Comparison of Efficacy and safety of Microneedling with 35% Glycolic acid peel versus Glycolic acid peel alone in the treatment of Atrophic acne scars; A Randomized Controlled Trial

Objective  To assess the effectiveness and safety profile of glycolic acid peel combined with microneedling versus 35% glycolic acid peel in the management of acne scars.   Methods This study was conducted from 27th September 2021 to 28th March 2022 at Outpatient Department of Dermatology, Services Hospital, Lahore. Patients of either gender, having acne scars of grade 2 to grade 4 were included. After written informed consent, they were divided randomly into two treatment groups. Patients in Group A were treated with 35% glycolic acid peel combined with microneedling while Group B was received 35% glycolic acid peel only. All patients underwent six treatment sessions at two weekly intervals. They were called for follow-up one month after the last treatment session and treatment response was noted. ‘Treatment response’ or efficacy was defined as Excellent response (reduction in two grades of scars), Good response (reduction in one grade) or Poor response (no reduction in grade of scars). Safety of treatments was assessed by side effects reported by patients and observed on examination.   Results Out of 60 patients, 51 (85%) were women and 09 (15%) were men with a ratio of 5.7:1. They were divided equally into two treatment groups. Group A patients had a mean age of 32.43±6.91 years while it was 33.27±7.24 years in group B patients. Majority of the patients (58.33%) were between 31 to 45 years of age. Efficacy of Group A (glycolic acid peel 35%, combined with microneedling) was seen in 29 (96.67%) patients whereas it was observed in 22 (73.33%) patients (p-value=0.011) in Group B. Two patients in combination group reported post-inflammatory hyperpigmentation, rest of the patients reported improvement in tone and texture of skin.   Conclusion This study concluded that use of glycolic acid peel 35% combined with microneedling is more effective treatment option in acne scars versus the peel alone. Patients in both the groups reported improvement in the quality of skin with a relatively good safety profile.