Management of Acne Scars: Comparative Study of Therapeutic Efficacy of Fractional CO2 Laser and Micro - Needling with and Without Topical Epidermal Growth Factor Application Post - Procedure

Introduction: Post - acne scarring is one of the very distressing and difficult problems for patient and physicians alike. The treatment modalities for acne scarring include surgical techniques like punch excision, subcision, resurfacing techniques like microdermabrasion, ablative and non - ablative lasers, fillers. The clearance of the lesions with these procedures is still not effective. Treating the acne scars to obtain adequate response is one of the most challenging cosmetic procedures. Aims & Objectives: The present study is undertaken to explore the effectiveness of modalities (fractional Co2 LASER and micro - needling) of treatment for acne scars and also to evaluate role of topicalepidermal growth factor in the improvement of acne scars. Materials & Methods: This study was carried out in the outpatient department of ASRAM hospital, Eluru in a group of 40 patients. A very detailed history, thorough clinical examination, dermoscopic evaluation and histopathological examination were documented. Dermlite dermoscope was used in the study. Results: In the present study, 37% patients were males and 63% patients were females with a male to female ratio of 1: 1.7. In the present study, majority of the cases belonged to 20 - 30 years age group followed by 30 - 40 years age group. Majority had acne scars with duration of 6 - 10 years.62.5% of patients had acne scars exclusively over cheeks, 12.5% of patients had scarring over cheeks and forehead and 25% of patients had scarring over cheeks and chin. The most common pattern found in the present study was the mixed type of scarring - combination of rolling, boxcar and ice pick scars followed by the rolling scars and superficial boxcar scars. Co2 laser resurfacing showed highest mean percentage of improvement in quantitative and qualitative scores, followed by micro - needling. Conclusion: Fractional Co2 laser resurfacing is more efficacious than micro needling with longer down time interfering with daily activity of patients and mandatory avoidance of sun exposure in post treatment period are the limiting factors.