Effect of Subcision and Microneedling in the Treatment of Atrophic Acne Scars in Ten Patients: A Case Series

Abstract

Background: Acne vulgaris is a common condition with a prevalence of over 90% among adolescents and postacne scarring is a well known sequelae. Different types of scars (ice pick, boxcar, and rolling scars) warrant a customized approach of treatment for each type. We propose a novel treatment of atrophic acne scars using combination of subcision and microneedling. Materials and Methods: Ten consecutive patients of skin types III IV with moderate and severe facial acne scarring received three sequential subcision and micro-needling treatments after informed consent over a period of three months with an interval of 4 weeks between each session. Goodman and Baron’s qualitative and quantitative acne scar grading systems along with side by side comparison of pre-operative and post-operative photographs were used for assessment at the end of three sessions of the combination procedure. Results: Estimation of improvement with Goodman and Baron’s Global qualitative acne scarring system, we found good results in patients with Grades 3 and 4 acne scars. Out of 7 patients with grade 4 scars, 29% showed improvement by 2 grades and 71% showed improvement by 1 grade and all the 3 patients with grade 3 scars showed improvement by 1 grade. Quantitative assessment showed 30% patients had minimal improvement, 50% had moderate improvement and 20% had good improvement in scars. Adverse effects were transient pain, erythema and oedema. Conclusion: Subcision and microneedling are simple and inexpensive office procedures which in combination are well tolerated and are efficacious in treatment of moderate and severe acne scars.