Clinical & Experimental Dermatology

Biography

Biography: Nooshin Bagherani

Abstract

Introduction and objective: Acne scars are extremely bothersome to patients and often challenging to treat. Regarding texture, they are divided into the scars with normal texture and the scars with atrophic texture. The acne scars with atrophic texture consist of ice pick, boxcarand rolled scars. Topical, physical, surgical, and light modalities, alone or in combination have been administered in the treatment of acne scars with variable results. Herein, for the first time I introduced serum injection therapy as a novel effective therapeutic option for the atrophic acne scars. Material and method: In this study, the patients with atrophic acne scars were selected among the patients had referred to my private dermatology office. After describing the process of the study, a written consent was acquired from them. I administered 0.9% sodium chloride serum in this study. After local anesthesia with lidocaine, the serum was injected intra- and sub-dermally in the regions of acne scars and skin pores. The amount of serum for injection was determined based on the severity of scars, so that it over-corrected the scars and widespread to the neighboring regions. In every session, before the procedure, photographs were taken from the patients. This process was done weekly for 5 weeks and topical alpha hydroxy acid-containing agents were prescribed beside this procedure. In every session, I objectively and subjectively assessed the results of treatment regarding the type of acne scar. In this study, for evaluating the response I used a visual score including in: scores1-3 as poor response, 4-6 as moderate response,7-9 as good response, and 10-12 as significant response.The subjective evaluation was acquired by questioning about the general success of treatment from the patients. For the objective evaluation, the photographs were observed. This observation included the assessment of response according to the type of acne scar. For every case, the objective and subjective scores in every session and the mean of these scoresafter the last session were considered for assessment of the response. At the end, the data was analyzed by the SPSS software. Result: Among the 12 cases studied, 10 (83.3%) cases were female and 2 (16.7%) cases were male. The minimum and maximum ages of patients were 18 and 56 years, respectively. Among the subjects, 6 (50%)and 1 (8.3%) patientshad unsuccessfully undergone laser therapy and microdermabrasion for treating their acne scars, respectively.Isotretinoin was simultaneously administered in 4 (33.3) patients with the active acne. The ice pick, boxcar and rolled scars, and large pores were seen in 4 (33.3%), 10 (83.3%), 8 (66.7%) and 6 (50%) of patients, respectively. The patients had Fitzpatrick's skin types of III and IV. After the first and fifth sessions, the mean subjective response scores were 7.1±1.2 and 10.2±1.08, respectively.In the objective assessment, the mean score responses were 6.7±1.5, 7.2±2.02, 7.0±1.8, and 7.2±1.01 for the ice pick, boxcar, rolled scars and pores, respectively. After the fifth session, these scores were 10.0±0.9, 10.9±1.01, 10.4±1.3, and 10.3±1.3, respectively.The response was better in the acne patients under oral isotretinoin therapy in comparison with other cases, but it was not statistically significant. No statistically significant difference in the response was reported regarding the age, gender, skin type, and severity of acne scar. The patients reported skin lightening and tightening, decreasing of wrinkles and eminent cheeks as side profits of this procedure. Mild ecchymosis was the only side effect was seen in about one third of patients. Conclusion: My study revealed that the response to serum therapywas significant in the large pores and all types of the atrophic acne scars. In comparison with the severe acne scar, the patients with mild and moderate scars showed better responses. This study showed that the serum injection therapy can be an effective therapeutic option for the atrophic acne scars with no significant side effects. In addition, my study revealed that this procedure can successfully be used in thetreatment of patients suffering from the large skin pores.