DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20191002

Patient perception, satisfaction and cosmetic results of platelet-rich plasma in the treatment of acne scars: a patient-reported outcome of a non-surgical management

Ozlem Colak, Kadri Ozer

Abstract


Background: Acne is a common skin condition of the pilosebaceous unit that is prevalent up to 80% of the adolescent population. Permanent, disfiguring scar is an unfortunate complication due to abnormal resolution following the damage during acne inflammation. Those troubling noticeable scars may lead to not only cosmetic problems but also psychological and social consequences which could impair the quality of life including diminished self-esteem and disruption of daily activities. We aimed to discuss our results of PRP procedure in the treatment of acne scars using scales based on patient satisfaction, perception and the quality of life.

Methods: This study included 11 patients suffering from post-acne scars who underwent 3 sessions of platelet-rich plasma injection. The outcome was determined by the difference in pre- and post- procedure FACE-Q modules, dermatology life quality index (DLQI) and body image questionnaire (BIQ) which were designed as patient-reported outcome instrument to evaluate the unique outcomes of patients undergoing facial cosmetic procedures.

Results: Overall satisfaction with outcome was 77.18±8.30 (range 63–87). No major complications such as hyper-/hypopigmentation, scar formation, infections, skin necrosis, nodulation, fibrosis, or calcification were recorded. All patients developed ecchymosis and edema in the treated area and all were improved during follow-up. The patient-reported FACE-Q satisfaction, FACE-Q quality of life, DQLI and BIQ scores of pre- and post- procedure showed statistically significant improvement (<0.05).

Conclusions: PRP can increase the quality of life in patients with acne scars in terms of social and psychological function without large damage to the skin.


Keywords


Acne scar, Body image, Face, FACE-Q, Quality of life, Platelet-rich plasma

Full Text:

PDF

References


Abdel Aal AM, Ibrahim IM, Sami NA, Abdel Kareem IM. Evaluation of autologous platelet-rich plasma plus ablative carbon dioxide fractional laser in the treatment of acne scars. J Cosmet Laser Ther. 2018;20(2):106-13.

El-Domyati M, Abdel-Wahab H, Hossam A. Microneedling combined with platelet-rich plasma or trichloroacetic acid peeling for management of acne scarring: A split-face clinical and histologic comparison. J Cosmet Dermatol. 2018;17(1):73-83.

Ibrahim MK, Ibrahim SM, Salem AM. Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study. J Dermatolog Treat. 2018;29(3):281-6.

Tenna S, Cogliandro A, Barone M, Panasiti V, Tirindelli M, Nobile C, et al. Comparative Study Using Autologous Fat Grafts Plus Platelet-Rich Plasma With or Without Fractional CO2 Laser Resurfacing in Treatment of Acne Scars: Analysis of Outcomes and Satisfaction With FACE-Q. Aesthetic Plast Surg. 2017;41(3):661-6.

Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, et al. Updated Scar Management Practical Guidelines: Non-invasive and invasive measures. J Plast Reconstr Aesthetic Surg. 2014;67(8):1017-15.

Min S, Yoon JY, Park SY, Moon J, Kwon HH, Suh DH. Combination of platelet rich plasma in fractional carbon dioxide laser treatment increased clinical efficacy of for acne scar by enhancement of collagen production and modulation of laser-induced inflammation. Lasers Surg Med. 2018;50(4):302-10.

Zhang M, Park G, Zhou B, Luo D. Applications and efficacy of platelet-rich plasma in dermatology: A clinical review. J Cosmet Dermatol. 2018;17(5):660-5.

Ozer K, Kankaya Y, Çolak Ö. An important and overlooked parameter in platelet rich plasma preparation: The mean platelet volume. J Cosmet Dermatol. 2018.

Ozer K, Colak O. Micro-Autologous Fat Transplantation Combined With Platelet-Rich Plasma for Facial Filling and Regeneration. J Craniofac Surg. 2019:1.

Atashi F, Jaconi MEE, Pittet-Cuénod B, Modarressi A. Autologous platelet-rich plasma: a biological supplement to enhance adipose-derived mesenchymal stem cell expansion. Tissue Eng Part C Methods. 2015;21(3):253-62.

Gholam P, Kroehl V, Enk AH. Dermatology Life Quality Index and Side Effects after Topical Photodynamic Therapy of Actinic Keratosis. 2013;226(3):253-9.

A revolutionary patient-reported outcome instrument by Memorial Sloan-Kettering Cancer Center: FACE-Q. Available at: http://qportfolio. org/faceq/. Accessed on 3 February 2019.

East C, Badia L, Marsh D, Pusic A, Klassen AF. Measuring Patient-Reported Outcomes in Rhinoplasty Using the FACE-Q: A Single Site Study. Facial Plast Surg. 2017;33(5):461-9.

Zhu JT, Xuan M, Zhang YN, Liu HW, Cai JH, Wu YH, et al. The efficacy of autologous platelet-rich plasma combined with erbium fractional laser therapy for facial acne scars or acne. Mol Med Rep. 2013;8(1):233-7.

Alser OH, Goutos I. The evidence behind the use of platelet-rich plasma (PRP) in scar management: a literature review. Scars, Burn Heal. 2018;4:2059513118808773.

Alam M, Goodman G. Treatment of acne scarring. In: Carniol PJ, Sadick NS, eds. Clinical procedures in laser skin rejuvenation. 1st ed. London: Informa Healthcare; 2007: 89-102.

Younis S, Rana F, Blumenberg M, Javed Q. Role of activated platelets in severe acne scarring and adaptive immunity activation. Clin Chem Lab Med. 2017;55(7):152-3.

Çolak Ö, Ozer K, Dikmen A. Toll-Like Receptor 4 Expression in Human Breast Implant Capsules: Localization and Correlation with Estrogen Receptors. Plast Reconstr Surg. 2016;138(4):757-8.

Kang S, Cho S, Chung JH, Hammerberg C, Fisher GJ, Voorhees JJ. Inflammation and extracellular matrix degradation mediated by activated transcription factors nuclear factor-kappaB and activator protein-1 in inflammatory acne lesions in vivo. Am J Pathol. 2005;166(6):1691-9.

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-96.

Cho JW, Kim SA, Lee KS. Platelet-rich plasma induces increased expression of G1 cell cycle regulators, type I collagen, and matrix metalloproteinase-1 in human skin fibroblasts. Int J Mol Med. 2012;29(1):32-6.

Nofal E, Helmy A, Nofal A, Alakad R, Nasr M. Platelet-rich plasma versus CROSS technique with 100% trichloroacetic acid versus combined skin needling and platelet rich plasma in the treatment of atrophic acne scars: a comparative study. Dermatol Surg. 2014;40(8):864-73.

Asif M, Kanodia S, Singh K. Combined autologous platelet-rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split-face study. J Cosmet Dermatol. 2016;15(4):434-43.

Chawla S. Split Face Comparative Study of Microneedling with PRP Versus Microneedling with Vitamin C in Treating Atrophic Post Acne Scars. J Cutan Aesthet Surg. 2014;7(4):209-12.

Faghihi G, Keyvan S, Asilian A, Nouraei S, Behfar S, Nilforoushzadeh MA. Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial. Indian J Dermatol Venereol Leprol. 2016;82(2):162-8.

Tian J, Lei XX, Xuan L, Tang JB, Cheng B. Application of plasma-combined regeneration technology in managing facial acne scars. J Cosmet Laser Ther. 2018:1-7.

Al-Saedy SJ, Al-Hilo MM, Al-Shami SH. Treatment of acne scars using fractional Erbium: YAG laser. Am J Dermatology Venereol. 2014;3(2):43-9.

Anaba EL, Adebola OO. Quality of life of adolescents with facial acne vulgaris before and after treatment in Ibadan, Nigeria. Int J Res Dermatology. 2019;5(1):155.