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Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials

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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.

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Acknowledgement

This manuscript was edited by Wallace Academic Editing.

Author information

Author notes

  1. Yi-No Kang and Chiehfeng Chen contributed equally to this work.

Authors and Affiliations

  1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Yu-Chun Shen

  2. Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan

    Wen-Kuan Chiu & Chiehfeng Chen

  3. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Wen-Kuan Chiu

  4. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Yi-No Kang & Chiehfeng Chen

  5. Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan

    Yi-No Kang & Chiehfeng Chen

  6. Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Yi-No Kang

  7. Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan

    Yi-No Kang

  8. Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Chiehfeng Chen

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  1. Yu-Chun Shen
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Correspondence to Chiehfeng Chen.

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Shen, YC., Chiu, WK., Kang, YN. et al. Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesth Plast Surg 46, 1913–1922 (2022). https://doi.org/10.1007/s00266-022-02845-3

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