Comparison between subcision followed by 35% TCA versus subcision followed by microneedling in the treatment of acne scars: a prospective comparative study.

Background:Acne scars treatment is difficult and challenging because of the variety in the acne scars morphology and the limited ability of the available treatment options to improve the scars. Multiple treatment modalities are used and each has its unique place in the treatment plan. Subcision is a non operative procedure that aims to break the fibrous strands that tether the scar to the underlying subcutaneous tissue, in which a needle is inserted through a puncture in the skin surface and passed in multiple directions to create a pocket under the scar to release the fibrous attachments.Microneedling, which is also known as percutaneous collagen induction therapy or needle dermabrasion, is a skin resurfacing procedure which involves the use of fine needles that create micro skin wounds. Trichloroacetic acid (TCA) causes protein denaturation named keratocoagulation resulting in white frost. 35% is used for medium depth peeling.Objective:To compare the efficacy and safety of both combined subcision and microneedling versus combined subcision and peeling in the treatment of acne scars.