Which Is More Effective: Microneedling With 35% Glycolic Acid Peeling or Microneedling With 15% Trichloroacetic Acid Peeling in the Treatment of Atrophic Acne Scars? A Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Clinical Improvement in Atrophic Acne Scar Severity Using the Goodman and Baron Qualitative Global Acne Scar Grading System
研究概览
简要总结
Atrophic acne scars are depressed scars that can remain after acne has healed. Microneedling is a procedure that uses very small needles to create controlled micro-injuries in the skin, which may stimulate collagen production and improve scar appearance. Chemical peels, including glycolic acid and trichloroacetic acid, may also improve acne scars.
This study compares three approaches for treating atrophic acne scars: microneedling followed by a 35% glycolic acid peel, microneedling followed by a 15% trichloroacetic acid peel, and microneedling alone. Sixty adults with atrophic acne scars are randomly assigned to one of the three groups.
Participants receive a series of microneedling treatments at 2-week intervals. The study evaluates changes in scar severity, participant satisfaction, treatment-related pain, recovery time after treatment, and side effects. The findings may help identify whether adding either chemical peel to microneedling provides greater benefit than microneedling alone and whether one combination has a shorter recovery time or fewer side effects.
详细描述
Atrophic acne scars are a common long-term consequence of acne vulgaris. They may appear as ice-pick, boxcar, or rolling scars and can affect facial appearance and quality of life. Available treatments include microneedling, chemical peeling, laser procedures, dermabrasion, subcision, and other scar-directed interventions. The choice of treatment may depend on scar morphology, skin type, recovery time, cost, and risk of adverse effects.
Microneedling creates controlled microchannels in the skin and may promote dermal remodeling through wound-healing mechanisms, including fibroblast activation and new collagen formation. Glycolic acid is a superficial chemical peeling agent that promotes epidermal exfoliation and remodeling. Trichloroacetic acid produces controlled protein coagulation and a wound-healing response. Combining microneedling with chemical peeling may provide complementary effects on atrophic acne scars.
This single-center randomized controlled study was conducted in the Dermatology and Venereology Department at Kafrelsheikh University Hospitals. A total of 60 adults with atrophic acne scars were allocated equally to one of three groups: microneedling followed by 35% glycolic acid peeling, microneedling followed by 15% trichloroacetic acid peeling, or microneedling alone.
Microneedling was performed with a Dermapen device after topical anesthetic application and skin cleansing. In the glycolic acid group, a 35% glycolic acid peel was applied immediately after microneedling and neutralized according to the clinical endpoint and participant tolerance. In the trichloroacetic acid group, a 15% trichloroacetic acid peel was applied immediately after microneedling until an appropriate frosting endpoint was observed. The microneedling-alone group received no chemical peel. Participants received post-procedure instructions that included sun avoidance, sunscreen use, moisturizer as needed, and topical antibiotic use for 3 days.
Standardized facial photographs were obtained before and after treatment and during follow-up. Two dermatologists who were blinded to treatment allocation assessed clinical response by comparing standardized photographs. The study also collected participant-reported satisfaction, procedure-related pain, post-procedure downtime, and treatment-related adverse effects, including prolonged erythema and post-inflammatory hyperpigmentation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Two dermatologists who assessed standardized pre-treatment and post-treatment facial photographs were blinded to treatment allocation. Participants and treatment providers were not blinded because the post-microneedling procedures differed between study groups.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults of either sex aged 18 years or older.
- •Presence of atrophic acne scars of any type or duration.
- •Fitzpatrick skin type I to IV.
排除标准
- •Active inflammatory acne lesions, skin infection, or a tendency to develop keloids.
- •Immunocompromised state, facial cancer, or severely damaged facial skin.
- •Known hypersensitivity to glycolic acid or trichloroacetic acid.
- •Oral isotretinoin use within 6 months before enrollment.
- •Pregnancy or breastfeeding.
- •Inability or unwillingness to adhere to study procedures.
- •Unrealistic expectations regarding treatment outcomes.
研究组 & 干预措施
Microneedling Plus Glycolic Acid 35%
Participants receive microneedling followed immediately by a 35% glycolic acid peel for treatment of atrophic acne scars.
干预措施: Microneedling with Glycolic Acid 35% Peel (Procedure)
Microneedling Plus Trichloroacetic Acid 15%
Participants receive microneedling followed immediately by a 15% trichloroacetic acid peel for treatment of atrophic acne scars.
干预措施: Microneedling with Trichloroacetic Acid 15% Peel (Procedure)
Microneedling Alone
Participants receive microneedling alone for treatment of atrophic acne scars, without a post-procedure chemical peel.
干预措施: Microneedling only (Procedure)
结局指标
主要结局
Clinical Improvement in Atrophic Acne Scar Severity Using the Goodman and Baron Qualitative Global Acne Scar Grading System
时间窗: Baseline to 1 month after the last treatment session
Clinical response is assessed by comparing standardized facial photographs obtained at baseline and 1 month after the last treatment session. Two dermatologists blinded to treatment allocation evaluate scar severity using the Goodman and Baron qualitative global acne scar grading system. Excellent response is defined as a reduction of two scar grades, good response as a reduction of one scar grade, and poor response as no reduction in scar grade.
次要结局
- Participant Satisfaction With Treatment(1 month after the last treatment session)
- Treatment-Related Adverse Effects(At each treatment session through 1 month after the last treatment session)
- Procedure-Related Pain Severity(Immediately after each treatment session within up to 30 minutes)
- Post-Procedure Downtime(After each treatment session up to 2 weeks)
研究者
Noura Abdelmoneim Mohammed Elseessy
Lecturer of Dermatology and Venereology, Faculty of Medicine, Kafrelsheikh University
Kafrelsheikh University