Shahbano, Saelah Batool, Hira Tariq, Faria Asad, Shahbaz Aman.
Comparison of Efficacy and safety of Micro needling with 35% Glycolic acid peel versus Glycolic acid peel alone in the treatment of Atrophic acne scars; a Randomized Controlled Trial.
J Pak Assoc Derma Jan ;33(2):608-13.

Background: Acne scars are permanent textural changes and indentations that occur on the skin because of severe acne. Micro needling and peels have emerged as major treatment options for acne scars. Micro needling enhances the production of new collagen. Fibroblasts migrate to the point of puncture for closure of wound and stimulate endothelial cells resulting in the formation of new microvasculature. Glycolic acid peel has anti-inflammatory, keratolytic and antioxidant action. It enhances corneosome breakdown and reduces cohesiveness leading to desquamation. There is dearth of data comparing the combination of these modalities to peeling alone in our population. Objective: To compare the efficacy and safety of glycolic acid peel combined with micro needling versus35% glycolic acid peel alone in the treatment of acne scars. Methods: This randomized controlled trial was conducted from 27th September 2021 to 28th March2022 at Outpatient Department of Dermatology, Services Hospital, Lahore. Patients of either gender, with grade 2 to grade 4 acne scars were included. After written informed consent, they were randomly divided into two treatment groups. Group A patients were treated with 35% glycolic acid peel combined with micro needling while Group B was treated with 35% glycolic acid peel alone. All patients received six treatment sessions with 2‐week interval between the sessions. They were called for follow-up one month after the last treatment session and treatment response was noted. ‘Treatment response’ or efficacy was defined as Excellent response (reduction in two grades of scars), Good response (reduction in one grade) or Poor response (no reduction in grade of scars). Safety of treatments was assessed by side effects reported by patients and observed on examination. Results: Out of 60 patients, 51 (85%) were females and 09 (15%) were males with female to male ratio of 5.7:1. They were divided equally into two treatment groups. The mean age of patients in group A was 32.43 ± 6.91 years and in group B was 33.27 ± 7.24 years. Majority of the patients (58.33%) were between 31 to 45 years of age. Efficacy of Group A (glycolic acid peel 35%, combined with micro needling) was seen in 29 (96.67%) patients while in Group B (peeling alone) was seen in 22(73.33%) patients (p-value=0.011). Two patients in combination group reported post-inflammatory hyper pigmentation, rest of the patients reported improvement in tone and texture of skin. Conclusion: This study concluded that use of glycolic acid peel 35% combined with micro needling i smore effective treatment option in acne scars when compared to glycolic acid peel alone. Patients in both the groups reported improvement in the tone and texture of skin with a relatively good safety profile. Keywords Acne scars, Glycolic acid peel 35%, Micro needling, Efficacy

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com