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.