Application of regenerative medicine in treatment of acne scars

Abstract

Aim: The aim of this study is to evaluate the efficacy of the protocol of nanofat and platelet-rich plasma (PRP) infiltration and fractional CO₂ laser resurfacing for face atrophic scars by acne and to analyse patient’s satisfaction with the original questionnaire.

Methods: From March 2014 to June 2015, 30 patients with acne scarsonthe cheeks were selected for this pilot study. Patients were evaluated pre- and postoperatively by a physical examination, photographs and ultrasound scan with a 22 MHz probe to measure subcutaneous tissue thickness. All patients were treated by infiltration of nanofat and PRP. The production of PRP was achieved by RegenLab THT tube^® method.

Results: Preoperative thickness of subcutaneous tissue of patients from group A was 0.532 mm, whilst preoperative thickness of subcutaneous tissue of patients from group B was 0.737 mm. Postoperative thickness of subcutaneous tissue was 1.201 mm in group A and 1.367 mm in group B. The improvement of thickness of subcutaneous tissue was 0.668 mm in group A and 0.630 mm in group B. The authors applied a t-test on unpaired data, comparing the difference in thickness obtained with the treatment both in group A and in group B, with a P = 0.7289 (not significant). All patients in both groups had a treatment benefit.

Conclusion: Combined approach with nanofat, PRP and CO₂ laser seems to be effective to improve trophic scars, however, infiltration alone proved to significantly increase skin and subcutaneous tissue thickness. QoL-Q confirmed the impact of acne scars on the face in social life and relationships.

Keywords

Acne / scars / regenerative / laser / nano-fat

References

[1] Basta-Juzbašić A.Current therapeutic approach to acne scars..Acta Dermatovenerol Croat2010;18:171-5

[2] Tonnard P,Peeters G,Cornelissen M.Nanofat grafting: basic research and clinical applications..Plast Reconstr Surg2013;132:1017-26

[3] Anitua E,Orive G.The potential impact of the preparation rich in growth factors (PRGF) in different medical fields..Biomaterials2007;28:4551-60

[4] Barrientos S,Golinko MS,Tomic-Canic M.Growth factors and cytokines in wound healing..Wound Repair Regen2008;16:585-601

[5] Phothong W,Sathaworawong A.High versus moderate energy use of bipolar fractional radiofrequency in the treatment of acne scars: a split-face double-blinded randomized control trial pilot study..Lasers Med Sci2016;31:229-34

[6] Zhou BR,Bin Jameel AA,Xu Y,Wang Y,Luo D.The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation..J Cosmet Laser Ther2016;18:138-48

[7] Min S,Yoon JY.Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acnescar and investigation of mechanism: comparative randomized controlled clinical trial..Arch Dermatol Res2015;307:897-904

[8] Seidel R.Improvement in atrophic acne scars using topical synthetic epidermal growth factor (EGF) serum: a pilot study..J Drugs Dermatol2015;14:1005-10

[9] Frank W.Therapeutic dermabrasion. Back to the future..Arch Dermatol1994;130:1187-9

[10] Alster TS.Resurfacing of atrophic facial acne scars with a high-energy, pulsed carbon dioxide laser..Dermatol Surg1996;22:151-4

[11] Ramesh M,Kumar S.Novel technology in the treatment of acne scars: the matrix-tunable radiofrequency technology..J Cutan Aesthet Surg2010;3:97-101 PMCID:PMC2956966

[12] Alam M,Kaminer MS.Subcision for acne scarring: technique and outcomes in 40 patients..Dermatol Surg2005;31:310-7

[13] Fabbrocini G,D'Arco V,Lodi G,Pastore F.Acne scars: pathogenesis, classification and treatment..Dermatol Res Pract2010;2010:893080 PMCID:PMC2958495

[14] Johnson WC.Treatment of pitted scars: punch transplant technique..J Dermatol Surg Oncol1986;12:260-5

[15] Lee JB,Kwahck H.Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method..Dermatol Surg2002;28:1017-21

[16] Wang F,Kang S,Orringer JS,Voorhees JJ.In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin..Arch Dermatol2007;143:155-63