title: Platelet-rich plasma versus CROSS technique with 100% trichloroacetic acid versus combined skin needling and platelet rich plasma in the treatment of atrophic acne scars: a comparative study.
abstract: BACKGROUND
  Platelet-rich plasma (PRP) is an autologous preparation of platelets in concentrated plasma that may be beneficial in the treatment of atrophic acne scars by promoting collagen deposition. Skin needling is a technique that uses a sterile dermaroller to puncture the skin and release growth factors. The combination of skin needling and PRP could enhance the efficacy of both modalities. Chemical reconstruction of skin scars technique consists of focal application of high concentration of trichloroacetic acid (TCA) on the acne scars to stimulate collagen production.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of intradermal injection of PRP, 100% focal TCA, and combined skin needling plus topical PRP in the treatment of atrophic acne scars.
  
  
  METHODS
  Forty-five patients with atrophic acne scars were randomly assigned to 3 equal groups; Group A received intradermal injection of PRP, Group B received chemical reconstruction of skin scars technique with TCA 100%, and Group C was treated by combined skin needling and PRP. Each patient underwent 3 sessions at 2-week interval.
  
  
  RESULTS
  All the patients completed the study. The 3 groups showed statistically highly significant improvement in the degree of acne scars after treatment (p < .001). No major adverse effects were observed in the studied groups.
  
  
  CONCLUSIONS
  This is the first study to use intradermal injection of PRP alone for the treatment of atrophic acne scars. The 3 modalities showed a promising efficacy and safety in the treatment of atrophic acne scars.
authors.affiliation: *All the authors are affiliated with the Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: Nofal
authors.forename: Afaf
authors.initials: A
authors.lastname: Helmy
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nofal
authors.forename: Rania
authors.initials: R
authors.lastname: Alakad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nasr
mesh_terms: D000152:Acne Vulgaris / Q000150:complications; D000328:Adult; D001284:Atrophy / Q000473:pathology / Q000628:therapy; D002921:Cicatrix / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005145:Face; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009339:Needles / Q000009:adverse effects; D010146:Pain / Q000209:etiology; D010781:Photography; D053657:Platelet-Rich Plasma; D016037:Single-Blind Method; D012867:Skin / Q000473:pathology; D014238:Trichloroacetic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D007641:Keratolytic Agents; D014238:Trichloroacetic Acid