{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:59:36Z","timestamp":1780084776896,"version":"3.54.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multimodality therapies including minimally invasive modalities are increasingly used in atrophic scarring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the role of platelet\u2010rich plasma (PRP) as adjunctive therapy to a combined subcision and needling treatment in severe (grade 4) atrophic acne scarring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 30 patients with grade 4 acne scars were randomly divided into two groups, 15 patients each: Group A underwent three sequential treatments of subcision and needling while Group B, three sequential treatments of subcision, needling, and topical application of PRP that were performed at 3\u2010week intervals. Scar grading was assessed 3\u00a0months following the final session. Participant's assessment of treatment response was registered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Scar improvement \u226550% was reported significantly more often by Group B than Group A patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.025). Regarding physician\u2010based assessment of scar grading post\u2010therapy (number of patients with two grades improvement vs one grade or no improvement), there was a trend toward more improvement in Group B (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.195). Physician's evaluation of acne scar improvement correlated with the patient's assessment of improvement: 60% of Group A and 66.6% of Group B patients appreciated an improvement of 25%\u201049% and 50%\u201074%, respectively. Mean duration of postprocedure erythema\/edema was shorter among Group B than Group A patients (16.1 vs 32.9\u00a0hours, respectively). Overall, substantial improvement was noticed in rolling and boxcar scars with only a mild change in icepick scars.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Platelet\u2010rich plasma appears to add to the improvement of grade 4 atrophic acne scars when combined with needling and subcision. These findings require further evaluation by future studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.12935","type":"journal-article","created":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T04:15:17Z","timestamp":1553832917000},"page":"1092-1097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Combination therapy using subcision, needling, and platelet\u2010rich plasma in the management of grade 4 atrophic acne scars: A pilot study"],"prefix":"10.1111","volume":"18","author":[{"given":"Shashank","family":"Bhargava","sequence":"first","affiliation":[{"name":"Department of Dermatology R.D. Gardi Medical College Ujjain India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5915-4640","authenticated-orcid":false,"given":"George","family":"Kroumpouzos","sequence":"additional","affiliation":[{"name":"Department of Dermatology Alpert Medical School of Brown University Providence Rhode Island"},{"name":"Department of Dermatology Medical School of Jundia\u00ed S\u00e3o Paulo Brazil"},{"name":"GK Dermatology, PC South Weymouth Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnendra","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Dermatology R.D. Gardi Medical College Ujjain India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujjwal","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Dermatology R.D. 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