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SKIN MICRONEEDLING PLUS SPOT TRICHLOROACETIC ACID PEEL IN THE TREATMENT OF ATROPHIC POST ACNE SCARS: COMPARATIVE SPLIT FACE STUDY

Background: Post Acne scarring is an unfortunate and frequent complication of acne vulgaris that results in many psychological and emotional problems for patients and the families. Acne scarring may be either atrophic or hypertrophic. Atrophic acne scars are further subdivided morphologically into boxcar, icepick, or rolling scars. Objective: To compare between the effect of microneedling using dermapen and microneedling plus medium depth chemical peeling using T.C.A 30% in post acne atrophic scars. Patients and methods: This study was carried out on 30 patients with different clinical variants of atrophic post acne scars diagnosed clinically on the basis of typical appearance of skin lesions. Patients were recruited from Dermatology Department outpatient clinic in Al-Azhar University hospitals from April 2019 to December 2019. Their ages ranged from 18: 30 years. Assessment of scars in both sides of face was done for their type, number, depth (severity) before and after each session and when the follow up period became completed (2 weeks after the last session). Digital Facial photographs for right and left sides of the face were obtained before treatment, during each session, and when the follow up period became completed (2 weeks after the last session). Results: Most of the patients (60%) achieved marked improvement, 30% achieved good improvement and 10% achieved excellent improvement on the left side of the face, while on the right side of the face most of patients (73.3%) achieved good response and 26.7 % achieved poor response. The mean percentage of improvement of the left side was 55.5 %, while the percentage of improvement of the right side was 33%. Conclusion: Automated microneedling (Dermapen) and T.C.A 30% chemical peel were minimally invasive simple, cheap and effective techniques in the treatment of post acne atrophic scars and improved skin homogeneity and texture. Microneedling plus spot T.C.A 30% have the advantage of rapid healing, short down time, eliminating most of risks and negative side-effects of laser resurfacing or cross technique. The treatment can be performed in an office setting and did not need any extensive special training or expensive instruments and can be used for rejuvenation of the skin, remodeling of the scar. Combination of automated microneedling with other modalities as spot T.C.A 30% for the treatment of post acne atrophic scars gave better results than the use of single modality of treatment as microneedling alone.