It’s a simple in-office procedure, with little downtime. More about treatment options for acne is here.

For a consultation and more information, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Drs. Binstock and Physician Assistant Cullinane will answer your questions. Call our office in Mill Valley (415) 383-5475.