Background: Atrophic acne scars are a common sequela of acne vulgaris and may cause significant cosmetic and psychosocial distress. Dermaroller therapy promotes collagen remodeling, while autologous platelet-rich plasma (PRP) may enhance tissue regeneration and scar remodeling.

Objective: To compare the efficacy and safety of dermaroller alone versus dermaroller combined with autologous PRP in the treatment of facial atrophic acne scars.

Materials and Methods: This prospective, randomized controlled study included 70 patients aged >18 years with clinically diagnosed facial atrophic acne scars. Patients were randomized into two groups: Group A received dermaroller alone, while Group B received dermaroller combined with autologous PRP. Four treatment sessions were performed at 4-week intervals. Clinical improvement was assessed using the Visual Analogue Scale (VAS) and Goodman and Baron (GB) qualitative and quantitative grading systems. Adverse events were recorded at each visit. A p-value <0.05 was considered statistically significant.

Results: Both groups demonstrated progressive improvement in acne scars over 12 weeks. Group B showed significantly greater VAS improvement at 8 weeks (3.7 ± 1.6 vs. 2.9 ± 1.2; p=0.048) and 12 weeks (3.9 ± 1.9 vs. 3.1 ± 0.5; p=0.036). Quantitative GB scores improved significantly in both groups (p<0.001), although the intergroup difference was not statistically significant. Qualitative assessment demonstrated significantly faster improvement with combination therapy, with 88.6% of patients in Group B achieving macular scars at 12 weeks compared with 8.6% in Group A (p<0.001). Rolling and boxcar scars showed better response than icepick scars. Both treatments were well tolerated, with transient pain and erythema being the most common adverse effects. Conclusion: Dermaroller is an effective treatment for atrophic acne scars. Addition of autologous PRP enhances and accelerates qualitative scar improvement, particularly in rolling and boxcar scars, without increasing adverse events.

Neha Khan is a dermatologist and researcher specializing in clinical and aesthetic dermatology. Her academic interests include cosmetic dermatology, acne and acne scar management, pigmentary disorders, laser therapies, skin rejuvenation, platelet-rich plasma (PRP), trichology, and minimally invasive aesthetic procedures. She has contributed to peer-reviewed research focused on advancing evidence-based dermatologic and cosmetic treatments while actively participating in scientific conferences and academic collaborations. Her work aims to improve patient outcomes through innovative approaches in skin health and aesthetic medicine.