Efficacy of Microneedle Fractional Radiofrequency Combined With Topical Insulin for the Treatment of Facial Atrophic Acne Scars: A Split-Face, Double-Blinded, Randomized, Placebo-Controlled Trial

Abstract

Introduction: Topical insulin (TI) has been shown to enhance wound healing by promoting re-epithelialization and collagen synthesis. However, there have been limited studies addressing its potential use in treating acne scars. Objectives: To assess the efficacy of combining TI with microneedle fractional radiofrequency (MFR) in the treatment of atrophic acne scars. Materials and Method: A split-face, double-blinded, placebo-controlled trial involved 30 participants with atrophic acne scars. Each side of the participants' face was randomly treated with a combination of MFR and TI or a placebo every 4 weeks for four consecutive sessions. Results: Significant improvements in scar volume were observed, with statistical significance at week 12 for MFR combined with TI sides (baseline 18.22 ± 9.86 vs. 16.20 ± 8.58 mm3, p = 0.017) and at week 16 for MFR combined with placebo sides (baseline 18.02 ± 9.24 vs. 15.28 ± 8.21 mm3, p = 0.001). The TI sides exhibited a reduction of 46.77% ± 21.33% in Echelle d’ évaluation clinique des cicatrices d’ acne (ECCA) (p ≤ 0.001), while the placebo sides showed a reduction of 46.39% ± 20.14% in ECCA (p ≤ 0.001). There were no significant differences in melanin, and hemoglobin index between the two groups. No hypoglycemic symptoms were reported. Conclusion: Combining topical insulin with MFR is safe and could accelerate the early acne scar improvement.