Efficacy of Intralesional Injection of Pentoxifylline, Platelet-Rich Plasma, and Combined Pentoxifylline With Platelet-Rich Plasma in Patients With Atrophic Acne Scars

Patients will be treated with intralesional PTX (Trentoximal Ampoule 100 mg/5 ml) in a dose of 1mg per lesion at a distance 1cm between two atrophic lesions with a maximum 20 mg per session (with insulin syringe 30Gx8mm). Lesion blanching is the endpoint of injection

Patients will be treated with intralesional PRP. PRP will be obtained by the double-spin method, followed by the collection of 10 mL of autologous whole blood into tubes containing trisodium citrate as an anticoagulant. The collected blood will first be centrifuged at 1000 RPM for 10 minutes at room temperature to separate the red blood cells at the bottom of the tube, the buffy coat (containing the white blood cells) in the middle, and the plasma above (soft spin). Then, the upper plasma will be pipetted above the buffy coat to undergo another centrifugation at 1500 RPM for another10 minutes (hard spin) to obtain a platelet pellet in the bottom of the tube (with a platelet count 4-4.5 times higher than that of baseline) and a platelet-poor plasma(PPP) in the upper part. The PPP will be partly removed and partly used to re-suspend the platelets to finally produce 2 mL of PRP

Patients will be treated with a combination of both intralesional 1mg of PTX per lesion (with a maximum 20mg per session) then 0.1ml of intralesional PRP at the same lesion after 5 minutes