Efficacy of transdermal microneedling redermalization with high-molecular-weight hyaluronic acid and sodium succinate in the correction of postacne scars

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BACKGROUND: Acne is a chronic inflammatory skin disease of multifactorial nature that affects more than 80% of adolescents and is one of the top 10 most common diseases in the world. Currently, dermatologists have various techniques for the correction of postacne scars: from minimally invasive hydroxy acid peels to surgical excision of scar tissue. One of the most effective, affordable, and at the same time minimally invasive and safe treatment methods is microneedling ― micro-damage of the skin with thin needles in the lesion area, stimulating the production of collagen and elastin.
 AIM: to study the efficacy and safety of transdermal redermalization with microneedling using high-molecular-weight hyaluronic acid and sodium succinate in patients with atrophic postacne scars of varying severity.
 MATERIALS AND METHODS: A prospective study was carried out at the Clinic of Skin and Venereal Diseases of the Sechenov University. A. Rakhmanov, Sechenov University, with the participation of 80 patients with postacne scars of varying severity. The Hyalual Perfoskin Complex device was used for microneedling in combination with a sodium succinate preparation based on hyaluronic acid. The apparatus was used in a linear technique along the Langer tension lines and in mutually perpendicular direction, 1015 passes in each area (lower jaw, cheek-curve area, forehead area). Each subject underwent 4 treatments at 21-day intervals. Clinical assessment of the treatment dynamics before and after treatment was performed using the Miravex 3D multispectral imaging device. Before and after treatment, patients were evaluated for the severity of postacne scars according to the International Qualitative Scale for the classification of postacne scars, as well as a dermatological index of quality of life. Subjective evaluation of the effectiveness of therapy by the physician and the patient was performed using the International Global Aesthetic Improvement Scale one month after each treatment and 3 months after the last treatment.
 RESULTS: Among the 80 patients, 47 women and 33 men aged 18 to 46 years had atrophic postacne scars of varying severity: I in 9, II in 26, III in 40, and IV in 5 patients; the rashes were most often localized to the cheek-cusp (55; 69%) and forehead (15; 19%) and were represented by U-shaped (35; 44%), V-shaped (17; 21%), M-shaped (19; 24%) and macular (9; 11%) patterns. The duration of the disease averaged 5.33.2 years. Improvement of the clinical picture was observed in 92.5% of cases after treatment. For example, 8 patients with I degree of scarring managed to achieve complete clearing of the skin; out of 26 patients with II degree of scarring, 15 patients achieved I degree of severity and 10 patients experienced clinical remission at the end of treatment; in the group of patients with III degree of scarring (n=40), 18 patients had I degree of severity, 20 patients had II degree of severity; in the group of patients with IV degree of severity after 4 treatments, 2 patients had III degree of severity and 1 patient had II degree of severity. The dermatological quality of life index decreased by 77% on the average: from 18.632.28 to 4.253.16. The final result was considered "optimal aesthetic result" by doctors and patients in 86% and 82% of cases, respectively, "significant improvement" in 4% and 12% of cases, respectively, "improvement" in 2.5% and 4% of cases, respectively, and "no change" in 7.5% and 2%, respectively. All patients noted good tolerability of treatment. Thus, side effects in the form of skin redness and painful sensations were insignificant and passed on their own within 23 days after the procedure.
 CONCLUSION: Microneedling with high-molecular-weight hyaluronic acid and sodium succinate has demonstrated high efficacy and safety in the treatment of postacne scars of varying severity. The minimal invasiveness and affordability of the procedure result in high patient adherence to therapy.