Wang Yi-Shi, Tay Yong Kwang, Kwok Colin
Department of Dermatology, Changi General Hospital, Singapore.
J Cosmet Laser Ther. 2010 Apr;12(2):61-4. doi: 10.3109/14764171003706166.
Ablative carbon dioxide resurfacing is the gold standard for treating atrophic acne scarring but is associated with prolonged recovery and many side effects. To address these limitations, newer modalities employing the principle of fractional photothermolysis have emerged.
We undertook a prospective study whereby five Asian patients of skin phototype IV with moderate to severe atrophic acne scarring received two sessions of a fractional carbon dioxide laser 6-8 weeks apart. Treatment parameters were: fluence, 28 J/cm(2); pulse width, 2.5 ms; spot size, 300 microm; penetration depth, up to 500 microm; degree of skin coverage, 20%; single pass. Photographic evaluation was done on the level of improvement according to a quartile grading scale: <or=25% (mild), 26-50% (moderate), 51-75% (marked), >75% (excellent).
At 2 months post-treatment, all five subjects showed some clinical improvement (four: mild improvement; one: moderate improvement). The treatment was well tolerated. All patients had erythema, which lasted for a mean of 6 days. No other complications were observed.
Our study has shown that in Asians the fractional ablative carbon dioxide laser produces mild to moderate improvement in acne scarring with the advantage of a quick recovery period with minimal adverse effects.
剥脱性二氧化碳皮肤磨削术是治疗萎缩性痤疮瘢痕的金标准,但恢复期长且伴有多种副作用。为克服这些局限性,采用局灶性光热作用原理的新型治疗方法应运而生。
我们进行了一项前瞻性研究,5名皮肤光型为IV型的亚洲中度至重度萎缩性痤疮瘢痕患者接受了间隔6 - 8周的2次局灶性二氧化碳激光治疗。治疗参数为:能量密度28 J/cm²;脉宽2.5 ms;光斑大小300微米;穿透深度达500微米;皮肤覆盖度20%;单次扫描。根据四分位分级量表对改善程度进行摄影评估:≤25%(轻度)、26 - 50%(中度)、51 - 75%(显著)、>75%(优秀)。
治疗后2个月,所有5名受试者均有一定临床改善(4名:轻度改善;1名:中度改善)。治疗耐受性良好。所有患者均出现红斑,平均持续6天。未观察到其他并发症。
我们的研究表明,对于亚洲人,局灶性剥脱性二氧化碳激光可使痤疮瘢痕得到轻度至中度改善,且恢复期短、副作用极小。