Do combined alternating sessions of 1540 nm nonablative fractional laser and percutaneous collagen induction with trichloroacetic acid 20% show better results than each individual modality in the treatment of atrophic acne scars? A randomized controlled trial.

BACKGROUND

There have been no well-controlled studies evaluating the efficacy of combining 1540 nm nonablative fractional laser with percutaneous collagen induction (PCI) and trichloroacetic acid (TCA) 20% in the treatment of atrophic acne scars.

OBJECTIVE

We hypothesized that combined alternating sessions of both modalities would show better results than each individual modality.

METHODS AND MATERIALS

Thirty-nine patients with post acne atrophic scars were included in this study. Patients were randomly equally divided into three groups; group 1 was subjected to six sessions of PCI combined with TCA 20% in the same session, group 2 was subjected to six sessions of 1540 nm fractional laser and group 3 was subjected to combined alternating sessions of the previously mentioned two modalities.

RESULTS

Scar severity scores improved by a mean of 59.79% (95% CI 47.38-72.21) (p < 0.001) in group 1, a mean of 61.83% (95% CI 54.09-69.56) (p < 0.001) in group 2 and a mean of 78.27% (95% CI 74.39-82.15) (p < 0.001) in group 3. The difference in the degree of improvement was statistically significant when comparing the three groups using ANOVA test (p = 0.004).

CONCLUSION

The current work recommends combining 1540 nm nonablative fractional laser in alternation with PCI and TCA 20% in the treatment of atrophic acne scars.