Efficacy of stem cell-conditioned medium vs. platelet-rich plasma as an adjuvant to ablative fractional CO2 laser resurfacing for atrophic post-acne scars: a split-face clinical trial
Ensaf M. Abdel-Maguid, Sara M. Awad, Youssef S. Hassan, Mohamed A. El-Mokhtar, Heba EM EL-Deek & Marwa MA Mekkawy
Received 22 Apr 2019, Accepted 26 May 2019, Accepted author version posted online: 10 Jun 2019, Published online: 05 Jul 2019
Download citation  https://doi.org/10.1080/09546634.2019.1630701 

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Abstract
Objectives: To explore the impact of using topical stem cell-conditioned medium (SC-CM) after fractional carbon dioxide laser (FCL) vs. combined FCL and platelet-rich plasma (PRP) or FCL alone in treatment of atrophic acne scars.

Methods: Thirty-three patients were randomly divided into two split-face groups. Group I (n  =  17) received FCL plus topical SC-CM on one side or FCL plus saline on the other. Group II (n  =  16) received FCL plus topical PRP or SC-CM. All patients had three monthly sessions. Clinical assessment was done at each visit, with a final assessment after 3 months. Skin biopsies were obtained for histological and quantitative molecular analysis after treatment.

Results: No significant difference in clinical improvement of acne scars was observed between the FCL/SC-CM and FCL only sides (p = .63), while better and faster improvement was detected on FCL/PRP side compared to FCL/SC-CM side (p = .006). There was no significant difference in downtime or adverse effects between the treated sides in either group. Dermal collagen was increased and procollagen type I gene was upregulated in both FCL/PRP and FCL/SC-CM sides compared to FCL only sides (p = .001 and p = .041, respectively).

Conclusions: Topical SC-CM could potentially enhance the efficacy of FCL. However, PRP seems to be a better alternative.

Keywords: Atrophic acne scars, fractional carbon dioxide laser, platelet-rich plasma, stem cell-conditioned medium