A Canadian study of the use of poly-L-lactic acid dermal implant for the treatment of hill and valley acne scarring.
BACKGROUND
Hill and valley scarring is 1 of 3 atrophic scar types that occur as a result of acne, becoming more apparent with facial skin aging. Treatment includes resurfacing techniques and the use of injectable fillers. Poly-L-lactic acid is an injectable collagen builder that has been used for the treatment of HIV-associated lipodystrophy and cosmetic enhancement.


OBJECTIVE
To determine the degree of correction attainable with poly-L-lactic acid and safety findings for the treatment of hill and valley acne scarring.


METHODS
Poly-L-lactic acid was injected over 3 to 4 serial treatments at 4-week intervals in 22 subjects in this single-arm, unblinded, open-label Phase II study. Efficacy was determined by physician, blinded evaluator, and subject assessment of scar improvement using Likert scales, comparing photographs taken by 3 camera systems at treatment visits 2 to 4 and follow-up to baseline. Subjects also assessed treatment satisfaction.


RESULTS
Percentage of patients with much to excellent improvement using the most sensitive camera system (VISIA-CR) ranged from 45.5% to 68.2%. Subject treatment satisfaction scores increased by 44%. One patient experienced a palpable nonvisible nodule. No subjects discontinued treatment.


CONCLUSIONS
Injectable poly-L-lactic acid facilitated improvement in hill and valley acne scarring and was well tolerated.
*Institute of Cosmetic and Laser Surgery, Oakville, Ontario, Canada; †Sanofi-Aventis, Laval, Quebec, Canada; ‡inScience Communications, Springer Healthcare.
Sheetal
S
Sapra
John A
JA
Stewart
Kelli
K
Mraud
Robert
R
Schupp
D000152:Acne Vulgaris / Q000150:complications; D000279:Administration, Cutaneous; D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage* / Q000009:adverse effects; D002170:Canada; D002921:Cicatrix / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D003357:Cosmetic Techniques; D005145:Face / Q000473:pathology; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage* / Q000009:adverse effects; D015595:Skin Aging / Q000473:pathology; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)