Atrophic
scars are a frequent consequence of
acne, with a negative esthetic and psychological influence. Treatment of atrophic
acne scars includes different invasive methods. In our study, we used a noninvasive method with local application of 0.05%
tretinoin gel by iontophoresis. In patients with a tendency towards exacerbation, we performed mild peeling with 5%
trichloroacetic acid (TCA)
solution 3-4 times during the treatment. Twenty-minute treatments were applied on 38 patients, 29 women and 9 men, during 3.5 months on average. Median age of patients was 21 years (range, 16-29). Clinical assessment included an assessment of
scars, pore size, skin moisture, vascularization, and skin firmness and elasticity. As confirmed by photographs taken before and after
therapy, the treatment proved to be clinically effective in decreasing
acne scars and persistence of effects. Flattening of
acne scars was observed in 79% of the patients. The results depended on duration of
scars persistence as well as on a the type of
scars. The best results were achieved with younger
scars as well as with superficial and
ice pick
scars. Side effects involved a very mild
retinoid dermatitis and more often
acne exacerbation. The
therapy was clinically effective and the patients accepted the treatment very easily. Local
therapy of
acne scars with
tretinoin by iontophoresis can in some cases successfully replace invasive techniques, and could also be combined with those techniques.