title: Percutaneous collagen induction: an effective and safe treatment for post-acne scarring in different skin phototypes.
abstract: BACKGROUND
  Atrophic scars can complicate moderate and severe acne. There are, at present, several modalities of treatment with different results. Percutaneous collagen induction (PCI) has recently been proposed as a simple and effective therapeutic option for the management of atrophic scars.
  
  
  OBJECTIVE
  The aim of our study was to analyze the efficacy and safety of percutaneous collagen induction for the treatment of acne scarring in different skin phototypes.
  
  
  METHODS
  A total of 60 patients of skin types phototype I to VI were included in the study. They were divided into three groups before beginning treatment: Group A (phototypes I to II), Group B (phototypes III to V), and Group C (phototypes VI). Each patient had three treatments at monthly intervals. The aesthetic improvement was evaluated by using a Global Aesthetic Improvement Scale (GAIS), and analyzed statistically by computerized image analysis of the patients' photographs. The differences in the GAIS scores in the different time-points of each group were found using the Wilcoxon's test for nonparametric-dependent continuous variables. Computerized image analysis of silicone replicas was used to quantify the irregularity of the surface micro-relief with Fast Fourier Transformation (FFT); average values of gray were obtained along the x- and y-axes. The calculated indexes were the integrals of areas arising from the distribution of pixels along the axes.
  
  
  RESULTS
  All patients completed the study. The Wilcoxon's test for nonparametric-dependent continuous variables showed a statistically significant (p < 0.05) reduction in severity grade of acne scars at T5 compared to baseline (T1). The analysis of the surface micro-relief performed on skin replicas showed a decrease in the degree of irregularity of skin texture in all three groups of patients, with an average reduction of 31% in both axes after three sessions. No short- or long-term dyschromia was observed.
  
  
  CONCLUSIONS
  PCI offers a simple and safe modality to improve the appearance of acne scars without risk of dyspigmentation in patient of all skin types.
authors.affiliation: Department of Systematic Pathology, Division of Dermatology, University of Naples Federico II , Naples , Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Fabbrocini
authors.forename: Valerio
authors.initials: V
authors.lastname: De Vita
authors.forename: Ambra
authors.initials: A
authors.lastname: Monfrecola
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: De Padova
authors.forename: Benedetta
authors.initials: B
authors.lastname: Brazzini
authors.forename: Fernanda
authors.initials: F
authors.lastname: Teixeira
authors.forename: Anthony
authors.initials: A
authors.lastname: Chu
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D003094:Collagen / Q000378:metabolism*; D003357:Cosmetic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles / Q000009:adverse effects; D010859:Pigmentation Disorders / Q000209:etiology; D012867:Skin / Q000378:metabolism / Q000473:pathology; D012880:Skin Pigmentation
chemical_list: D003094:Collagen