Comparison between the therapeutic effect of microneedling versus tretinoin in patients with comedonal acne: a randomized clinical trial

Background: Microneedling has been shown to be a clinically effective and safe treatment for comedonal acne vulgaris. The aim of the present study was to compare the clinical effect of microneedling and the most commonly used topical drug, tretinoin, in the treatment of comedonal acne. Methods: Patients with comedonal acne (n = 82) were randomized to receive topical tretinoin (n = 41) or 6 sessions of microneedling (n = 41) over a period of 3 months. Objective assessments such as changes in acne severity score by global acne grading system (GAGS) and patients’ subjective satisfaction were investigated at the baseline, at the end of the treatment period, and at the 3-month follow up. Results: GAGS was significantly reduced in both microneedling (7.8±3.8 to 3.5±2.6) and tretinoin (8±3.8 to 6.6±3.2) groups at the end of the treatment course compared with the baseline. The overall acne severity index reduction in microneedling group was significantly higher than that of the tretinoin group (P<0.001). Improvement in acne severity was also more permanent by microneedling. The severity of acne in tretinoin recipients was increased to 8.2±3.2 at the follow-up visit, while it remained nearly unchanged in the microneedling group. (3.3±2.4). Patients’ subjective assessment concerning acne improvement was significantly more satisfactory in microneedling group (P<0.001). Conclusion: Compared with tretinoin, microneedling seems to be a more effective, permanent and satisfactory treatment in the treatment of comedonal acne.