Fractional Microneedling Radiofrequency Versus Intralesional Steroid Injection with and Without Microneedling on Tissue Levels of PDGF And CTGF In Hypertrophic Scars: A Randomized Comparative Clinical Trial.

Abstract

Background: Hypertrophic scarring is a fibroproliferative disorder that can cause severe functional and cosmetic deformities, and unfortunately is still lacking a reliable treatment method. Objective: To evaluate and compare the efficacy and safety of fractional microneedling radiofrequency (FMR) versus intralesional corticosteroid injection (ILCS) followed or not by microneedling in the treatment of hypertrophic scars and their implication on platelet derived growth factor (PDGF) and connective tissue growth factor (CTGF) tissue levels. Methods: One side of the hypertrophic scar of the thirty enrolled patients, was randomly treated with FMR, and the other half was treated by ILCS injection alone or followed by microneedling for 5 sessions with 1-month intervals. Evaluation of response was done by clinical assessment, patient and observer scar assessment scale, and biochemical PCR measurement of tissue levels of both PDGF and CTGF at baseline and 1 month after the last session. Results: Both therapeutic modalities yielded clinical and biochemical statistically significant improvements of HTSs (p<0.05). By comparing both modalities, there was no clinical statistical significance, however, ILCS showed significant decrease in biochemical parameters. Conclusion: FMR, ILCS and microneedling are all effective in the treatment of hypertrophic scars. FMR is a safe option for treatment of HTSs in dark skinned patients, with low downtime and rapid healing. ClinicalTrials.govID: NCT04389619