Combination therapy in the management of atrophic acne scars.
BACKGROUND
Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing.


OBJECTIVE
To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA) peel in the management of atrophic scars.


METHODS
Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed.


RESULTS
Out of 16 patients with Grade 4 scars, 10 (62.5%) patients improved to Grade 2 and 6 (37.5%) patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7%) patients were left with no scars, 2 (9.1%) patients improved to Grade 1and 15 (68.2%) patients improved to Grade 2. All 11 (100%) patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction.


CONCLUSIONS
This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars.
Department of Dermatology, Base Hospital, Delhi Cantonment, Delhi, India.
Shilpa
S
Garg
Department of Dermatology, Base Hospital, Delhi Cantonment, Delhi, India.
Sukriti
S
Baveja
Ablative laser for scars; dermaroller for scars; subcision