Abstract :
Background: Severe acne scars results in permanent scarring and facial disfigurement causing physical and psychosocial distress. Management of acne scars poses a therapeutic challenge for the dermatologists. Ablative lasers do produce significant improvement but associated with post inflammatory hyperpigmentation, prolonged recovery time and scarring. Recently development of fractional carbon dioxide laser and microneedling radiofrequency has proven to be quite effective in the treatment of acne scars. However, till date they have not been compared side by side especially in Indian population. Hence, we intend to conduct the present comparative study.
Objectives: To compare the efficacy of fractional carbon dioxide laser and microneedling fractional radiofrequency in the treatment of facial acne scars.
Materials and Methods: A total of 30 patients (18-40 years) having atrophic scars, attending the out-patient department at the Department Of Dermatology, Venereology and Leprosy, Adichunchanagiri Hospital and Research Centre, B.G. Nagara were alternately allocated into group-A (fractional CO2 group) and group-B (MnRF group). Patients in both the groups received four sequential treatments with an interval of 4 weeks between each session. Clinical assessment of the improvement of atrophic scars was done based on Goodman & baron grading system at the end of 1 month after the last session, by a side by side comparison of preoperative and post-operative photographs. In addition, patients were asked to provide their opinion on improvement of scars using the patient satisfaction Visual Analogue Score (VAS).
Results: At the end of one month after last session (4 sessions) based on Goodman and Baron’s qualitative assessment, 3(20%) patients showed reduction by 3 grades in group B compared to 2 (13.3%) patients in group A. 10(66.6%) patients showed reduction by 2 grades in group B compared to 9(60%) patients in group A which was found to be statistically not significant (p=0.475).
At the end of one month after last session (4 sessions) based on Goodman and Baron’s quantitative assessment 3(20%) patients showed very good reduction in group B compared to 2(13.3%) in group A [p=0.850 which was statistically not significant].
At the end of 1 month after the last treatment session (4 sessions), 33.3% of patients (n=5) in Group B were very satisfied with the treatment as compared to only 13.33% of patients (n=2) in Group A. The patient satisfaction VAS score after treatment in Group B patients was better when compared to Group A patients [p=0.00086 which was found to be statistically significant].
The side effects of all 30 patients (100%) immediately after treatment was erythema and edema which were minimal but 2 (13.3%) patients developed post inflammatory hyperpigmentation in GROUP A whereas none in GROUP B [p=0.0001 which was statistically significant].
Keyword :
Scabies, Permethrin Ivermectin, Benzyl Benzoate, Pruritus.