Efficacy of Microneedling with Dermaroller Alternating with CROSS Peeling with 30% TCA in Management of Acne Induced Scarring

Abstract

Objective: To study the effect of combination of two therapies i.e. Microneedling with Dermaroller alternating with Chemical Reconstruction Skin Scar (CROSS) peeling with 30% TCA in management of acne induced scarring.Patients and Methods: This experimental study was conducted in the department of Dermatology, Benazir Bhutto Hospital, Rawalpindi from March 2017 to December 2017. A total of 20 patients underwent microneedling with dermaroller at week=0 (baseline) and were subjected to CROSS peeling with 30% TCA on follow up after 2 weeks. Four sessions of each procedure were repeated at 2 weeks’ interval. Photographs were taken at baseline and 4 weeks after the end of therapy (week=18). The baseline and final photographs were assessed for acne scar grading as per Goodman and Baron qualitative scale by two dermatologists who were blinded to the whole study.Results: Out of 20 patients, 16 (80%) of the patients had grade IV acne scarring and 4 (20%) had grade III scarring at baseline (week=0). On assessment at 4 weeks after the end of therapy (week=18), 16 patients who were having grade IV acne 6 (37.5%) improved to grade III, and 10 (62.5%) improved to grade II. Out of 4 patients who were initially having grade III at week=0, all 4 (100%) improved to grade II by week=18. A Wilcoxon signed rank test showed highly significant improvement in the grading of scarring (z=-3.92, p=0.00008).Conclusion: The combination therapy of microneedling with dermaroller, alternating with CROSS peeling with 30% TCA was highly effective in treating all types of atrophic acne scarring.