<b>Efficacy of Microneedling Combined with Platelet-Rich Plasma for Atrophic Acne Scars</b>

Background: Atrophic acne scars may produce persistent cosmetic and psychosocial morbidity. Microneedling stimulates dermal remodeling, while platelet-rich plasma may augment the regenerative response through platelet-associated mediators. Objective: To compare the short-term efficacy and safety of microneedling alone with microneedling combined with autologous platelet-rich plasma in adults with moderate-to-severe atrophic facial acne scars. Methods: In this parallel-group randomized controlled trial, 80 participants were allocated equally to microneedling alone or microneedling plus platelet-rich plasma. Three treatment sessions were administered at baseline, week 4, and week 8, with final assessment at week 12. The primary outcome was change in Goodman and Baron scar grade. Secondary outcomes included scar-depth score, patient satisfaction, and adverse effects. Results: Mean scar-grade reduction was 0.90 ± 0.44 with microneedling alone and 1.60 ± 0.51 with combination treatment, yielding a between-group difference of 0.70 grade units (95% CI, 0.49–0.91; p < 0.001). At week 12, the scar-depth score was 5.10 ± 1.12 and 3.60 ± 1.25, respectively (difference, −1.50; 95% CI, −2.03 to −0.97; p < 0.001). Good or excellent satisfaction was reported by 55.0% and 80.0% of participants, respectively. Adverse effects were predominantly mild and temporary. Conclusion: Microneedling combined with platelet-rich plasma produced greater short-term improvement than microneedling alone, although confirmation using standardized protocols and longer follow-up is required