Russian Journal of Physiotherapy, Balneology and RehabilitationRussian Journal of Physiotherapy, Balneology and Rehabilitation1681-34562413-2969Eco-Vector10825210.17816/rjpbr108252Research ArticleCombined use of combined laser therapy and autologous plasma with cells in patients with post-acne atrophic scarsTalibovaAliya P.<p>MD, Cand. Sci. (Med.)</p>tynrik@yandex.ruhttps://orcid.org/0000-0003-0850-3238GryazevaNatalia V.<p>MD, Cand. Sci. (Med.), Associated Professor</p>tynrik@yandex.ruhttps://orcid.org/0000-0003-3437-5233Central State Medical Academy of Department of Presidential AffairsInstitute of Plastic Surgery and Cosmetology150720212042832882605202230052022Copyright © 2021, Talibova A.P., Gryazeva N.V.2021<p><em>BACKGROUND:</em> The formation of atrophic post-acne scars often leads patients to severe psychological depression and social exclusion. To date, many post-acne treatment options have been described, in particular fractional non-ablative laser resurfacing, exposure to platelet-rich plasma, but there is still no standard line of therapy.</p>
<p><em>AIMS:</em> to study the effectiveness of combined therapy with neodymium (Nd:YAG) and erbium (Er:YAG) lasers and autologous platelet-rich plasma in patients with various phenotypes of atrophic post-acne scars.</p>
<p><em>MATERIAL AND METHODS:</em> The study involved patients (<em>n</em>=58) over the age of 18 with different types (cleaved, rectangular, navicular) of atrophic post-acne scars, who were divided into 2 groups depending on the method of therapy. Group 1A (<em>n</em>=28) received phototherapy using combined exposure to neodymium (Nd:YAG) and erbium (Er:YAG) lasers; Group 1B patients (<em>n</em>=30) were treated with autologous platelet-rich plasma immediately after laser treatment.</p>
<p>To assess the effectiveness of therapy, the Manchester scale of scar deformities was used according to five indicators ― color, texture, relief, displacement of surrounding tissues, density (MSS) and the International Global Aesthetic Improvement Scale (GAIS). Indicators of skin elasticity in the foci of atrophy were determined using cutometry; epidermal-dermal structure (thickness, echogenicity) was assessed by ultrasound. The clinical picture was assessed before and after treatment.</p>
<p><em>RESULTS:</em> The effectiveness of therapy was confirmed by the dynamics of symptoms on the MSS scale, in particular, an improvement in the "color" indicators by 54.8% in group 1A, by 83.7% in group 1B, "texture" ― by 57.1 and 78.1%, "relief" ― by 43.8 and 66.7%, "displacement" ― by 54.9 and 82.1%, respectively. The proportion of patients with an optimal result according to GAIS in group 1A was 50%, in group 1B ― 90%; with a significant improvement ― 50 and 10%, respectively. Cutometry and ultrasound data also showed better results in the autologous platelet-rich plasma supplemented group.</p>
<p><em>CONCLUSION: </em>Thus, complex treatment, including the use of combined laser therapy (erbium and neodymium lasers) and autologous plasma with cells, is a highly effective method for the treatment of atrophic post-acne scars.</p>post-acne atrophic scarsNd:YAG laserEr:YAG laserautologous plasma with cellsатрофические рубцы постакнеNd:YAG лазерEr:YAG лазераутологичная плазма с клетками[Acne and rosacea. Ed. by L.S. Kruglova. Moscow: GEOTAR-Media; 2021. 207 р. (In Russ).][Al Tawil AA, Al Refae AA, Hamed AM, Kamal AM. Comparative study of the effectiveness of platelet-rich plasma in combination with carboxytherapy compared to its use with a fractional carbon dioxide laser in atrophic acne scars. J Cosmet Dermatol. 2018;18(1):150–155. doi: 10.1111/jocd.12561][Al-Saedi SJ, Al-Hilo MM, Al-Shami SH. Treatment of acne scars using fractional erbium:YAG-laser. Am J Dermatol Venereol. 2014;3(2):43–49. doi: 10.5923/j.ajdv.20140302.04][Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23(1):49–60. doi: 10.5978/islsm.14-RE-01][Potekaev NN, Kruglova LS. Laser in dermatology and cosmetology. Moscow: MDV; 2018. 280 р. (In Russ).][Kumaran MS, Arshdeep A. Platelet-rich plasma in dermatology: a blessing or a curse? Indian J Dermatol Venereol Leprol. 2014;80(1):5–14. doi: 10.4103/0378-6323.125467][Abdel-Aal AM, Ibrahim IM, Sami NA, Abdel Karim IM. Evaluation of autologous platelet-rich plasma plus ablative fractional carbon dioxide laser in the treatment of acne scars. J Cosmetic Laser Ther. 2018;20(2):106–113. doi: 10.1080/14764172.2017.1368667]