A Split Face Study to Compare the Efficacy of Platelet Rich Plasma Versus Normal Saline Injections in Acne Scars and to Assess the Utility of Ultrabiomicroscopic Sonography in Evaluation of Treatment Response

BACKGROUND: Multiple studies have proposed the effectiveness of Platelet rich plasma (PRP) in treatment of atrophic acne scars. But an unanswered question is - whether it is the presence of growth factors in PRP or the mechanical factors during the injection that are responsible for its effectiveness? Also, no study compares PRP as a monotherapy against inert solution like normal saline (NS), that too, in a split face pattern using a non-invasive objective evaluation method. AIMS: Primary – To compare the efficacy of intralesional PRP and NS injections, in the treatment of atrophic acne scars. Secondary - To assess the side effect profile of the PRP injections. STUDY DESIGN: Prospective Interventional Comparative Split Face study MATERIALS AND METHODS: 30 out of 33 patients completed the study and 20 of them were subjected to Ultrabiomicroscopic (UBM) analysis. Each patient received intralesional injections of NS and PRP in a split face pattern at two weekly intervals for five sittings. Treatment response was assessed using Goodman And Baron qualitative grading system, photographic evaluation by two blinded dermatologist and UBM analysis (scar depth & length). RESULTS: All the three methods showed a statistically significant treatment response. However, there was no significant inter group difference and PRP and NS had similar efficacy in treating acne scars. CONCLUSION: We conclude that subscision like mechanical effect of injecting solution is more important than the nature of the solution in treatment of atrophic acne scars and UBM sonography can be proposed as an objective assessment tool for such studies.