The Efficacy of Autologous Platelet Rich Plasma Combined with Ablative Carbon Dioxide Fractional Resurfacing for Acne Scars: A Simultaneous Split-Face Trial

Abstract

BACKGROUND Ablative carbon dioxide (CO2) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma (PRP) is known to enhance wound healing and has applications in many areas of medicine. OBJECTIVES To evaluate the synergistic effects of autologous PRP with CO2 fractional resurfacing for acne scars. MATERIALS AND METHODS A split-face trial was conducted in 14 Korean participants with acne scars. All participants received one session of ablative CO2 fractional resurfacing. Immediately after resurfacing, facial halves were randomly assigned to receive treatment with autologous PRP injections on one side (experimental side) and normal saline injections on the other side (control side). The participants were monitored for degree of recovery and resurfacing-associated adverse events, including prolonged erythema, edema, and other effects on days 0, 2, 4, 6, 8, 15, and 30. The intensity of erythema was objectively measured using a chromometer at the same time intervals. After one additional treatment session using the same protocol, two independent dermatologists evaluated clinical improvement using a quartile grading scale. RESULTS All participants completed the study. Erythema on the experimental side improved faster than on the control side and was significantly less at day 4 (p = .01). This difference was confirmed using a chromometer (p = .049). Total duration of erythema was an average of 10.4 +/- 2.7 days on the control side and 8.6 +/- 2.0 days on the experimental side (p = .047). Edema also improved faster on the experimental side than on the control side. The total duration of edema was an average of 7.1 +/- 1.5 days on the control side and 6.1 +/- 1.1 days on the experimental side (p = .04). Participants were also assessed for duration of post-treatment crusting, with a mean of 6.8 +/- 1.0 days on the control side and 5.9 +/- 1.1 days on the experimental side (p = .04). No other adverse effects were observed in any participant. Four months after the final treatment, overall degree of clinical improvement was significantly better on the experimental side (2.7 +/- 0.7) than on the control side (2.3 +/- 0.5) (p = .03). CONCLUSIONS Treatment with PRP after ablative CO2 fractional resurfacing enhances recovery of laser-damaged skin and synergistically improves the clinical appearance of acne scarring.