Improvement Of Scars Research Articles

Fractional Q-Switched 1064 nm Laser for Treatment of Atrophic Scars in Asian Skin.

Background and Objectives: Asian patients with Fitzpatrick skin type III–IV are a less studied subtype of patients in the medical literature. Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a fractionated beam profile (QSF) is a new modality that was reported to be effective in the treatment of scars. This study aims to evaluate the efficacy and safety of QSF Nd: YAG laser in treating scars in Asian patients. Materials and Methods: A total of 29 Subjects were treated with 1064 nm QSF laser. Each patients had three treatments with a fractionated microlens array handpiece every 8 weeks). Efficacy of treatment was evaluated using the Goodman and Baron’s quantitative grading scale before and 3 months after the last treatment. Results: All 29 patients treated had significant improvement of acne scars according to Goodman and Baron’s Quantitative Global Acne Scarring Grading System. No side effect has been observed except some minor erythematous reactions in three patients. Conclusions: Our results confirm that the 1064 nm QSF Nd: YAG laser is a safe and effective technique for treating scars in Asians.

Effectiveness and Safety Analysis of Plasma Beam in the Treatment of Facial Depressed Scars.

The study aimed to analyze the effectiveness and safety of microplasma beam in the treatment of facial depression scars. 106 patients with facial depression scars treated in the hospital between January 2017 and September 2021 were selected as the observation subjects. According to different treatment methods, the patients were divided into the control group (receiving ultrapulsed carbon dioxide lattice laser treatment, n = 51) and the observation group (undergoing plasma beam treatment, n = 55). The two groups were treated for 6 months, and the treatment effects were compared between the two groups. The Visual Analogue Scale (VAS) was used to compare the pain between the two groups, and the duration of pain and the time of scab shedding were recorded. The improvement of scars was compared between the two groups according to the Evaluation Clinique des Cicatrices d' Acne (ECCA), and the adverse reactions during treatment were compared between the two groups. A clinical effective rate of 94.55% in the observation group was higher than a clinical effective rate of 82.35% in the control group (P < 0.05). The VAS score in the observation group was lower than that in the control group, and the pain duration and the scab shedding time were shorter than those in the control group (P < 0.05). ECCA scores in the observation group after twice and 3 times of treatments were lower than those in the control group (P < 0.05). The total incidence rate of adverse reactions of 10.91% in the observation group was lower, whereas it was 25.49% in the control group (P > 0.05). Plasma beam has a significant efficacy in the treatment of facial depressed scars, and it has mild pain, quick recovery, and high safety. Clinical Trial Registration Number. The clinical trial registration number is T2017081.

Patient Education on Scarring Following Mohs Micrographic Surgery: Patient Preference for Information Delivery.

There are multiple modalities for patient education ranging from written to audiovisual formats. However, little is known regarding which modality is optimal. To assess patient preference for educational materials about scar care following surgery for facial skin cancer using the FACE-Q Skin Cancer patient reported outcome measure. On the day of Mohs surgery, patients were given a written handout or viewed a 3-minute animation video regarding best practices in scar improvement. Afterward, patients received the FACE-Q Skin Cancer-Satisfaction with Information: Appearance scale. Three months later, patients were called and given the same scale and additional questions regarding scar care. A total of 75 patients were enrolled. There was no difference between the 2 groups' preoperative information scores (p = .85) and the three-month postoperative scores (p = .37). The change in preoperative and postoperative score showed no significant difference between the 2 groups (p = .21); but there was a trend of higher satisfaction in the video group on the day of Mohs surgery. After the 3-month timepoint, there was a higher satisfaction trend observed with the written handout group. Patient preferences in information delivery and accessibility will contribute to greater information retention and satisfaction.

Glucocorticosteroid and Silicone Gel During Patch Application Without Clinical Scar Improvement After Central Venous Catheter Removal: A Randomized Trial.

We studied whether glucocorticosteroid during patch occlusion has a beneficial effect on scar outcome in children and adolescents treated for cancer. A double-blinded placebo-controlled randomized clinical trial was performed. The main outcome was the Vancouver Scar Scale. Secondary outcomes were scar width and scar quality measured using the Patient and Observer Scar Assessment Scale. The patients were divided into an intervention groups and a control group. The intervention group was randomized into active and placebo group. The active treatment consisted of cream with glucocorticosteroid and fusidic acid. The placebo treatment consisted of cream with fusidic acid. Both groups received silicone gel patch after central venous catheter removal. The control group received no specific skin care. Assessment at 12 months showed that the intervention group had a significantly lower Vancouver Scar Scale and a smaller scar (0,1cm) compared with the control group ( P =0.00, P =0.02) but no benefit of glucocorticosteroid. The Patient and Observer Scar Assessment Scale showed no significant difference between the intervention and control groups ( P =0.84, P =0.36). Silicone gel sheet alone or in combination with application of glucocorticosteroid during sheet occlusion does not clinically improve scar outcome after removal of central venous catheter in children treated for neoplastic diseases.

Satisfaction survey of secondary rhinoplasty among unilateral cleft lip and palate patients

To evaluate patient satisfaction following secondary cleft rhinoplasty with a specific assessment for patients with Unilateral Cleft Lip and Palate (UCLP). Our retrospective cross-sectional study is composed of 29 patients with UCLP with a mean age of 23years old, who underwent secondary rhinoplasty between 2010 and 2021 in our department. The survey was conducted postoperatively using a cleft-nose specific custom designed questionnaire based on the Byrne questionnaire, over the phone. This satisfaction questionnaire comprises six questions about physical appearance and one question about functional aspect. Patients were asked to answer "yes" or "no" or to rate from 0 (no improvement) to 10 (perfect result) depending on the question. Twenty out of 29 people responded to the questionnaire, representing an answer rate of 69%. The average score given by the patient for nasolabial scar improvement was 7.2/10, and the one concerning global improvement was 8.2/10. All patients would be ready to undergo the same procedure again, knowing the final result. A functional improvement concerning breathing or snoring was reported in 45% of cases. All dorsum or tip issues were improved after surgery (P=0,07). Our results demonstrate high patient satisfaction after cleft rhinoplasty, which encourages the continuation of this surgery. We would recommend the use of this simple questionnaire to allow a more accurate evaluation of patient outcomes.

Magnesium microneedle patches for under-eye wrinkles.

Microneedling is a common cosmetic procedure for improvement of wrinkles, acne, scars, and other conditions. Various microneedle (MN) patches have been developed as home care therapy for wrinkles and skin texture. Most of them are made of soluble and absorbable needles. To evaluate the efficacy and safety of non‐absorbable magnesium (Mg) MN patches on under‐eye wrinkles. A total of 20 subjects aged 27–58 years was enrolled in the study. The subjects applied Mg MN patches on the under‐eye wrinkle area for 1–2 h every other night for 12 weeks. The evaluation comprised grading by clinicians, measuring the wrinkle index with a facial analyzer, and measuring the dermal thickness of the under‐eye area with ultrasonography. Any adverse events and discomfort were addressed during the study. The application of Mg MN patches on under‐eye areas showed improvements in under‐eye grading scale, wrinkle index, and dermal thickness after 12 weeks. The mean grading scale significantly improved after 8 weeks of application (p < 0.01). The wrinkle index showed significant improvement after 12 weeks on the right under‐eye area (p < 0.05). The dermal thickness of the under‐eye area tended to increase, but no statistically significant changes were observed. Non‐absorbable Mg MN patches can be used for under‐eye wrinkles with minimal discomfort.

Combination treatment with 30% salicylic acid and fractional CO2 laser for acne scars: A 20-week prospective, randomized, split-face study.

Multiple approaches are used to treat acne scars, but some are expensive, ineffective, and cause complications. We aimed to evaluate the efficacy and safety of ultra-pulsed CO2 fractional laser combined with 30% supramolecular salicylic acid in the treatment of acne scars in a prospective split-face control study. Twenty patients with facial symmetrical acne scars were enrolled. One side of face was randomly treated with 30% supramolecular salicylic acid, and two sides were treated with ultra-pulsed CO2 fractional laser. The Echelle d'evaluation clinique des cicatrices d'acne (ECCA) scale was used to evaluate the clinical efficacy before and 3 months after treatment, and a quartile scale was used to self-evaluate the improvement of patients. A visual analog scale was used to record pain scores after each treatment, and side effects and other adverse reactions on the face were recorded. All the patients completed treatment and follow-up. There was statistical difference in ECCA scores of bilateral facial acne scars after three treatments (p < 0.001). ECCA scores on the combined side were lower after three treatments than those on the laser side (p=0.003). The patient satisfaction quartile scale on the combined side was higher than that on the laser side alone (p=0.015). Ultra-pulsed CO2 fractional laser combined with 30% supramolecular salicylic acid has better efficacy in the treatment of acne scars than laser alone, and patient self-assessment of combined treatment has a greater degree of improvement in acne scars, and does not increase patient pain scores and related adverse reactions.

A split-face, blind, randomized placebo-controlled clinical trial investigating the efficacy and safety of hyaluronic acid filler for the correction of atrophic facial scars.

Hyaluronic acid fillers have been studied extensively for facial wrinkles; however, their efficacy for atrophic facial scars has yet to be analyzed in a prospective placebo-controlled study. To analyze the efficacy and safety of a hyaluronic acid filler for atrophic facial scars. Fifteen subjects were randomized to receive up to 1 ml of VYC-17.5L on one cheek and up to 1ml of saline on the other side, with an optional touch-up treatment. Subjects were graded by a live blind evaluator using the Quantitative Global Scarring Grading System (QGSGS) (J Cosmet Dermatol. 2006;5:48), the Global Aesthetic Improvement Scale (GAIS), and Canfield photo-analysis. According to the blind evaluator, there was a significant reduction 90 days after the last treatment on the QGSGS for VYC-17.5L compared with saline (-6.6 VYC-17.5L vs -1.7 saline [t(28)=-4.3196, p= 0.008]). There was a smaller, but still significant reduction on the QGSGS for saline alone (10.4 to 8.6 [t(14)=-3.453, p= 0.004]). In addition, 93% (13/14) of subjects chose VYC-17.5L over saline treatment and reported an improvement on the GAIS. There were no serious side effects and all minor side effects resolved by Day 30. VYC-17.5L achieved significant improvements in rolling atrophic scars as compared to saline, though saline also had modest improvements.

Microneedling Outcomes in Early Postsurgical Scars.

Scars are a vexing sequela of surgery. Microneedling, also known as minimally invasive percutaneous collagen induction, has demonstrated impressive improvements in chronic acne scars; however, no evidence exists for treating postsurgical scars during active wound healing. The purpose of this study was to demonstrate the utility and safe use of minimally invasive percutaneous collagen induction in acute postsurgical scars. Twenty-five patients who underwent surgery had scars treated with three treatments of minimally invasive percutaneous collagen induction in the postoperative period. Scar assessment was measured by Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, and Global Aesthetic Improvement Scale after each of the three treatments and at final 2-month follow-up. Patients had positive improvement in Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, and Global Aesthetic Improvement Scale scores at 16-week posttreatment initiation evaluation compared to initial measurement ( p < 0.001). No statistically significant differences were noted when comparing the age of the patient, location of scars, or Fitzpatrick phototype scales among patients. When comparing patients who began treatment early (6 to 7 weeks postoperatively) to those who began treatment late (13 to 16 weeks postoperatively), there was a statistically significant difference in the Patient and Observer Scar Assessment Scale group ( p < 0.04). Postsurgical scars treated with minimally invasive percutaneous collagen induction in the maturation and remodeling phase had no adverse outcomes. Interestingly, the data show treatment initiated early in the maturation phase (6 to 7 weeks postoperatively), while natural collagen formation was tapering off, demonstrated improved aesthetic outcomes compared to treatments initiated late in the maturation phase (13 to 16 weeks postoperatively). Therapeutic, IV.

Effects of scar massage on burn scars: A systematic review and meta-analysis.

This study explored the physical and psychological effects of scar massage on burn patients. Hypertrophic scar development is highly prevalent following burn injuries. Scar massage may have physical and psychological effects, although evidence of its effectiveness for burn scar improvement remains inconsistent. A systematic review and meta-analysis of randomised controlled trials and quasi-experimental trials. This study was conducted following the Centre of Reviews and Dissemination guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PubMed, EMBASE, and Chinese Electronic Periodical Services were searched for studies published between January 1990 and February 2022. Quality was assessed using the Joanna Briggs Institute (JBI) Appraisal Checklist. The final recommendation strength was assessed according to the JBI recommendation rating. A meta-analysis was performed using Review Manager Version 5.4 software with a random-effect model. Seven studies (420 participants) investigating scar massage for burn patients were included. The scar massage sessions lasted 5-30 min and were delivered by massage therapists 1-3 times a week for 12 weeks. Overall, scar massage decreased pain levels (standardised mean difference [SMD]: -2.39; 95% confidence interval [CI]: -3.96 to -0.83), improved scar thickness (mean difference: -0.05; 95% CI: -0.1 to -0.0), reduced pruritus (SMD: -1.89; 95% CI: -2.95 to -0.82) and reduced anxiety (SMD: -1.52; 95% CI: -2.73 to -0.32), but no significant effect on depression(SMD: -0.92; 95% CI:-2.28 to 0.44). The meta-effects of scar massage among burn patients are significantly improved scar formation and reduced pruritus and anxiety. Providing scar massage is feasible and effective for burn patients. Future research should evaluate its long-term effects. Scar massage is relatively convenient and effective in preventing and alleviating hypertrophic burn scarring. Further research can provide detailed suggestions for effective scar massage implementation.

Skin Fractional Scar Treatment with a New Carbon Dioxide Scanner: Histological and Clinical Evaluation.

Background: The mechanism of action of fractional carbon dioxide (CO2) laser in the management of skin scarring is stimulation of collagen and fibroblasts in the dermis, resulting in remodeling and shrinking of the skin. Objective: The purpose of this research is to assess the safety and performance of a new CO2 laser scanner for treatment of acne scars. Methods: The study was carried out on 20 patients of both sexes, with a mean age of 25.7 ± 6.7 years. To assess the performance and safety of this new CO2 scanner, a preclinical histological evaluation was done. A clinical evaluation of acne scars was performed using Goodman and Baron's quantitative global acne scarring grading system (GBQGASGS) and a crusting scale where crusting scores ranged from 1 = none to 4 = severe. Digital photographs were taken to obtain esthetic results. Results: GBQGASGS showed a significant improvement in patients' scars and the treatment was well tolerated, with no lasting side effects. Conclusions: The new scanner seems to be an effective and safe device for skin scarring treatment, speeding up the healing time of scars.

Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review.

Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead to the formation of atrophic scars. In this review, we summarize current knowledge on acne scars and methods for their improvement. There are three types of atrophic scars: icepick, rolling, and boxcar. They are of different depths and widths and have different cross-sections. Scars can combine to form clusters. If acne scars are located on the face, they can reduce the patient’s quality of life, leading to isolation and depression. There are multiple effective modalities to treat acne scars. Ablative lasers, radiofrequency, micro-needling, and pilings with trichloroacetic acid have very good treatment results. Contemporary dermatology and cosmetology use treatments that cause minimal side effects, so the patient can return to daily functioning shortly after treatment. Proper dermatological treatment and skincare, as well as the rapid implementation of cosmetological treatments, will certainly achieve satisfactory results in reducing atrophic scars.

Acne scar treatment using combination therapy: Subcision and human autologous fibroblast injection

Acne scar treatment is a problem for both the dermatologist and the dermatologic surgeon. Many therapies have been advanced to improve acne scars over the past years. Nevertheless, they were often related to adverse side effects like hyperpigmentation. These combination therapy using subcision and autologous fibroblast injection can provide a better technique for the acne scar treatment. In this study, we describe nine patients with the age of 25 to 48 and rolling acne scars (moderate to severe) that were treated with combination therapy using subcision (cannula, 18gauge) and autologous fibroblast injection. Finally, before and 6months after the final injection, the patients' biometric characteristics were evaluated by Visioface 1000D and Mexameter and a skin ultrasound imaging system. The results show a significant improvement in the acne scars in the patients. The Visioface results showed that the size and number of skin pores and spots were reduced after combination therapy. Also, the results of skin ultrasonography exhibited denser skin layers both in the epidermis and dermis. In summary, the combination therapy of autologous fibroblast injection and subcision can be considered as a new alternative, safe, and useful method for acne scar treatment.

Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

614 Laser-treatment of Hypertrophic Scar Induces Change to Epidermal Histoarchitecture Correlating to Improved Epidermal Barrier Function

IntroductionMechanisms and timing of hypertrophic scar (HTS) improvement with laser therapy are incompletely understood. Epidermal keratinocytes influence HTS through paracrine signaling, yet they are understudied compared to fibroblasts. It was hypothesized that fractional ablative CO2 laser scar revision (FLSR) would change the fibrotic histoarchitecture of the epidermis in HTS.MethodsDuroc pigs (n=4 FLSR and n=4 controls) were injured and allowed to form HTS. HTS and normal skin (NS) were assessed weekly by non-invasive skin probes measuring trans-epidermal water loss (TEWL) and biopsy collection. There were 4 weekly FLSR treatments. Early laser treatment began on day 49, and late began on day 77. Punch biopsies from NS and HTS were processed and stained with H&E. Image J was used to obtain epidermal thickness and rete ridge ratios (RRR). Gene and protein expression of involucrin (IVL) was examined through qRT-PCR and immunofluorescent (IF) staining.ResultsAfter treatment, peeling sheets of stratum corneum were apparent which were not present in the controls. TEWL was increased in HTS vs. NS at day 49 indicating decreased barrier function (42.2±8.0 vs. 22.0±4.62g/m2h, p=0.05). In the early group, TEWL was significantly decreased at week 4 to 16.4±3.5 g/m2h (p< 0.05). The late group was not significantly altered from NS at the pre-laser timepoint (day 77=12.1±1.99 g/m2h). Hence, there was no decrease in TEWL post-FLSR. After 4 sessions, epidermal thickness was significantly increased in treated scars in both FLSR groups (early:pre=85.6±6.8 vs. week 4=115.2±12.0 µm, p< 0.01) and (late:pre=75.2±6.6 vs. week 4=125.7±12.0 µm p< 0.001, n=8 scars,). There was no increase in controls. Late intervention significantly increased RRR (pre=1.3±0.1 vs. week 4=1.9±0.1, n=8 scars, p< 0.05), and early treatment trended towards increase (pre=1.17±0.05 vs. week 4=1.4 + 0.1). There was no increase in controls. There was increased IVL gene expression in HTS vs. NS that decreased after FLSR. Eight scars had up-regulated gene expression of IVL vs. NS levels pre-treatment (FC >1.5) compared to 4 scars at week 4. This was confirmed by IF where IVL staining decreased at week 4.ConclusionsChanges in epidermal HTS histoarchitecture and expression levels of epidermal differentiation markers were induced by FLSR. The timing of laser intervention contributed to differences in TEWL, epidermal thickness, and RRR.

The Importance of Scar Cosmesis across the Surgical Specialties: Factors, Perceptions, and Predispositions.

Background:Existing disparities in the perception of scars between patients and practitioners can translate into undesirable physical and psychological outcomes. An understanding of the determinants of surgeons’ perceptions on the importance of scar cosmesis is a first step toward bridging this gap.Methods:In an online survey, surgeons were asked about the extent to which various patient and technical factors affect the importance of scar cosmesis. Additional data were obtained on surgeon characteristics, including their specialty, gender, years of experience, and work sector to investigate potential relationships.Results:A total of 303 responses were obtained from surgeons across six specialties. Based on the survey, the importance of scar cosmesis was rated highest among plastic surgeons and obstetricians and gynecologists, and lowest among orthopedic and vascular surgeons. Compared with surgeons in private practice, publicly employed surgeons’ rating of the importance of cosmesis was lower. The patient’s request for a cosmetic outcome was the most highly rated factor. Regarding the influence of patient demographics on surgeons’ attitudes, scar cosmesis in young and female patients was favored in comparison with older and male patients. Factors that reduced the importance of cosmesis were emergency and late-night surgeries followed by lengthy procedures, large incisions, and busy operative lists.Conclusions:These initial findings highlight a need to investigate means of fostering a more holistic, impartial approach toward scar cosmesis, as well as addressing potential workplace barriers that may prevent surgeons from seeking a more cosmetic result. Greater alignment between the priorities of surgeons and patients may manifest in objective and subjective improvements in patient’s scars and well-being.

Efficacy and adverse reactions of fractional CO2 laser for atrophic acne scars and related clinical factors: A retrospective study on 121 patients.

This study was performed to analyze the efficacy, adverse reactions of fractional CO2 laser for atrophic acne scars, and related clinical factors. The clinical data of 121 patients with atrophic acne scars treated with ultra-pulsed fractional CO2 laser in the Cosmetic Dermatology from August 2014 to March 2020 were retrospectively analyzed. The efficacy and adverse reactions of atrophic acne scar after fractional CO2 laser therapy were statistically analyzed. The clinical factors related to efficacy and adverse reactions after the first therapy session were analyzed by multivariate logistic regression. A total of 121 patients received 206sessions of fractional CO2 laser therapy, with an average of 1.7sessions. Moderate to excellent improvement rate reached 50.4% after the first session. Multivariate logistic regression analysis indicated that rolling scars responded better to fractional CO2 laser treatment than icepick scars (OR=7.3, 95% CI [1.2, 43.4], p=0.029), and scar improvement was more significant in the high-energy laser group than in the low-energy laser group (OR=10.9, 95% CI [1.1, 106.8], p=0.041). The main adverse reactions after fractional laser surgery were pigmentation, skin sensitivity, persistent erythema, and acneiform eruption. Multivariate logistic analysis revealed that the longer the scar duration, the higher incidence of postoperative adverse reactions (OR=1.3, 95% CI [1.1, 1.5], p=0.008). Compared with icepick scars, rolling scars (OR=10.4, 95% CI [2.3, 47.7], p=0.003) and boxcar scars (OR=12.0, 95% CI [3.3, 44.0], p<0.001) had higher risk of developing adverse reactions. The incidence of postoperative adverse reactions was also higher in the combined mode group (DeepFX mode+ActiveFX mode) than in the single-mode group (OR=7.8, 95% CI [2.4, 25.5], p<0.001). Fractional CO2 laser was effective in the treatment of atrophic acne scars, without serious adverse reactions. Scar type and laser energy were independent clinical factors affecting its efficacy. Scar course, scar type, and fractional laser mode were independent clinical factors affecting its adverse reactions.

Effect and Safety Analysis of PRP and Yifu Combined with Ultrapulsed CO2 Lattice Laser in Patients with Sunken Acne Scar.

Objective To investigate the effect and safety of PRP and Yifu combined with ultrapulsed CO2 lattice laser in patients with sunken acne scar. Methods 700 subjects were selected from the group of patients with sunken acne scar treated in our hospital from November 2010 to December 2020. They were divided into control group (n = 350) and study group (n = 350). The grouping was mainly based on the random number table method. Patients in the control group were treated with ultrapulse CO2 lattice laser, while those in the study group were treated with ultrapulse CO2 lattice laser combined with PRP and Yifu. The clinical effect, scar improvement and quality of life before and after treatment, and adverse events during treatment were compared between the two groups. The clinical effect was categorized into cure after treatment, significant effect, effective, and ineffective. The total effective rate = 1 − ineffective rate. Results After treatment, the total effective rate of the study group (81.43%) was higher than that of the control group (70.00%). After treatment, ECCA, VSS scores, daily activities, symptoms and feelings, work and study, leisure and entertainment, interpersonal relationship, treatment status, and total scores were all lower in both groups than before treatment, and the study group was lower than the control group. During the treatment, the incidence of adverse events in the study group (17.33%) was lower than that in the control group (28.57%), P < 0.05. Conclusion PRP and Yifu combined with ultrapulse CO2 lattice laser in the treatment of sunken acne scar can effectively improve the scar, reduce the incidence of adverse events, and the treatment effect is obvious, which can improve the quality of life of the patients.

Evaluation of the cumulative effect of Radiofrequency Microneedling and fractional Erbium: Glass 1565 laser in moderate to severe acne scars in skin of color.

Evaluation of the cumulative effect of Radiofrequency Microneedling and fractional Erbium: Glass 1565 laser in moderate to severe acne scars in skin of color. This retrospective study was conducted on 20 patients of skin types III -V having moderate to severe atrophic acne scars. The study was carried out over 1year from March 2019 to March 2020. All patients underwent 4 sessions of non-ablative Fractional Erbium: Glass 1565 laser to alternate with 4 sessions of Fractional Radiofrequency Microneedling once a month over 8months. Of the 20 patients enrolled, 18 completed treatment protocol. Two patients were withdrawn from the study because they were unable to attend follow-up treatment sessions. The subjective evaluation was performed using photographs at baseline, 8months, and 12months. A photographic evaluation was performed using the following numeric responses: <25%, 25-50%, 51-75%, and 76-100% difference in severity. None of the patients had worsening of their scars. The improvement in scars was statistically significant. The combination of Fractional Erbium: Glass 1565 laser and Fractional Radiofrequency Microneedling can be used in the treatment of acne scars in skin of color. Our protocols helped achieve significant improvement of scars.

Single‐center, assessor‐blind study to evaluate the efficacy and safety of DA‐5520 topical gel in patients with acne scars: A pilot study

Unlike various topical treatment options for acne vulgaris, options for acne scars mostly involve invasive interventions. So far, only a few clinical trials have investigated the effects of topical treatment for acne scars. We evaluated the safety and efficacy of DA-5520, a recently developed topical gel for the treatment of different types of acne scars. A 12-week prospective, randomized, active-controlled, evaluator-blind, single-center study involving 36 participants with acne scars was performed. Participants were randomized into four different groups at a 1:1:1:1 ratio: laser resurfacing with DA-5520 application (test 1); laser resurfacing without DA-5520 application (control 1); comedone extraction with DA-5520 application (test 2); and comedone extraction without DA-5520 application (control 2). For 12weeks, participants in the two test groups applied DA-5520 twice daily, while participants in the control groups applied moisturizers alone. Participants in the test 1 and control 1groups received a single session of laser resurfacing at visit 1 (week 0). All participants were followed up at 1, 4, 8, and 12weeks, and objective scar evaluation using the échelle d'évaluation clinique des cicatrices d'acné (ECCA) score was performed at each visit. Clinical improvement of acne scars, confirmed by the ECCA grading scale (1 for atrophic scar and 2 for hypertrophic scar), was observed after using DA-5520 when combined with laser resurfacing or individually, and no associated adverse reactions were noted. Preliminary results of this study revealed that DA-5520may be a promising new formulation for treating all type of acne scars.