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<p>Postponing acne lesion treatment leads to a higher degree of scarring. Scarring occurs as a continuous process due to healing of severe inflammatory acne for long time. Prolonged inflammation is a key risk factor for scarring, with long-lasting papules exhibiting a B-cell (CD20) infiltrate and T-helper lymphocytes. The severity and duration of inflammation are closely linked. Atrophic acne scars, the most common type, include icepick, boxcar, and rolling scars. Microneedling treats acne scars by creating microchannels that stimulate new collagen and elastin production beneath the scar. Timolol, a beta-blocker, enhances wound epithelialization by counteracting elevated epinephrine levels post-trauma and blocking beta-2 adrenergic receptors in keratinocytes, so timolol accelerates their migration toward wound edges. The study aimed to compare the efficacy and safety of topical timolol maleate 0.5% combined with microneedling versus microneedling alone in treating atrophic post-acne scars. This split-face comparative study included 30 patients diagnosed with atrophic acne scars. Each patient’s face was divided into two sides: Side I (Right side): treated by a combination of microneedling (Dermapen) and topical timolol solution. Side II (Left side): treated by microneedling alone. Scar severity was graded using Goodman and Baron’s qualitative and quantitative scarring system. Before treatment, there was no significant difference between the two sides of the face. Comparing the reduction in the quantitative Goodman-Baron Score on both sides of the face before and after treatment, there was a highly significant difference between both sides of the face, where patient satisfaction was better on the side with timolol. A few patients suffered from a burning sensation. Edema and erythema extended for more than three days, especially in cold weather. In some patients, erythema slightly decreased on the side with timolol. Timolol, a safe, affordable, and effective beta-2 adrenergic blocker, enhances microneedling outcomes by improving scar appearance and reducing post-acne erythema.</p>

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Efficacy and safety of topical 0.5% timolol maleate enhanced by microneedling for treatment of post-acne scars

  • 期刊论文

  • 发表日期：

    2025年7月3日

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  • Asmaa Atia Mohamed Ali El Bestawi,
  • Hanan Mohamed Aly Darwish,
  • Radwa Osama Mohamed Kamel

摘要

Postponing acne lesion treatment leads to a higher degree of scarring. Scarring occurs as a continuous process due to healing of severe inflammatory acne for long time. Prolonged inflammation is a key risk factor for scarring, with long-lasting papules exhibiting a B-cell (CD20) infiltrate and T-helper lymphocytes. The severity and duration of inflammation are closely linked. Atrophic acne scars, the most common type, include icepick, boxcar, and rolling scars. Microneedling treats acne scars by creating microchannels that stimulate new collagen and elastin production beneath the scar. Timolol, a beta-blocker, enhances wound epithelialization by counteracting elevated epinephrine levels post-trauma and blocking beta-2 adrenergic receptors in keratinocytes, so timolol accelerates their migration toward wound edges. The study aimed to compare the efficacy and safety of topical timolol maleate 0.5% combined with microneedling versus microneedling alone in treating atrophic post-acne scars. This split-face comparative study included 30 patients diagnosed with atrophic acne scars. Each patient’s face was divided into two sides: Side I (Right side): treated by a combination of microneedling (Dermapen) and topical timolol solution. Side II (Left side): treated by microneedling alone. Scar severity was graded using Goodman and Baron’s qualitative and quantitative scarring system. Before treatment, there was no significant difference between the two sides of the face. Comparing the reduction in the quantitative Goodman-Baron Score on both sides of the face before and after treatment, there was a highly significant difference between both sides of the face, where patient satisfaction was better on the side with timolol. A few patients suffered from a burning sensation. Edema and erythema extended for more than three days, especially in cold weather. In some patients, erythema slightly decreased on the side with timolol. Timolol, a safe, affordable, and effective beta-2 adrenergic blocker, enhances microneedling outcomes by improving scar appearance and reducing post-acne erythema.