Subject(s)
Burns , Cicatrix, Hypertrophic , Keloid , Fluorouracil , Humans , Injections, Intralesional , Triamcinolone AcetonideABSTRACT
BACKGROUND: Acne effects 80-90% of teenage population all around the world. Resulting scars can lead to facial disfigurement and psychological issues in affected population. To counter this problem many treatment options have been tried including resurfacing lasers, dermabrasion, peeling, fillers, platelet rich plasma therapy etc. All have shown variable results. Among these modalities, micro needling is showing promising results in treatment of acne scars due to collagen induction. This study was conducted to assess efficacy and safety of micro-needling on acne scars. METHODS: In this cross-sectional study a total of 50 patients (female 35, male 15) underwent treatment for post acne scarring, 4 sessions of micro-needling were done under local anaesthesia 3 weeks apart over the span of 2 months. Initial and follow up qualitative assessment was done. Photographs were taken of each patient on their subsequent visit, they were analysed and compared for final results. Grading was done by using Goodman Baron scale. RESULTS: 70% (35) were females and 30% (15) were males with mean age of 27.31±4.41 ranging from 19-35 years. After the treatment of scars, 73% (08) of Grade 4 scars have showed improvement by 2 grades, remaining 27% (03) showed improvement to Grade 3. In 20 patients with Grade 3 scars, 30% (06) showed improvement by 1 grade. Remaining 70% (14) improved by 2 grades. All patients with Grade 2 scar downgraded to grade 1 after treatment. Chi-square test was used to assess pre-treatment and post treatment grading improvement among subjects and was statistically significant. (X2=30.010 p=000).. CONCLUSIONS: Micro needling is an effective tool for aesthetic improvement of post acne scarring.
Subject(s)
Acne Vulgaris/complications , Cicatrix , Cosmetic Techniques , Needles , Adult , Cicatrix/etiology , Cicatrix/therapy , Cross-Sectional Studies , Female , Humans , Male , Young AdultABSTRACT
The treatment of keloid and hypertrophic scar is challenging with no universally accepted mode for permanent ablation. Conventional therapies yield unpredictable results, significant complications and require elaborate hardware. OBJECTIVE: The objective was to establish the safety and efficacy of intralesional 5-fluorouracil (5-FU) for the treatment of keloids and hypertrophic scars. STUDY DESIGN: Randomized controlled trial (RCT). PLACE AND DURATION: It was conducted at the Jinnah Burn and Reconstructive Surgery Center/Allama Iqbal Medical College, Lahore, Pakistan from May 2012 to March 2013. SUBJECTS AND METHODS: We included 120 patients divided in two groups. The group A patients received intralesional triamcinolone acetonide (TAC) and the group B patients received both 5-FU and TAC. 8 injections at a week interval were given and patients were evaluated at the start of treatment and then at 4th and at 8th week during the treatment and then 4 weeks after the end of treatment. Patents were assessed for mean reduction in scar height, efficacy and complications. RESULTS: Total of 108 patients completed the study. The mean reduction in the scar height in group B (5-FU+TAC) 1.144+.4717 was markedly better than that of group A (TAC alone) 1.894+1.0751 (t=4.781, p=.000). The efficacy (defined previously as >50% reduction in initial scar height) was superior in group B 44 (77.2%) than that of group A 25 (49.0% (X2=9.260, p=.002). Recurrence was seen in 39.2% (20) of patients of the group A while in only 17.5% (10) of the cases of group B (P=0.012). Mean follow up was of 22 months. CONCLUSION: 5-FU+TAC is safe, easy to administer and effective treatment for problematic scars and has the lower rate of recurrence on larger follow up.
