title: Assessment of the Combined Efficacy of Needling and the Use of Silicone Gel in the Treatment of C-Section and Other Surgical Hypertrophic Scars and Keloids.
abstract: OBJECTIVE
  To evaluate the individual effectiveness of needling therapy using the Dermapen (Dermapen, Salt Lake City, Utah) and topical therapy with silicone gel (Kelo-cote, Sinclair Pharma, London, England), and their combined effectiveness for the treatment of linear surgical scars, hypertrophic scars, and keloids.
  
  
  METHODS
  Twenty patients were randomly selected and equally divided into 2 groups (A and B), with each group of 10 including 6 patients with keloids and 4 with hypertrophic scars. Treatment assignments were random. In group A, the entire scar was treated by skin needling, with silicone gel applied to half of the scar. Patients in group B were treated with silicone gel on the whole scar, with only half of the scar also treated with skin needling. During follow-up visits, clinical photographs, evaluation of the scars' thickness, skin ultrasound, and modified Vancouver Scar Scale were performed.
  
  
  RESULTS
  Group A showed an average improvement of 68% (P < .01) on the half of the scar with the combination treatment (skin needling plus silicone gel) compared with a 52% improvement on the half of the scar that was treated with only skin needling. Group B showed an average improvement of 63% (P < .01) where the combination treatment was performed, compared with 47% improvement on the area treated with only the silicone gel.
  
  
  CONCLUSIONS
  In conclusion, the combination of these 2 treatments is safe and effective for the treatment of hypertrophic scars and keloids. These modalities achieved favorable results with each patient adhering to the study paramenters.
authors.affiliation: Gabriella Fabbrocini, Prof MD, is a Professor, and Claudio Marasca, MD, is a Resident, Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy. Sadia Ammad, MD, is a Dermatologist, and Benedetta Brazzini, MD, is a Dermatologist, London Medical Centre, London, United Kingdom. Rosanna Izzo, MD, is a Resident; Marianna Donnarumma, MD, is a Resident; and Giuseppe Monfrecola, Prof MD, is a Professor, Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy. The authors have disclosed that they have no financial relationships related to this article. Submitted October 13, 2014; accepted in revised form December 9, 2104.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Fabbrocini
authors.forename: Claudio
authors.initials: C
authors.lastname: Marasca
authors.forename: Sadia
authors.initials: S
authors.lastname: Ammad
authors.forename: Benedetta
authors.initials: B
authors.lastname: Brazzini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Izzo
authors.forename: Marianna
authors.initials: M
authors.lastname: Donnarumma
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Monfrecola
mesh_terms: D000287:Administration, Topical; D000328:Adult; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D007627:Keloid / Q000209:etiology / Q000628:therapy*; D009339:Needles; D020034:Silicone Gels / Q000008:administration & dosage*; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020034:Silicone Gels