Post-acne atrophic scars (PAS) are common sequelae of acne. Peels, platelet rich plasma (PRP), subcision, dermabrasion, lasers etc. are useful in PAS; however, many of them are associated with major adverse effects (AE). We conducted a split-face comparative study of microneedling with PRP (Left side) and microneedling with topical insulin (TI) (Right side) for PAS. Sixteen patients of PAS were enrolled after taking written consent. Exclusion criteria included presence of active acne and/or infections over face, pregnancy or lactation, on isotretinoin, and history of keloidal tendency, bleeding disorders and deranged blood sugar levels. Under antiseptic measures and topical anaesthesia, microneedling (using dermaroller with 1.5 mm length and 192 needles on roller drum) was performed in a standard manner on both side of the face. On right side of the face, 1-2ml TI (Human actrapid insulin 40IU/ml® solution) was applied, while on left side 1-2ml autologous PRP was applied. Ice pack was applied over the treated areas and face was cleaned after 30min. Patients were advised to follow photoprotection. All the patients received such 4 sittings at monthly interval and followed till 3 months post last sitting. Qualitative Global Acne Scarring System was used to compare treatment-associated improvement. Of 16 patients, 14 patients completed the study. Right side of the face showed 45.73% improvement, while left side showed 26.44% improvement in PAS. “Paired t-test” showed significant improvement in both, right (t =12.20, p=0.01) and left side of the face (t =2.67, p=0.03). Icepick and boxcar scars responded better to TI therapy. AE included transient erythema (n=8), pain (n=6) and edema (n=3). Both, TI and PRP, combined with microneedling may achieve comparable improvement with advantageous safety profile in PAS. However, readily accessibility, low cost, and non-invasive nature merits the use of TI over PRP.

ESDR624 - Microneedling with autologous platelet-rich plasma verses microneedling with topical insulin in the treatment of post-acne atrophic scars: a simultaneous split-face comparative study

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