What is the relationship between epidermal growth factor and atrophic acne scars?
After the inflammation caused by active acne lesions, proteins called metalloproteinases and collagenases are activated, which are responsible for degrading collagen in the inflamed area. These changes lead to local atrophy that explains the depressed appearance of acne scars. One of the molecules that manage to increase collagen production is epidermal growth factor (EGF), which is why, if used early, it can reduce protein degradation after inflammatory acne lesions.
Treatment of acne scars with topical epidermal growth factor: How is epidermal growth factor used?
EGF can be applied by compounding with a topical preparation (“cream”), which is administered once or twice a day.
In this case, the magistral formulation also allows other components to be added to the cream that can have a synergistic effect to improve acne scars, such as salicylic acid, glycolic acid or tretinoin (see here for more details). Any of these three molecules performs a gentle peel (depending on its concentration) and partially improves the appearance of acne scars.
Once the compounding formula has been prescribed by your dermatologist, a pharmacy that makes formulas can provide the product.
How much improvement is seen in acne scars with the use of topical epidermal growth factor?
In the largest study, by Seydel i Moy (click here), where patients with mild, moderate and severe atrophic acne scars were treated, 66.6% of them reported positive results. They were asked about the beneficial impact that the topical treatment had had on their self-esteem and 55.5% of them responded that it had been between “very significant” and “significant”.
The treatment was performed with the application of a cream with epidermal growth factor for 3 months, morning and night, without combining it with any other therapeutic option. On the scar severity scale, 50% of the patients showed a decrease in their score (from an average of 2.875 out of 4, it dropped to 2.38).
Treatment of acne scars with topical epidermal growth factor What are the adverse effects of topical epidermal growth factor?
In the studies analysed to date, no patient has had any adverse effects and the tolerance of the product is excellent.
So, should acne scars be treated with epidermal growth factor cream only?
No. In isolation, the effect of topical EGF is likely to be discreet. However, it is a supportive tool to treat mild acne scars or in combination with other techniques (laser or peels) to increase its effectiveness and/or reduce the number of treatments.
What is the interest of using epidermal growth factor to treat acne scars?
The possibility of combining it in magisterial formulas with other active ingredients that improve acne scars and being able to apply it during acne treatment with ablative or non-ablative lasers. A clear advantage of EGF is its high tolerance and a very affordable economic cost.
In recent months, the technique of transcutaneous release of active ingredients has begun to be developed in combination with lasers: they open permeable skin channels that reach the dermis, in such a way that by subsequently applying topical preparations (e.g., platelet-rich plasma) we get their active ingredients to reach it deeply so that its effect is greater. EGF can be applied perfectly after the laser session to promote a faster recovery and enhance the effect of the light device.
Thanks to Dr. Julio Alonso for providing me with the reference article.
REFERENCES
· Seidel R, Moy RL. Improvement in Atrophic Acne Scars Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study. J Drugs Dermatol. 2015 Sep 1; 14(9):1005-10.