Fractional Carbon Dioxide Laser and its Combination with Subcision in Improving Atrophic Acne Scars

Document Type : Original Article

Authors

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

2 Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran

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

Abstract

Background: Acne is a very common skin disease in which scars are seen in 95% of the patients. Although numerous treatments have been recommended, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. We compared the effects of fractional carbon dioxide (CO2) laser alone and in combination with subcision in the treatment of atrophic acne scars. Materials and Methods: This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011–2012. Eligible patients with atrophic acne scars were treated with fractional CO2laser alone (five sessions with 3-week interval) on the right side of the face and fractional CO2laser plus subcision (one session using both with four sessions of fractional CO2laser, with 3-week interval) on the left side. The subjects were visited 1, 2, and 6 months after the treatment. Patient satisfaction rate was analyzed using SPSS 20 software. Results: 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 was significantly higher with the combination method than laser alone (6.6 ± 1.2 vs. 5.2 ± 1.8; P < 0.001). Bruising was only seen with the combination method and lasted for 1 week in 57.0% and for 2 weeks in 43.0%. Erythema was seen in both methods. Postinflammatory pigmentation and hyperpigmentation were associated with combination method. No persistent side effects were seen after 6 months. Conclusion: Using a combination of subcision and laser had suitable results regarding scar recovery and satisfaction rate.

Keywords

1.
Fife D, Zachary CB. Combining techniques for treating acne scars. Curr Dermatol Rep 2012;1:82-8.  Back to cited text no. 1
    
2.
Fife D. Practical evaluation and management of atrophic acne scars: Tips for the general dermatologist. J Clin Aesthet Dermatol 2011;4:50-7.  Back to cited text no. 2
    
3.
Hwang EJ. The efficacy and safety of new total combination techniques compared with classic sequential combination therapy with punch, fractional and long-pulsed Er-YAG laser for the treatment of acne scars. J Am Acad Dermatol 2011;64:AB168.  Back to cited text no. 3
    
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;11:212-5.  Back to cited text no. 4
    
5.
Khunger N. Standard guidelines of care for acne surgery. Indian J Dermatol Venereol Leprol 2008;74 Suppl:S28-36.  Back to cited text no. 5
    
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.  Back to cited text no. 6
    
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;33:263-8.  Back to cited text no. 7
    
8.
Taub AF, Garretson CB. Treatment of acne scars of skin types II to V by sublative fractional bipolar radiofrequency and bipolar radiofrequency combined with diode laser. J Clin Aesthet Dermatol 2011;4:18-27.  Back to cited text no. 8
    
9.
Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesthet Surg J 2008;28:675-8.  Back to cited text no. 9
    
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;35:826-32.  Back to cited text no. 10
    
11.
Aalami Harandi S, 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;25:92-9.  Back to cited text no. 11
    
12.
Chandrashekar B, Nandini A. Acne scar subcision. J Cutan Aesthet Surg 2010;3:125-6.  Back to cited text no. 12
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13.
Alam M, Omura N, Kaminer MS. Subcision for acne scarring: Technique and outcomes in 40 patients. Dermatol Surg 2005;31:310-7.  Back to cited text no. 13