| Background:Atrophic acne scars are a common dermatological concern that significantly impact patients’ quality of life. Combination therapies involving microneedling, chemical peels, and fractional lasers have gained popularity due to their synergistic effects on scar remodeling and skin rejuvenation. Aim & Objective:To compare the efficacy and safety of microneedling followed by 35% glycolic acid (GA) peel versus fractional Erbium:YAG laser followed by 15% trichloroacetic acid (TCA) peel in the management of facial atrophic acne scars. Methods:A total of 50 patients with atrophic acne scars were enrolled and randomly assigned into two groups (n=25 each). Group A was treated with 4 sessions of microneedling followed by 35% GA peel and Group B with 4 sessions of fractional Erbium:YAG laser treatment followed by 15% TCA peel, repeated every 28 days. Improvement was assessed using Goodman and Baron’s qualitative and quantitative global acne scar grading systems and patient-reported outcomes via Visual Analogue Scale (VAS) for scar improvement. Results: Both groups showed significant improvement in acne scar grades from baseline (p<0.05). The mean percentage reduction in Goodman and Baron’s quantitative acne scar scores was significantly more in Group B (20.56% ± 6.90% ) compared to group A (22.02% ± 8.2% ) (p<0.05). In regards of complications, both procedures were well tolerated with few cases of minor post inflammatory hyperpigmentation in Group B. In VAS, the results were comparable (p>0.05). Conclusion:Both combination therapies—microneedling with glycolic acid and fractional Erbium:YAG laser with TCA—are effective and safe for treating atrophic acne scars. While overall efficacy was comparable, Erbium YAG laser-TCA combination showed marginally superior results but microneedling with GA has better safety profile. |
