Fractional CO ₂ laser resurfacing as monotherapy in the treatment of atrophic facial acne scars

Abstract

Background:While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between.Aim:The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars.Materials and Methods:Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ‘excellent’ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ‘good’ and ‘poor’ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted.Results:Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3%) while 15 (25%) and 19 patients (31.7%) demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks.Conclusions:Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal adverse effects.

Fractional CO2 laser versus combined platelet‐rich plasma and fractional CO2 laser in treatment of acne scars: Image analysis system evaluation

“…In this work, the best improvement happened in rolling and ice pick scars and the least improvement was found in boxcar scars. In contrast, Majid et al found that rolling and superficial boxcar scars responded better than pitted scars.…”

“…These microthermal treatment zones provide deep penetration and, subsequently, collagen remodeling and dermal regeneration can be achieved. Moreover, the tissue surrounding each column is spared, which leads to faster re‐epithelization and better wound healing than traditional CO 2 ablation . Platelet‐rich plasma (PRP) therapy is an autologous preparation of platelets in concentrated plasma.…”

Diode Laser and Fractional Laser Innovations

“…Atrophic scars can result from any inflammatory skin disease, causing sufficient damage to the epidermis and dermal collagen. 6 One of the most common causes of atrophic scars on the face is severe nodular or nodulocystic acne. 6 Atrophic acne scars are divided into four main morphological types: ice pick/pitted, boxcar, rolling, and linear.…”

“…6 One of the most common causes of atrophic scars on the face is severe nodular or nodulocystic acne. 6 Atrophic acne scars are divided into four main morphological types: ice pick/pitted, boxcar, rolling, and linear. 6 Facial resurfacing with fractional lasers is currently one of the most effective treatment options for acne scars.…”

“…6 Facial resurfacing with fractional lasers is currently one of the most effective treatment options for acne scars. 6…”