Combined use of combined laser therapy and autologous plasma with cells in patients with post-acne atrophic scars

Abstract

BACKGROUND: The formation of atrophic post-acne scars often leads patients to severe psychological depression and social exclusion. To date, many post-acne treatment options have been described, in particular fractional non-ablative laser resurfacing, exposure to platelet-rich plasma, but there is still no standard line of therapy.
 AIMS: to study the effectiveness of combined therapy with neodymium (Nd:YAG) and erbium (Er:YAG) lasers and autologous platelet-rich plasma in patients with various phenotypes of atrophic post-acne scars.
 MATERIAL AND METHODS: The study involved patients (n=58) over the age of 18 with different types (cleaved, rectangular, navicular) of atrophic post-acne scars, who were divided into 2 groups depending on the method of therapy. Group 1A (n=28) received phototherapy using combined exposure to neodymium (Nd:YAG) and erbium (Er:YAG) lasers; Group 1B patients (n=30) were treated with autologous platelet-rich plasma immediately after laser treatment.
 To assess the effectiveness of therapy, the Manchester scale of scar deformities was used according to five indicators ― color, texture, relief, displacement of surrounding tissues, density (MSS) and the International Global Aesthetic Improvement Scale (GAIS). Indicators of skin elasticity in the foci of atrophy were determined using cutometry; epidermal-dermal structure (thickness, echogenicity) was assessed by ultrasound. The clinical picture was assessed before and after treatment.
 RESULTS: The effectiveness of therapy was confirmed by the dynamics of symptoms on the MSS scale, in particular, an improvement in the "color" indicators by 54.8% in group 1A, by 83.7% in group 1B, "texture" ― by 57.1 and 78.1%, "relief" ― by 43.8 and 66.7%, "displacement" ― by 54.9 and 82.1%, respectively. The proportion of patients with an optimal result according to GAIS in group 1A was 50%, in group 1B ― 90%; with a significant improvement ― 50 and 10%, respectively. Cutometry and ultrasound data also showed better results in the autologous platelet-rich plasma supplemented group.
 CONCLUSION: Thus, complex treatment, including the use of combined laser therapy (erbium and neodymium lasers) and autologous plasma with cells, is a highly effective method for the treatment of atrophic post-acne scars.