Microneedling, chemical reconstruction combination therapy improves atrophic acne scars
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Key takeaways:
- Patients received a maximum of three chemical reconstruction of scarred skin therapy sessions and three microneedling sessions.
- 18% showed a grade-1 and 81% showed a grade-2 aesthetic improvement.
Atrophic acne scars are difficult to treat, but a new study found that combination therapy with microneedling and 60% phenol and 0.2% croton oil was an effective and safe treatment option.
“Microneedling has become more popular recently compared to 15 years ago,” Quita Lopez, MD, a cosmetic surgeon at Aesthetic Laser Center, wrote. “Studies in the literature show that combination therapies are the most effective for treating acne scars.”
One such treatment that could be combined with microneedling is chemical reconstruction of scarred skin (CROSS) therapy using a 60% phenol and 0.2% croton oil combination.
“Phenol formulas with croton oil in the range of 0.1% to 0.7% were popular from the 1920s to the 1960s,” Lopez wrote. “Croton oil is a vesicant, allowing the phenol to penetrate more deeply.”
In the current study, Lopez assessed the safety and efficacy of microneedling in combination with CROSS for the treatment of acne scars in 21 patients (mean age, 33 years; 11 women) treated over a 5-year period for atrophic scarring.
Approximately 90% of patients had Fitzpatrick skin types IV through V and had grade 3 (42.9%; n = 9) or grade 4 (47.6%; n = 10) acne scarring consisting of rolling, box car and ice picks scars.
To begin the procedure, skin was cleansed with an antiseptic solution prior to applying a topical anesthetic. After the anesthetic sat on the skin for 20 minutes, the face was cleansed again. The patients then received a microneedling session following by a topical administration of CROSS therapy solution.
Among those that received a maximum of three CROSS and three microneedling sessions, 18% showed a grade-1 improvement and 81% showed a grade-2 improvement according to photographic evaluation using the Global Aesthetic Improvement Scale.
The Goodman and Baron Qualitative scar grading system also showed that 62% of patients achieved a grade-1 improvement and 38% achieved a grade-2 improvement.
“Combination treatments with platelet-rich plasma, radio frequency, peeling and microneedling have already been described,” Lopez wrote. “It is of the author’s opinion that the combination of microneedling and CROSS, using phenol/croton oil concentration ... offers comparable results which are cost effective for the patients.”
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