title: Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial.
abstract: BACKGROUND
  Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability.
  
  
  OBJECTIVE
  This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring.
  
  
  METHODS
  Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal platelet-rich plasma treatment on one half of their face and ablative fractional carbon dioxide laser with intradermal normal saline on the other half. The injections were administered immediately after laser therapy. The treatment sessions were repeated after an interval of one month. The clinical response was assessed based on patient satisfaction and the objective evaluation of serial photographs by two blinded dermatologists at baseline, 1 month after the first treatment session and 4 months after the second. The adverse effects including erythema and edema were scored by participants on days 0, 2, 4, 6, 8, 15 and 30 after each session.
  
  
  RESULTS
  Overall clinical improvement of acne scars was higher on the platelet-rich plasma-fractional carbon dioxide laser treated side but the difference was not statistically significant either 1 month after the first treatment session (P = 0.15) or 4 months after the second (P = 0.23). In addition, adverse effects (erythema and edema) on the platelet-rich plasma-fractional carbon dioxide laser-treated side were more severe and of longer duration.
  
  
  CONCLUSIONS
  Small sample size, absence of all skin phototypes within the study group and lack of objective methods for the evaluation of response to treatment and adverse effects were the limitations.
  
  
  CONCLUSIONS
  This study demonstrated that adding platelet-rich plasma to fractional carbon dioxide laser treatment did not produce any statistically significant synergistic effects and also resulted in more severe side effects and longer downtime.
authors.forename: Gita
authors.initials: G
authors.lastname: Faghihi
authors.affiliation: Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Keyvan
authors.forename: Ali
authors.initials: A
authors.lastname: Asilian
authors.forename: Saeid
authors.initials: S
authors.lastname: Nouraei
authors.forename: Shadi
authors.initials: S
authors.lastname: Behfar
authors.forename: Mohamad Ali
authors.initials: MA
authors.lastname: Nilforoushzadeh
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D002921:Cicatrix / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D004487:Edema / Q000139:chemically induced / Q000209:etiology; D005260:Female; D006801:Humans; D007271:Injections, Intradermal / Q000009:adverse effects; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D016896:Treatment Outcome; D055815:Young Adult