Efficacy of microneedling with topical vitamin C in treatment of acne scars

Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. There is no single treatment modality that has been shown to be universally effective. Microneedling is a relatively new minimally invasive procedure used as a collagen induction therapy for skin rejuvenation and facial scars. Aim of the work: Evaluation of efficacy of microneedling with topical vitamin  C in treatment of acne scars. Patients and Methods: Ten patients with post acne atrophic facial scars attending the  outpatient clinic of  Dermatology in Sohag University Hospitals between June 2014 to September 2017 were offered  six microneedling sessions plus topical  vit. C (during the session of microneedling and daily topical application in between sessions) microneedling sessions were four weeks apart. They were evaluated monthly and one month after completion of sessions for both efficacy and safety of the procedure. Results: The mean ± SD of the patients' age in the study population were 28.900 ±5.384yers old nine females and one males with mean acne  scars duration ± SD 11.900±5.506 years, 90%% of patients had psychological distress from their acne scars. At the end of study duration Out of the ten patients 6(60%) achieved one grade reduction in their Goodman and Baron qualitative grading score and 2 (20%) achieved two grade reduction. According to the  quantitative ECCA Echella d'e valuation Clinique des cicatrices d'acne score 80% 0f patients achieved reduction in their score  with 27.5%  improvement in the ECCA score.  The mean  ECCA score value of V scar started to decrease earlier than  both U scar, and M scar. 40% of patients had excellent satisfaction and 60% had very good satisfaction. All treated patients, had adverse events of temporary erythema,  edema, bleeding, or a serous ooze resolving with crusting or scabbing following each session of microneedling, bacterial infection not occurred in any of our patients. Conclusion: Multiple minimally invasive sessions of skin microneedling with topical vitamin C during sessions and daily application is an effective treatment for post-acne atrophic scars with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.