Does Dermaroller really work on acne scars

Microneedling helps so well with atrophic acne scars

the essentials in brief

  • Question: Can atrophic acne scars be effectively treated with a topical tazarotene gel?
  • Answer: Six months after the start of treatment, the effectiveness and tolerability were comparable to microneedling.
  • Importance: According to the authors, tazarotene gel can be seen as a new therapeutic approach for the treatment of atrophic acne scars.

CHANDIGARH. Microneedling, among other things, has proven itself for the treatment of patients with atrophic scars after severe acne. To test a method that would allow patients to self-treat at home, Dr. T. P. Afra from the Postgraduate Institute of Medical Education and Research in Chandigarh and colleagues compared the effectiveness of the needle technique with a topical 0.1% tazarotene gel (JAMA Facial Plast Surg 2018; online November 15).

The prospective study at an Indian tertiary care clinic enrolled 36 patients with atrophic acne scars on the face of stages 2–4.

Effect on the fibroblasts

Only people who had not undergone any surgical or laser therapy of the scars in the past year were taken into account. One half of the face was randomly treated with a dermaroller (needle length 1.5 mm; four times within three months), the other half with tazarotene gel (once daily), which the patients applied themselves, for the same period of time. The topical retinoid stimulates the skin's collagen formation through its action on the fibroblasts.

After three and six months, the result was compared with the initial situation, whereby the investigators had no knowledge of the respective type of treatment. Quantitative (type and number) and qualitative scores (visibility) according to Goodman and Baron as well as an independent dermatological score (0–10 points) based on the photo documentation were used to assess the severity of the scars.

In addition, patient satisfaction was recorded using the Patient Global Assessment Score (PGA, 0–10 points). The 34 patients, of whom a complete data set was available at the end of the study, were on average 23 years old and had suffered from acne for four to eight years.

Significant decrease

In 91.2 percent of the study participants in both groups, the quantitative acne scar score had improved as a result of the respective treatment. Six months after the start of treatment, it had fallen significantly for the halves of the face that had been treated with microneedling from an average of 7.0 to 4.5 points and in the tazarotene group from 8.0 to 5.0 score points. The effectiveness of the retinoid gel was thus comparable to that of the microneedling.

The blinded assessment of the final results by independent dermatologists using photo comparison also signaled similar successes for both methods (microneedling 5.5 versus tazarotene 4.4). The patients rated microneedling somewhat better using the Patient Global Assessment Score. The qualitative ratings, on the other hand, did not change significantly after either of the two forms of treatment.

There were only minor adverse effects in both treatment groups. Microneedling caused pain and redness, the tazarotene therapy caused dryness in about a third of the patients and the skin flaked in about every fifth patient. However, all adverse effects could be brought under control and therefore none of the patients stopped the therapy, as the Indian authors report.