What it means for a patient
- One CO2 laser session improved depressed acne scars in this study.
- Redness lasting about 2 months was usual after treatment.
- Some patients had temporary darkening of the skin that lasted about 3 months on average.
- No patient developed a raised scar.
- The authors conclude the laser can improve or even eliminate atrophic facial scars.
- Limits: 50 patients, one surgeon, 24 weeks of follow-up and no comparison group.
Why this paper matters
It reported single-session high-energy pulsed CO2 laser resurfacing for atrophic acne scars, with blinded assessment and texture measurements.
Overview
Depressed (atrophic) acne scars were treated for many years with dermabrasion and chemical peels. High-energy pulsed carbon dioxide (CO2) lasers can create a controlled heat injury with limited side effects. The authors tested how well one laser treatment removed atrophic facial scars and recorded side effects.
Findings
- 50 patients, skin phototypes I to V, with moderate to severe atrophic facial acne scars.
- Each patient had one high-energy pulsed CO2 laser treatment with identical settings, by the same laser surgeon.
- Photographs and clinical assessments at baseline and at 1, 4, 8, 12 and 24 weeks.
- Skin texture was measured before and after treatment in 10 patients to confirm the clinical findings.
- Two blinded assessors rated the results independently.
- Average clinical improvement in acne scars: 81.4%.
- Texture measurements of treated scars were comparable to normal skin nearby.
- Temporary hyperpigmentation: 36%, lasting 3 months on average.
- Prolonged redness, averaging 2 months, was usual and considered part of normal healing.
- No hypertrophic scarring was seen.
Terms
- Atrophic acne scar: a depressed scar left by acne.
- CO2 laser resurfacing: removal of thin outer layers of skin with a carbon dioxide laser so new skin forms.
- Skin phototype: a scale from I (very fair, always burns) to VI (very dark, never burns).
- Hyperpigmentation: darkening of the skin.
- Erythema: redness of the skin.
- Hypertrophic scar: a raised scar that stays within the edges of the wound.
- Dermabrasion: sanding down the outer layers of skin to smooth it.
- Blinded assessor: a person who rates results without knowing details that could bias the rating.