Behrangi Elham; Sadeghi Somayeh; Sadeghzadeh-Bazargan Afsaneh; Goodarzi Azadeh; Ghassemi Mohammadreza; Sepasgozar Saba; Rohaninasab Masoomeh
Abstract
Background: Insulin resistance and increased insulin-like growth factor (IGF)-1 with consequent mammalian target of rapamycin complex (mTORC) 1 overexpression is responsible for acne pathogenesis, especially in women with polycystic ovary syndrome (PCOS). Metformin is shown to improve acne as an adjunct ...
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Background: Insulin resistance and increased insulin-like growth factor (IGF)-1 with consequent mammalian target of rapamycin complex (mTORC) 1 overexpression is responsible for acne pathogenesis, especially in women with polycystic ovary syndrome (PCOS). Metformin is shown to improve acne as an adjunct therapy in females with PCOS and males with altered metabolic profile. We evaluated the use of metformin in the treatment of resistant and late-onset acne in females, and compared it with isotretinoin.
Methods: Females with late-onset acne or acne resistant to common therapies (n=70) were randomized to receive metformin (n=35) or isotretinoin (n=35) for 6 months. Changes in acne severity were scored by global acne grading system (GAGS) which was the primary outcome. Other endpoints were changes in the components of metabolic profile.
Results: Six-month treatment with metformin and isotretinoin significantly reduced the GAGS from 31.9 to 24.6 and from 34.1 to 13.3, respectively, indicating the superior impact of isotretinoin. Metfromin was more effective in decreasing the GAGS score in those with PCOS (13.5±7.1 vs. 24.2±19.4, P<0.05). Furthermore, patients with hirsutism had a higher reduction score with metformin compared to patients without hirsutism (21.1±9.1 vs. 30.2±6.4) (P<0.05). Lipid profile and fasting blood sugar were improved following the 6-month treatment with metformin, and isotretinoin increased the levels of liver enzymes and bilirubin (P<0.05).
Conclusion: Metformin is effective in treating late-onset or resistant acne and improving metabolic status, without serious side effects. In patients with altered metabolic profiles such as PCOS, metformin seems to be superior to isotretinoin regarding acne treatment.
Mehran Golnaz; Fotooei Mahrokh; Goodarzi Azadeh; Forghani Siamak Farokh; Rohaninasab Masoomeh; Ghassemi Mohammadreza; Sadeghi Somayeh; Behrangi Elham
Abstract
Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling ...
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Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling to CO2 laser in the treatment of hypertrophic burn scars in a randomized clinical trial. Methods: Patients with second and third-degree burn scars (n=60) were randomized to receive 3 sessions of microneedling (n=30) or CO2 laser (n=30), 4-6 weeks apart. The outcomes, including physical characteristics of the scar scored by Vancouver Scar Scale (VSS) and patients’ satisfaction with the treatment measured by Visual Analogue Scale (VAS), were investigated at baseline, at the end of the treatment period, and at the 3-month follow-up. Results: The VSS score at the follow-up visit showed a significant reduction from 6.63±1.95 to 3.8±2.3 in the microneedling group and from 7.1+2.3 to 5.6±1.7 in the CO2 laser group; while, the reduced VSS score was significantly higher in the microneedling group (P<0.05), especially in reducing the thickness (P=0.001) and pliability (P=0.001) scores. The patients’ subjective assessments for acne improvement were significantly more satisfactory in the microneedling group (P=0.025).
Conclusion: Microneedling seems to be an effective method to improve hypertrophic burn scars. It also causes better scores in the physical characteristics of scar and the patients’ satisfaction compared to the CO2 laser at the 3-month follow-up.