Combined use of combined laser therapy and autologous plasma with cells in patients with post-acne atrophic scars

Abstract

BACKGROUND: The formation of atrophic post-acne scars often leads patients to severe psychological depression and social exclusion. To date, many post-acne treatment options have been described, in particular fractional non-ablative laser resurfacing, exposure to platelet-rich plasma, but there is still no standard line of therapy.

AIMS: to study the effectiveness of combined therapy with neodymium (Nd:YAG) and erbium (Er:YAG) lasers and autologous platelet-rich plasma in patients with various phenotypes of atrophic post-acne scars.

MATERIAL AND METHODS: The study involved patients (n=58) over the age of 18 with different types (cleaved, rectangular, navicular) of atrophic post-acne scars, who were divided into 2 groups depending on the method of therapy. Group 1A (n=28) received phototherapy using combined exposure to neodymium (Nd:YAG) and erbium (Er:YAG) lasers; Group 1B patients (n=30) were treated with autologous platelet-rich plasma immediately after laser treatment.

To assess the effectiveness of therapy, the Manchester scale of scar deformities was used according to five indicators ― color, texture, relief, displacement of surrounding tissues, density (MSS) and the International Global Aesthetic Improvement Scale (GAIS). Indicators of skin elasticity in the foci of atrophy were determined using cutometry; epidermal-dermal structure (thickness, echogenicity) was assessed by ultrasound. The clinical picture was assessed before and after treatment.

RESULTS: The effectiveness of therapy was confirmed by the dynamics of symptoms on the MSS scale, in particular, an improvement in the "color" indicators by 54.8% in group 1A, by 83.7% in group 1B, "texture" ― by 57.1 and 78.1%, "relief" ― by 43.8 and 66.7%, "displacement" ― by 54.9 and 82.1%, respectively. The proportion of patients with an optimal result according to GAIS in group 1A was 50%, in group 1B ― 90%; with a significant improvement ― 50 and 10%, respectively. Cutometry and ultrasound data also showed better results in the autologous platelet-rich plasma supplemented group.

CONCLUSION: Thus, complex treatment, including the use of combined laser therapy (erbium and neodymium lasers) and autologous plasma with cells, is a highly effective method for the treatment of atrophic post-acne scars.

Keywords

post-acne atrophic scars / Nd:YAG laser / Er:YAG laser / autologous plasma with cells

References

[1] Acne and rosacea. Ed. by L.S. Kruglova. Moscow: GEOTAR-Media; 2021. 207 р. (In Russ).

[2] Акне и розацеа / под ред. Л.С. Кругловой. Москва: ГЭОТАР-Медиа, 2021. 207 с.

[3] Al Tawil AA, Al Refae AA, Hamed AM, Kamal AM. Comparative study of the effectiveness of platelet-rich plasma in combination with carboxytherapy compared to its use with a fractional carbon dioxide laser in atrophic acne scars. J Cosmet Dermatol. 2018;18(1):150–155. doi: 10.1111/jocd.12561

[4] Al Taweel A.A., Al Refae A.A., Hamed A.M., Kamal A.M. Comparative study of the efficacy of рlatelet-rich plasma combined with carboxy therapy vs its use with fractional carbon dioxide laser in atrophic acne scars // J Cosmet Dermatol. 2018. Vol. 18, N 1. Р. 150–155. doi: 10.1111/jocd.12561

[5] Al-Saedi SJ, Al-Hilo MM, Al-Shami SH. Treatment of acne scars using fractional erbium:YAG-laser. Am J Dermatol Venereol. 2014;3(2):43–49. doi: 10.5923/j.ajdv.20140302.04

[6] Al-Saedy S.J., Al-Hilo M.M., Al-Shami S.H. Treatment of acne scars using fractional erbium:YAG laser // Am J Dermatol Venereol. 2014. Vol. 3, N 2. Р. 43–49. doi: 10.5923/j.ajdv.20140302.04

[7] Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23(1):49–60. doi: 10.5978/islsm.14-RE-01

[8] Omi T., Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology // Laser Ther. 2014. Vol. 23, N 1. Р. 49–60. doi: 10.5978/islsm.14-RE-01

[9] Potekaev NN, Kruglova LS. Laser in dermatology and cosmetology. Moscow: MDV; 2018. 280 р. (In Russ).

[10] Потекаев Н.Н., Круглова Л.С. Лазер в дерматологии и косметологии. Москва: МДВ, 2018. 280 с.

[11] Kumaran MS, Arshdeep A. Platelet-rich plasma in dermatology: a blessing or a curse? Indian J Dermatol Venereol Leprol. 2014;80(1):5–14. doi: 10.4103/0378-6323.125467

[12] Kumaran M.S., Arshdeep A. Platelet-rich plasma in dermatology: boon or a bane? // Indian J Dermatol Venereol Leprol. 2014. Vol. 80, N 1. Р. 5–14. doi: 10.4103/0378-6323.125467

[13] Abdel-Aal AM, Ibrahim IM, Sami NA, Abdel Karim IM. Evaluation of autologous platelet-rich plasma plus ablative fractional carbon dioxide laser in the treatment of acne scars. J Cosmetic Laser Ther. 2018;20(2):106–113. doi: 10.1080/14764172.2017.1368667

[14] Abdel-Aal A.M., Ibrahim I.M., Sami N.A., Abdel Kareem I.M. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars // J Cosmet Laser Ther. 2018. Vol. 20, N 2. Р. 106–113. doi: 10.1080/14764172.2017.1368667

RIGHTS & PERMISSIONS

Talibova A.P., Gryazeva N.V.