Tretinoin-iontophoresis in atrophic acne scars

Background Atrophic acne scars are a frequent problem after acne. Hitherto, mainly invasive treatment measures were possible. In a recent paper, we de monstrated the positive effects of iontophoresis with 0.025% tretinoin gel vs. estriol 0.03%. Objective In this further study, the recording of the clinical effects of i ontophoresis with 0.025% tretinoin gel in atrophic acne scars was supplemen ted by immunohistochemistry investigations of collagen I and Ill, prolifera tion markers, and the estimation of epidermal thickness. Methods The treatment was performed twice weekly in 32 volunteer patients f or a period of 3 months by application of the substance under a constant di rect current of 3 mA for 20 min. Skin biopsies prior to and at the end of t reatment were performed in 32 voluntary patients in order to investigate co llagen I/III and proliferation markers by immunohistochemistry methods. Results Clinically, at the end of treatment. in 94% of patients a significa nt decrease in the scar depth was observed. Neither epidermal thickness nor proliferation markers revealed a significant increase at the end of treatm ent. Furthermore, collagen I and collagen III showed no common trend, as ex pressed statistically by a lack of significance. In some cases, increases i n collagen III became evident at the end of treatment. Conclusions Tretinoin-iontophoresis is an effective, noninvasive treatment of atrophic acne scars without causing disturbing side-effects.