Objective:

The objective of study is to compare the efficacy of micro needling for the treatment of acne scars in Asian skin with and without subcision.

Study Design:

A randomized controlled trial.

Settings:

This study was conducted from May 2014 to July 2014, in the department of dermatology DHQ hospital, Faisalabad, Pakistan.

Patients and Method:

Total of 70 patients having acne scars were randomly divided into two equal groups having 35 patients in each group. Group 1 underwent micro needling alone every month for 3 consecutive months and Group 2 underwent micro needling and subcision both (combined in a single session) every month for 3 consecutive months. To determine efficacy, a simple 5 grade scoring system was used in either group, with grade 0 (no improvement), grade 1 (minimal improvement), grade 2 (good improvement), grade 3 (very good improvement), grade 4 (excellent improvement), where minimal is 25%, good is 50%, very good is 75% and excellent is 100%. Efficacy was considered as obtaining grade 1 or above.

Results:

Efficacy was present in 27 patients (77.1%) in group A and 35 patients (100%) in group B. Efficacy was not seen in 8 patients (22.9%) of group A. In age group 15-20 yrs: Efficacy was present in 3 patients of group A (75%) and all the 3 patients of group B (100 %). In one patient of group A (25%) the treatment was not effective. P value was 0.350. In age group 21-25 yrs: Efficacy was present in 9 patients of group A (69.2%) and 13 patients of group B (100%). In 4 patients of group A (30.8%), the treatment was not effective. P value was 0.030. In age group 26-30 yrs: Efficacy was present in 15 patients of group A (83.3%) and 19 patients of group B (100%). In 3 patients of group A (16.7%) the treatment was not effective. P value was 0.063. In males: Efficacy was seen in 14 patients of group A (66.7%) and 18 patients of group B (100%). 7 patients in group A (33.3%) did not respond to the treatment. P value was 0.007. In females: Efficacy was seen in 13 patients of group A (92.9%) and 17 patients of group B (100%). One patient in group A (7.1%) did not show efficacy. P value was 0.0263.

Conclusion:

The combination of treatment modalities (micro needling and subcision) for treating acne scars have better results as compared to micro needling alone. Males are more commonly and more severly affected by acne scars. If duration of study is extended beyond 3 months then even better results can be achieved in both groups. Achieving grade 0 i-e complete recovery of acne scars is very difficult even if combination of treatment modalities is used.

Keywords: Micro needling, Subcision, Acne scars, Asian skin