Comparison of Fractional Carbon Dioxide Laser Alone and in Combination with Subcision in Improving Atrophic Acne Scars

Document Type : Original Article (s)

Authors

1 Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Professor, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Researcher, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

5 Associate Professor, Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

6 Student of Medicine, Skin Diseases and Leishmaniasis Research Center AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Acne is a very common skin disease. Scars are seen in 95% of patients with acne. Although numerous treatments have been recommended to cure acne scars, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. In other words, a combination of available methods is required to reach satisfactory results. We compared the effects of fractional carbon dioxide (CO2) laser alone and in combination with subcision.Methods: This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011-12. Eligible patients with atrophic acne scars were treated with fractional CO2 laser alone (five sessions with three-week interval) on right side of the face and fractional CO2 laser plus subcision (one session using both followed by four sessions of fractional CO2 laser, all with three-week intervals) on the left side. The subjects were visited one, two, and six months after the treatment. Patient satisfaction rate was analyzed by SPSS20.Findings: The average of recovery rate was 54.7% using the combination method and 43.0% using laser alone (P < 0.001). The mean patient satisfaction rate according to visual analogue scale (VAS) score was significantly higher with the combination method than with laser alone (6.6 vs. 5.2; P < 0.001). Bruising was only seen with the combination method and lasted for one week in 57.0% of patients and for two weeks in 43.0%. Erythema was a side effect of both methods. Post-inflammatory pigmentation and hyperpigmentation were only caused by the combination method. None of the patients had persistent side effects after six months.Conclusion: Using a combination of subcision and laser had suitable results regarding scar recovery and satisfaction rate. However, bruising, post-inflammatory pigmentation, and hyperpigmentation were the side effects of this method. In general, subcision plus laser can be beneficial in the treatment of atrophic acne scars.

Keywords

References

  1. Lee JB, Chung WG, Kwahck H, Lee KH. Focal treatment of acne scars with trichloroacetic acid: chemical reconstruction of skin scars method. Dermatol Surg 2002; 28(11): 1017-21.
  2. Burton JL, Cunliffe WJ, Stafford I, Shuster S. The prevalence of acne vulgaris in adolescence. Br J Dermatol 1971; 85(2): 119-26.
  3. Cunliffe WJ, Gould DJ. Prevalence of facial acne vulgaris in late adolescence and in adults. Br Med J 1979; 1(6171): 1109-10.
  4. Kang WH, Kim YJ, Pyo WS, Park SJ, Kim JH. Atrophic acne scar treatment using triple combination therapy: dot peeling, subcision and fractional laser. J Cosmet Laser Ther 2009; 11(4): 212-5.
  5. Khunger N. Standard guidelines of care for acne surgery. Indian J Dermatol Venereol Leprol 2008; 74 (Suppl): S28-S36.
  6. Woo SH, Park JH, Kye YC. Resurfacing of different types of facial acne scar with short-pulsed, variable-pulsed, and dual-mode Er:YAG laser. Dermatol Surg 2004; 30(4 Pt 1): 488-93.
  7. Weiss RA, Weiss MA, Beasley KL, Munavalli G. Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, Phase III clinical trial. Dermatol Surg 2007; 33(3): 263-8.
  8. Koranda FC. Treatment and modalities in facial acne scars. In: Thomas JR, Holt GR, editors. Facial scars. Saint Louis, MO: C.V. Mosby Co; 1989. p. 278–89
  9. Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesthet Surg J 2008; 28(6): 675-8.
  10. Hu S, Chen MC, Lee MC, Yang LC, Keoprasom N. Fractional resurfacing for the treatment of atrophic facial acne scars in asian skin. Dermatol Surg 2009; 35(5): 826-32.
  11. Aalami HS, Balighi K, Lajevardi V, Akbari E. Subcision-suction method: a new successful combination therapy in treatment of atrophic acne scars and other depressed scars. J Eur Acad Dermatol Venereol 2011; 25(1): 92-9.
  12. Chandrashekar B, Nandini A. Acne scar subcision. J Cutan Aesthet Surg 2010; 3(2): 125-6.
  13. Alam M, Omura N, Kaminer MS. Subcision for acne scarring: technique and outcomes in 40 patients. Dermatol Surg 2005; 31(3): 310-7.
Journal of Isfahan Medical School
Volume 31, Issue 226 - Serial Number 226
January and February 2013
Pages 131-137

Files

History

  • Receive Date: 16 February 2013
  • Revise Date: 20 April 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics