摘要

Objectives: The objectives are to highlight the potential role of insulin in improving wounds and scars, including acne scars, safely and effectively, and to compare insulin against other well-known modalities such as PRP, and additionally elaborate the benefits of synergistic combination of insulin with laser and EBDs such as fractional CO2 laser. Introduction: Inflammatory acne can leave scars. Rather than fading with time, the appearance of scars often worsens with aging or photo-damaging leading to low self-esteem, and embarrassment which can lead to depression and even suicide inclinations. Topical insulin enhances wound healing by regulating oxidative stress and inflammatory responses. Additionally, insulin enhances fibroblast activity depending on insulin receptors, with the PI3K-Akt-Rac1 pathway playing a key role. Only recently have a few studies suggested that insulin could be used as a novel treatment for scars with promising results. Materials / method: This was a single blinded, randomized, comparative, split-face study conducted on 30 patients with atrophic acne scars. All patients received 4 sessions of fractional CO2 laser resurfacing of the face at 1-month intervals on both sides followed, in each session, by topical PRP application on one side of the face, and topical insulin on the other side. The topical treatment for each side of the face was randomly chosen using a coin toss. Based on the Acne Scar Assessment Scale (ASAS), two non-treating dermatologists evaluated the level of improvement. Results: Prior to treatment, there was no difference in the ASAS scores between the two sides of the face. One month after the last treatment session, ASAS scores improved significantly on both sides of the face. Conclusion: Insulin significantly reduced the symptoms of atrophic acne scars. Fractional CO2 laser-assisted topical administration of both modalities may develop into a viable treatment approach in clinical settings in the future. While there are few studies of topical insulin in treating atrophic acne scars, it appears to be a promising modality for improving the texture and appearance of scars. It yielded a similar result to PRP and may be considered a cost-effective alternative.