Which is more effective in atrophic acne scars treatment microneedling alone or platelet rich plasma alone or combined both therapeutic modalities?

Acne scarring usually causes cosmetic and psychological problems. Our aim of the study was to compare the efficacy of microneedling alone, intradermal injection of platelet rich plasma (PRP) alone and combined microneedling with PRP in the treatment of atrophic post-acne scars. Thirty adult patients with facial post-acne scars were randomly recruited and divided into two groups: A and B. Group A: included 15 patients; the left sides of their faces were treated with microneedling by dermapen followed by PRP while on the right side of the faces microneedling alone was performed. Group B: included 15 patients; the left sides of their faces were treated with microneedling by dermapen followed by PRP while the right sides of the faces were treated with intradermal injection of PRP. For both groups, the treatment session was repeated every 3 weeks until clearance of the atrophic acne scars or for four sessions maximally. Patients' evaluation was done pre-treatment and 3 weeks after the last session by photography, Goodman and Baron qualitative grading system and Echelle d'Evaluation Clinique des Cicatrices d'Acné (ECCA) scale. By using all of these evaluation methods, group A showed that there was better improvement on the left side but without statistical significant difference. However, group B showed that there was a significant reduction in the total number of post-acne scars on the left side compared to the right side by using photographic assessment and ECCA grading scale. Skin microneedling, PRP and combined microneedling with PRP are effective therapeutic modalities in atrophic post-acne scars treatment. However, combined microneedling with PRP gives better results and is better tolerated in all types of atrophic acne scars.