Safety and efficacy of injectable platelet-rich fibrin with fractional carbon dioxide versus fractional carbon dioxide per se in post-acne scars – A split-face study

Objectives: Injectable platelet-rich fibrin (iPRF) is a second-generation platelet concentrate that uses fibrin matrix which entraps platelets and leukocytes, thus releasing growth factors slowly compared to platelet-rich fibrin. Ablative fractional carbon dioxide (CO2) laser (FCL) uses thermal damage to cause microscopic trauma zones. Combination of the two modalities benefits the patient as iPRF has the ability to induce rapid healing after ablative resurfacing. The aims and objectives of the study are to explore the safety and efficacy of iPRF with FCL versus FCL alone in Grade 3 and 4 post-acne atrophic scars. Material and Methods: There were 40 adult patients with Grades 3 and 4 post-acne atrophic scars. Consent was obtained with knowledge. At baseline, a quantitative Goodman and Baron (GB) score analysis was conducted. Every patient received FCL as part of a split-face research with iPRF done on the right cheek and only FCL done on the left cheek. This was repeated monthly for 3 months with a 2-month follow-up after the 4 th sitting. Post-procedure sunscreen and moisturizer application were advised. Side effects, if any, were noted. Results were analyzed. Results: Both the right and left sides’ mean baseline GB quantitative scores displayed a P = 0.4568. The mean score of right and left side of face on the 5 th visit showed P = 0.0363. After five visits, the left side of the face had a P = 0.0064 and the right side had a P < 0.0001, indicating considerable improvement on both sides of the face. The right side’s mean difference was 4.59 ± 1.27 and the mean difference on the left side was 2.43 ± 0.96 after 5 visits. Conclusion: Combination therapy of FCL with iPRF is a method for treating atrophic scars from acne that is both safe and effective.