Interventions for acne scars.
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ABSTRACT:
SUBMITTER: Abdel Hay R
PROVIDER: S-EPMC7069546 | biostudies-literature | 2016 Apr
REPOSITORIES: biostudies-literature
Publications
Interventions for acne scars.
Abdel Hay Rania R Shalaby Khalid K Zaher Hesham H Hafez Vanessa V Chi Ching-Chi CC Dimitri Sandra S Nabhan Ashraf F AF Layton Alison M AM
The Cochrane database of systematic reviews 20160403
<h4>Background</h4>Acne scarring is a frequent complication of acne and resulting scars may negatively impact on an affected person's psychosocial and physical well-being. Although a wide range of interventions have been proposed, there is a lack of high-quality evidence on treatments for acne scars to better inform patients and their healthcare providers about the most effective and safe methods of managing this condition. This review aimed to examine treatments for atrophic and hypertrophic ac ...[more]
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| S-EPMC10795687 | biostudies-literature
Project description:BackgroundAcne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and risk factors of acne scars in patients with acne.Materials and methodsA systematic search of published studies in three databases was performed and the meta-analyses were conducted.ResultsFinally, we included 37 studies involving 24 649 acne patients. And, the pooled prevalence of acne scars in these patients was 47% (95% confidence interval [CI]: 38-56%). Besides, the differences in prevalence were observed based on the subgroup analysis for age, gender, acne severity, source of patients, and so on. Subsequently, we quantified the relationship of three risk factors with acne scars: male gender (odds ratio [OR]: 1.58, 95% CI: 1.19-2.09), positive family history of acne (OR: 2.73, 95% CI: 1.26-5.91), and acne severity (OR for moderate acne: 2.34, 95% CI: 1.54-3.57; OR for severe acne: 5.51, 95% CI: 2.45-12.41).ConclusionHerein, we found that 47% of acne patients suffered from acne scars and identified three risk factors: male gender, positive family history of acne, and acne severity. In order to reduce acne scarring, attention and effective therapy early in the course of acne is important.
| S-EPMC10240192 | biostudies-literature
Project description:BackgroundThere are numerous laser treatments for acne scars in clinical practice. However, there are no clinical studies comparing all laser methods to provide an evidence-based bias for clinicians to choose the best strategy. Therefore, this systematic review and network meta-analysis was conducted to explore the efficacy of different types of laser treatment on acne scars. This study can provide the most effective treatment for acne scars in clinical practice.MethodsThe databases of PubMed, Embase, Cochrane Library, and Web of Science were searched from their inception to July 2022. The Cochrane risk of bias assessment tool was used to assess the bias of the included original studies. Bayesian network meta-analysis was used to investigate the efficacy of laser treatment strategies in scar improvement, cure rate, and satisfaction.ResultsAs shown by the results, the top 3 treatment options for scar improvement were fractional carbon dioxide laser (FCL) + platelet-rich-plasma (PRP) [surface under the cumulative ranking curve (SUCRA): 0.699], 1064Nd (1,064-nm neodymium-doped yttrium aluminum garnet picosecond laser) + 15%VC (Vitamin C; SUCRA: 0.675), and 1064Nd (SUCRA: 0.627). The standard mean difference (SMD) of FCL + PRP was -1.76 (95% CI: -3.49, -0.03), compared with that of FCL. The top 3 treatment options for improving cure rate were Er (Er:YAG laser treatment) + PRP (SUCRA: 0.873), FCL (SUCRA: 0.773), and FCL + 30% salicylic acid (30%SC) (SUCRA: 0.772). The RR of Er + PRP cure rate was 13.86 (95% CI: 1.79, 107.22), compared with non-laser radiofrequency therapy.ConclusionsThe findings suggested that combined therapies should be used to treat acne scars. Er + PRP showed the highest cure rate of acne scar, followed by FCL + 30%SC or FCL monotherapy. FCL combined with PRP could improve acne scarring to the greatest extent, and 1064Nd combined with 15%VC can also exert a good effect. As for satisfaction, FCL monotherapy was the most satisfactory methods for patients, followed by PRP monotherapy. Therefore, Er + PRP and FCL + PRP can be used as the first choice for clinical treatment of acne scars. Additionally, using FCL alone is also an effective and elective treatment method due to its affordable cost and comfort.
| S-EPMC9843402 | biostudies-literature
Project description:INTRODUCTION:Scarring is an unfortunate clinical outcome of acne. Current treatment options for atrophic acne scars are dominated by non-pharmacological, invasive procedures which may not be suitable or affordable to all patients. This phase II, single-center, open-label, exploratory study assessed the efficacy, safety and subject-reported outcomes of adapalene 0.3% gel in the treatment of atrophic acne scars. METHODS:The study included subjects aged 18-50 years with past history of acne and moderate to severe facial atrophic acne scars. Subjects received adapalene 0.3% gel once daily for the first 4 weeks and twice daily for the following 20 weeks. Assessments were performed at baseline, day 10 and weeks 4, 8, 16 and 24, and at post-treatment follow-ups (weeks 36 and 48-72). RESULTS:At week 24, investigator and subject assessments reported improvement in skin texture/atrophic scars in 50% and > 80% of subjects, respectively. Subjects were satisfied with the treatment and reported improvements in quality of life. CONCLUSION:Daily use of adapalene 0.3% gel for the treatment of atrophic acne scars showed promising clinical efficacy, a favorable tolerability profile, and improvement in quality of life. FUNDING:Nestlé Skin Health-Galderma R&D. TRIAL REGISTRATION:ClinicalTrials.gov Identifier NCT01213199.
| S-EPMC6002315 | biostudies-literature
Project description:PurposeFractional microneedle radiofrequency (FMR) systems are used to treat inflammatory acne and scarring. Nonetheless, few controlled studies have combined this treatment with the traditional ablative fractional laser (AFL). We aimed to assess the safety and efficacy of the combination of FMR and AFL versus AFL alone in treating acne and acne scars.Materials and methodsIn this 20-week, randomized, split-face study, 23 Korean patients with facial acne and acne scars underwent FMR and AFL treatments. One half of each patient's face was randomly assigned to receive FMR+AFL, whereas the other half received AFL alone. Treatments were administered in three consecutive sessions at 4-week intervals. This study investigated the severity of inflammatory acne, acne scars, individual lesion counts, depressed scar volumes, as well as patient and physician satisfaction. In addition, five patients underwent skin biopsy, and sebum output was measured.ResultsThe FMR+AFL treatment demonstrated superior efficacy compared to AFL alone in terms of inflammatory acne and acne scar grading, lesion counts, and subjective satisfaction. The side effects were minimal and well-tolerated in both groups. Immunohistochemical findings from skin biopsy samples revealed that the application of FMR+AFL could induce an inhibitory effect on sebum secretion at the molecular level.ConclusionFMR combined with AFL is a well-tolerated and effective treatment modality for inflammatory acne and acne scarring.
| S-EPMC10681823 | biostudies-literature
Project description:IntroductionAtrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars.MethodsAn online survey administered in the USA, UK, Japan, Germany, France and Brazil to respondents 18 years and over presented three facial pictures of clear skin or digitally superimposed acne scars (but no active acne lesions) in a random fashion. At least one clear and one scar picture were presented to each participant.ResultsAmong the 4618 responders, 33% themselves had facial acne scars. The skin was the first thing noticed about the face by 41% when viewing pictures with scars vs 8% viewing clear skin (p < 0.05). Those with scars were less likely to be considered attractive (17% vs 25%), confident (25% vs 33%), happy (23% vs 30%), healthy (21% vs 31%) and successful (17% vs 24%), and more likely to be perceived as insecure (15% vs 8%) and shy (23% vs 14%) compared with those with clear skin (all p < 0.05). The significance of the responses obtained varied according to the acne and scar status of the respondent. Skin care was cited as the habit most in need of improvement by 59% vs 13% of respondents viewing pictures with scars vs clear skin, respectively (p < 0.05). All respondent subgroups cited skin care irrespective of their own acne and scar status (all p < 0.05 vs pictures with clear skin). Those with scars were thought less likely to have a promising future (78% vs 84%) than those with clear skin (p < 0.05). The majority of respondents reported willingness to pay money to eradicate scars.ConclusionThe results of this multi-national survey demonstrate that facial acne scars are perceived negatively by society, confirming the importance of preventing acne scars with early treatment of inflammatory acne.FundingGalderma International S.A.S France.
| S-EPMC4906107 | biostudies-literature
Project description:BackgroundAtrophic acne scarring often accompanies acne vulgaris. The efficacy of topical retinoids for treatment of acne is well documented; however, evidence for use in atrophic acne scars is limited.MethodsIn this randomized, split-face, double-blind study, subjects (age: 17-34 years, N = 121) with moderate-to-severe facial acne, with acne scars present, were treated with either trifarotene 50 μg/g or vehicle once daily for 24 weeks. Efficacy was assessed by absolute and percent change from baseline in atrophic acne scar counts, Scar Global assessment (SGA), and IGA success rates as well as acne lesion counts.ResultsAt week 24, a statistically significantly greater reduction in the mean absolute change from baseline in the total atrophic scar count was noted in the trifarotene- vs vehicle-treated area (- 5.9 vs - 2.7; p < 0.0001) with differences between sides noted as early as week 2 (- 1.5 vs - 0.7; p = 0.0072). The SGA success rate was higher in the trifarotene side at week 12 (14.9% vs 5.0%, P < 0.05) and improved through week 24 (31.3% vs 8.1%, P < 0.001). Similarly, at week 24, the IGA success rate was higher with trifarotene (63.6% vs 31.3%, P < 0.0001) along with reductions in total (70% vs 45%) and inflammatory (76% vs 48%) lesion counts. The incidence of treatment-emergent adverse events was 5.8% (trifarotene) and 2.5% (vehicle); most common (> 1%) was skin tightness (1.7% vs 0.8%), and all events were mild to moderate in severity.ConclusionsTrifarotene was effective and well tolerated in treating moderate-to-severe facial acne and reducing atrophic acne scars, with reduction of total atrophic scar count as early as week 2.Trial registrationClinicaltrials.gov NCT04856904.
| S-EPMC10689318 | biostudies-literature
Project description:BackgroundFractional picosecond lasers (FPL) are reported to be effective and safe for atrophic acne scars and post-acne erythema. However, there is no evidence regarding the effectiveness and safety of FPL treatment for non-acne atrophic scars and scar erythema among Chinese patients.MethodsIn this retrospective study, 12 Chinese patients with non-acne atrophic scars, including nine with scar erythema, were treated with one to three sessions of 1064 nm FPL treatment. Clinical improvement was objectively assessed through blinded evaluations by external physicians. A modified Manchester Scar Scale (mMSS) and the Clinician Erythema Assessment Scale (CEAS) were individually used to evaluate atrophic scars and scar erythema based on photographs. Physician-assessed and subject-assessed Global Aesthetic Improvement Scale (GAIS) were used to assess changes before and after FPL treatment. Patient satisfaction and adverse events were also documented.ResultsTotal mMSS scores, as well as three parameters (color, distortion, and texture), were significantly decreased after FPL treatment, with a mean reduction of 3.18 ± 1.60 in total scores (p < 0.05). The CEAS scores were significantly reduced from 2.41 ± 0.98 before treatment to 0.41 ± 0.40 at the final visit (p < 0.05). Based on physician-assessed and subject-assessed GAIS scores, 11 (91.7%) patients were improved after FPL treatment. 33.3% of patients were very satisfied, and 41.7% were satisfied. No serious, prolonged (> 3 weeks) adverse events were observed.ConclusionOur study suggests that 1064 nm FPL treatment may be a promising option for non-acne atrophic scars, especially with scar erythema. Further studies are needed to confirm our results.
| S-EPMC11259539 | biostudies-literature
Project description:BackgroundAcne affects more than 80% of adolescents and young adults, who most often develop acne scars. Supporting data on the effect of acne scars on patient's health-related quality of life (HRQOL) are limited.ObjectiveThe aim was to determine how the severity of acne scars impacts the HRQOL of afflicted individuals.MethodsIn this population-based cross-sectional study, 723 adults with facial acne scars but without active acne lesions self-completed the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire formulated to investigate degree of acne scarring. The Facial Acne Scar Quality of Life (FASQoL), Dermatology Life Quality Index (DLQI), and Dysmorphic Concern Questionnaire (DCQ) were completed to assess the attitude of these patients toward their scars and the impact of scarring on their HRQOL.ResultsThe mean (standard error) DLQI score for facial acne scars was 6.26 (0.22). Acne scars were considered a 'very large' or 'extremely large' concern by 19.3% of participants with mild scars as compared to 20.1% and 34.0% of participants with moderate and severe/very severe scars, respectively (P = 0.003). Higher FASQoL scores were associated with increased severity of scarring (P = 0.001). In total, 16.9% of participants had clinical features of dysmorphia (i.e., DCQ > 13). DCQ scores were significantly higher among participants with more severe scarring (mean DCQ score of 8.04 [0.28], 8.40 [0.18], and 10.13 [0.08] among participants with mild, moderate, and severe/very severe acne scars, respectively; P = 0.001). Most commonly reported signs of emotional distress were self-consciousness (68.0%) and worry about scars not going away (74.8%).ConclusionsThis study highlights the significant psychosocial impact of atrophic acne scars in the form of embarrassment and self-consciousness. Individuals with mild scars also expressed significant impact on quality of life that increased with aggravation of scar severity. Patient-reported outcomes provide an insight into the physical, functional, and psychological impact of acne scarring from the patient's perspective.
| S-EPMC8776674 | biostudies-literature
Project description:Background: Acne-induced scarring is associated with a similar burden as acne, i.e. diminished quality of life, and may be avoided if patients receive appropriate and timely acne treatment. In 2017, a four item-Acne-Scar Risk Assessment Tool (4-ASRAT) was designed by Tan et al. to categorise patients with acne into lower-risk or higher-risk for acne scarring. Its applicability outside the initial study population (France, Brazil and United States) remains to be determined. Methods: A study protocol was developed to create a systematic approach for validating and adapting 4-ASRAT to different populations, Ecuador in this case. The protocol was reviewed by 11 local and international dermatologists and pilot-tested in an Ecuadorian population using a sample of 10 participants who currently had or had had acne. Feedback from the pilot study was used to improve the study protocol. The results of the pilot study are included here, and the final study protocol is available as extended data. Results: The protocol proved to be applicable. Images taken of participants were a valuable resource for dermatological evaluation about the presence or absence of acne scars. Tangential light is necessary for this evaluation. Although dermatological assessments varied, we concluded that assessment by three local dermatologists for each participant was adequate for reaching a consensus on the presence or absence of acne scars. Conclusions: Considering the morbidity related to acne and acne scars, tools designed as prevention that alert patients about risk of developing scarring are necessary. The proposed protocol shows a feasible way of validating and adapting 4-ASRAT to different populations.
| S-EPMC7431969 | biostudies-literature