Hedelund Lene, Haak Christina S, Togsverd-Bo Katrine, Bogh Morten K, Bjerring Peter, Haedersdal Merete
Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
Lasers Surg Med. 2012 Aug;44(6):447-52. doi: 10.1002/lsm.22048. Epub 2012 Jul 5.
The treatment of acne scars with fractional CO(2) lasers is gaining increasing impact, but has so far not been compared side-by-side to untreated control skin.
In a randomized controlled study to examine efficacy and adverse effects of fractional CO(2) laser resurfacing for atrophic acne scars compared to no treatment.
Patients (n = 13) with atrophic acne scars in two intra-individual areas of similar sizes and appearances were randomized to (i) three monthly fractional CO(2) laser treatments (MedArt 610; 12-14 W, 48-56 mJ/pulse, 13% density) and (ii) no treatment. Blinded on-site evaluations were performed by three physicians on 10-point scales. Endpoints were change in scar texture and atrophy, adverse effects, and patient satisfaction.
Preoperatively, acne scars appeared with moderate to severe uneven texture (6.15 ± 1.23) and atrophy (5.72 ± 1.45) in both interventional and non-interventional control sites, P = 1. Postoperatively, lower scores of scar texture and atrophy were obtained at 1 month (scar texture 4.31 ± 1.33, P < 0.0001; atrophy 4.08 ± 1.38, P < 0.0001), at 3 months (scar texture 4.26 ± 1.97, P < 0.0001; atrophy 3.97 ± 2.08, P < 0.0001), and at 6 months (scar texture 3.89 ± 1.7, P < 0.0001; atrophy 3.56 ± 1.76, P < 0.0001). Patients were satisfied with treatments and evaluated scar texture to be mild or moderately improved. Adverse effects were minor.
In this single-blinded randomized controlled trial we demonstrated that moderate to severe atrophic acne scars can be safely improved by ablative fractional CO(2) laser resurfacing. The use of higher energy levels might have improved the results and possibly also induced significant adverse effects.
二氧化碳点阵激光治疗痤疮瘢痕的影响日益增加，但迄今为止尚未与未治疗的对照皮肤进行直接比较。
在一项随机对照研究中，对比非治疗组，研究二氧化碳点阵激光磨削术治疗萎缩性痤疮瘢痕的疗效和不良反应。
将13例患者双侧具有相似大小和外观的萎缩性痤疮瘢痕部位，随机分为两组：（i）接受3次每月1次的二氧化碳点阵激光治疗（MedArt 610；12 - 14W，48 - 56mJ/脉冲，13%密度）；（ii）不接受治疗。由3名医生采用10分制进行盲法现场评估。观察指标包括瘢痕质地和萎缩程度的变化、不良反应以及患者满意度。
术前，干预组和非干预对照组的痤疮瘢痕均呈现中度至重度的质地不均（6.15 ± 1.23）和萎缩（5.72 ± 1.45），P = 1。术后，1个月时瘢痕质地和萎缩程度得分降低（瘢痕质地4.31 ± 1.33，P < 0.0001；萎缩4.08 ± 1.38，P < 0.0001），3个月时（瘢痕质地4.26 ± 1.97，P < 0.0001；萎缩3.97 ± 2.08，P < 0.0001），6个月时（瘢痕质地3.89 ± 1.7，P < 0.0001；萎缩3.56 ± 1.76，P < 0.0001）。患者对治疗满意，且评估瘢痕质地有轻度或中度改善。不良反应轻微。
在这项单盲随机对照试验中，我们证明了剥脱性二氧化碳点阵激光磨削术可安全改善中度至重度萎缩性痤疮瘢痕。使用更高能量水平可能会改善结果，但也可能引发显著的不良反应。
