Yu-Chun Shen1, Wen-Kuan Chiu2,3, Yi-No Kang4,5,6,7, Chiehfeng Chen8,9,10,11. 1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 2. Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan. 3. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. 5. Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan. 6. Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 7. Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan. 8. Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan. clifchen@tmu.edu.tw. 9. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. clifchen@tmu.edu.tw. 10. Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan. clifchen@tmu.edu.tw. 11. Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. clifchen@tmu.edu.tw.
Abstract
INTRODUCTION: Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. METHOD: Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. RESULTS: Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. CONCLUSION: Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
INTRODUCTION: Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. METHOD: Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. RESULTS: Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. CONCLUSION: Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Authors: Brian S Biesman; Joel L Cohen; Barry E DiBernardo; Jason J Emer; Roy G Geronemus; Michael H Gold; Alayne S Lehman; Brian K Pilcher; Gary D Monheit; Todd E Schlesinger; Craig F Teller Journal: Dermatol Surg Date: 2019-12 Impact factor: 3.398