Clinical and histopathological comparison of microneedling combined with platelets rich plasma versus fractional erbium-doped yttrium aluminum garnet (Er: YAG) laser 2940 nm in treatment of atrophic post traumatic scar: a randomized controlled study

J Dermatolog Treat. 2021 Dec;32(8):965-972. doi: 10.1080/09546634.2020.1729334. Epub 2020 Apr 2.

Abstract

Background: Different modalities have been tried for treating atrophic post traumatic scars.

Objective: To compare the efficacy of microneedling combined with PRP with that of fractional erbium-doped yttrium aluminum garnet (Er: YAG) laser in treating post-traumatic atrophic scars.

Methods: Forty-five patients with atrophic post traumatic scars were subdivided into three groups. Group I was subjected to four sessions of skin microneedling followed by topical application of platelet-rich plasma (PRP) immediately after each session. Group II was subjected to the same protocol of treatment but for six sessions. Group III was subjected to four sessions of fractional Er: YAG laser at 4 weeks intervals for four sessions. Response to treatment was assessed clinically using the Quartile Grading Scale and histopathologically using H&E stain, trichrome and Orcein special stains.

Results: All patients showed significant clinical improvement regardless of the treatment. There was a significant difference in clinical and histopathological improvement between groups I and III, but there was no significant difference in improvement neither between groups I and II nor between groups II and III.

Conclusion: microneedling could be as effective as a fractional laser when combined with PRP and when used for more sessions.

Keywords: Post traumatic scars; fractional laser; microneedling; platelet-rich plasma.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris*
  • Aluminum
  • Blood Platelets
  • Cicatrix / etiology
  • Cicatrix / pathology
  • Cicatrix / therapy
  • Erbium
  • Humans
  • Lasers, Solid-State* / therapeutic use
  • Platelet-Rich Plasma*
  • Treatment Outcome
  • Yttrium

Substances

  • Yttrium
  • Erbium
  • Aluminum