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BIBLIOGRAPHIC SURVEY N°101

MICRONEEDLING IN THE TREATMENT OF PIGMENTED POST ACNE SCARRING IN DARKER SKIN

This study aimed to evaluate the efficacy and safety of the use of microneedling for the treatment of hyperpigmented acne scars in patients with darker skin types.

Thirty-nine patients with skin type III, IV and V (Fitzpatrick) were included. There was an initial evaluation of both acne scars and pigmentation indexes using PAHPI (post-acne hyperpigmentation index) and Goodman and Baron scale (GB scale). Treatment with microneedle was performed and patients were assessed after 2 and 4 weeks. Photos were taken at baseline and at the final evaluation for comparison.

Results indicated a statistically significant improvement in both the PAHPI index and Goodman and Baron scale. The adverse effects observed were transient erythema, mild dryness and small bruising and there was no pigmentation exacerbation in any of the patients.

The authors concluded that use of microneedling for the treatment of hyperpigmented acne scars in higher skin phototypes is effective and safe, presenting only mild and transient adverse effects. It was pointed out that some patients may require complementary treatments to improve hyperpigmentation.

J Cosmet Dermatol. 2018 Mar 15. doi: 10.1111/jocd.12520. [Epub ahead of print]
Skin microneedling for acne scars associated with pigmentation in patients with dark skin.
Al Qarqaz F, Al-Yousef A.

IDIOPATHIC GUTTATE HYPOMELANOSIS - TREATMENT WITH FRACTIONAL ABLATIVE PHOTOTHERMOLYSIS VERSUS TOPICAL RETINOID

This prospective study compared the efficacy of idiopathic guttate hypomelanosis treatment with fractional CO2 laser (CO2FL), Er: YAG fractional laser (EYFL) and topical use of 0.025% tretinoin.

A total of 122 lesions of 18 patients (mean age 70 ± 20 years) were analyzed. The lesions were distributed among 3 treatment groups: A. (n = 42) CO2FL, B. (n = 40) EYFL and C. (n = 40) topical tretinoin. Results were evaluated using Visual Analogue Scale (VAS) - measuring the severity of the lesion, Investigator's Global Assessment (IGA) - checking the extent of improvement achieved by the treatment, and Patient's Satisfaction Score (PSS).

The results indicated significantly superior efficacy with laser treatments (CO2FL and EYFL) compared to topical tretinoin treatment (p <0.01 in VAS, IGA and PSS). There was, however, no significant difference between the results obtained with both fractional lasers.

The authors concluded that fractional ablative lasers are effective in the treatment of idiopathic guttate hypomelanosis, showing results in a short period of time and without any serious adverse effects.

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J Cosmet Laser Ther. 2018 Mar 16:1-5. doi: 10.1080/14764172.2018.1444771. [Epub ahead of print]
Comparative study of ablative fractional photothermolysis versus topical retinoid cream in the treatment of idiopathic guttate hypomelanosis.
Koh WS, Kim JE, Ro YS, Ko JY.

INTRADERMAL TRANEXAMIC ACID TO PREVENT POST-INFLAMMATORY HYPERPIGMENTATION AFTER SOLAR LENTIGINES REMOVAL

This study evaluated safety and efficacy of intradermal tranexamic acid (TA) injections after treatment of solar lentigines with Q-switched 532nm Nd: YAG laser, aiming at reducing the risks of post-inflammatory hyperpigmentation (PIH).

Twenty-five patients presenting 50 solar lentigines in the forearms were included. All selected lesions were submitted to QS 532nm Nd: YAG laser treatment. After the laser treatment, intradermal injections of TA 50mg / mL were applied in one lesion and saline solution (0.9%) in the other lesion. Assessment using Mexameter® was performed and two blinded dermatologists examined photos taken at baseline and after 2, 4, 8 and 12 weeks. Side effects observed with TA were minimal, with resolution within 1 hour.

Results at the end of the study indicated a significant reduction of the mean melanin index (MI) in both groups. At week 4 assessment, TA group presented a significant reduction in the mean MI compared to the control group (p = 0.025). Overall PIH rates were 16% for the TA group and 28% for the control group.

The authors concluded that TA (50m/mL) intradermal injections may reduce the risk of post-inflammatory hyperpigmentation 4 weeks after treating solar lentigines with QS 532nm Nd: YAG laser.

J Cosmet Laser Ther. 2018 Mar 5:1-7. doi: 10.1080/14764172.2018.1444770. [Epub ahead of print]
Intradermal tranexamic acid injections to prevent post-inflammatory hyperpigmentation after solar lentigo removal with a Q-switched 532-nm Nd:YAG laser.
Sirithanabadeekul P(1), Srieakpanit R(1).