Comparison of Outcome of Microneedling with Autologous Platelet Rich Plasma versus Microneedling with Topical Insulin in the Treatment of Post-Acne Atrophic Scars

Background: Post-acne atrophic scars are a common cosmetic concern with significant psychological impact. Microneedling is a minimally invasive technique that stimulates collagen remodeling. Platelet-rich plasma (PRP) and topical insulin have both been used as adjuncts to enhance its efficacy, but limited comparative data exist. Objective: To compare the outcomes of microneedling with autologous PRP versus microneedling with topical insulin in the treatment of post-acne atrophic scars. Material and Methods: This randomized controlled trial was conducted at the Dermatology Department of Sheikh Zayed Hospital, Rahim Yar Khan, over six months. A total of 60 patients aged 18–40 years with post-acne atrophic scars were enrolled and randomly divided into two groups: Group A received microneedling with 2 ml topical insulin, and Group B received microneedling with 2 ml autologous PRP. Each patient underwent four monthly sessions. Outcomes were assessed using scar severity scores before and after treatment, patient satisfaction scores, adverse effects, and blood glucose levels. Data were analyzed using SPSS v25.0, and independent samples t-tests were applied. Results: Both groups had comparable pre-treatment scar scores (p = 0.924). Post-treatment scar scores were significantly lower in the PRP group (4.23 ± 1.30) compared to the insulin group (4.98 ± 1.13) (p = 0.021). Patient satisfaction was also significantly higher in the PRP group (4.27 ± 0.79 vs. 2.77 ± 0.68, p < 0.001). No significant changes in blood glucose levels were noted in either group. Conclusion: Microneedling with PRP is more effective and better tolerated than microneedling with topical insulin for treating post-acne atrophic scars.