Tretinoin-iontophoresis in atrophic acne scars.
BACKGROUND
Atrophic acne scars are a frequent problem after acne. Hitherto, mainly invasive treatment measures were possible. In a recent paper, we demonstrated the positive effects of iontophoresis with 0.025% tretinoin gel vs. estriol 0.03%.


OBJECTIVE
In this further study, the recording of the clinical effects of iontophoresis with 0.025% tretinoin gel in atrophic acne scars was supplemented by immunohistochemistry investigations of collagen I and III, proliferation markers, and the estimation of epidermal thickness.


METHODS
The treatment was performed twice weekly in 32 volunteer patients for a period of 3 months by application of the substance under a constant direct current of 3 mA for 20 min. Skin biopsies prior to and at the end of treatment were performed in 32 voluntary patients in order to investigate collagen I/III and proliferation markers by immunohistochemistry methods.


RESULTS
Clinically, at the end of treatment, in 94% of patients a significant decrease in the scar depth was observed. Neither epidermal thickness nor proliferation markers revealed a significant increase at the end of treatment. Furthermore, collagen I and collagen III showed no common trend, as expressed statistically by a lack of significance. In some cases, increases in collagen III became evident at the end of treatment.


CONCLUSIONS
Tretinoin-iontophoresis is an effective, noninvasive treatment of atrophic acne scars without causing disturbing side-effects.
Schmidt
J B
JB
Department of Dermatology, Institute of Clinical Pathology, University of Vienna Medical School, Austria.
Donath
P
P
Hannes
J
J
Perl
S
S
Neumayer
R
R
Reiner
A
A
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001284:Atrophy; D002921:Cicatrix / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D003094:Collagen / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007478:Iontophoresis; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000627:therapeutic use*
D007641:Keratolytic Agents; D019394:Ki-67 Antigen; D014212:Tretinoin; D003094:Collagen