Department of Dermatology and Sexually Transmitted Diseases, Maulana Azad Medical College and Lok Nayak Hospital, Delhi, India.
Dermatol Surg. 2014 Mar;40(3):288-300. doi: 10.1111/dsu.12428. Epub 2014 Jan 21.
Few studies have examined the role of fractional lasers in individual acne scars (ice-pick, box car, rolling) using objective assessment tools in darkly pigmented skin.
To evaluate the effect of 1,540-nm fractional lasers on individual acne scars.
A prospective interventional study was conducted in 35 patients using a 1,540-nm fractional laser. Six sessions were performed with four passes per session and a dose varying from 70 to 100 mJ to maximize the DWR. A self-devised objective assessment tool with dose settings to optimize the depth-to-width ratio (DWR) and a visual analog scale (VAS) were used to count individual atrophic scars. Final results were assessed 6 months after final laser treatment.
Acne scar reduction efficiency was used to validate the improvement of individual scars, a meaningful difference was considered as 51% or greater improvement. The boxcar scars (52.9%) responded better than the rolling (43.1%) and ice-pick scars (25.9%), with statistically significant improvement (p < .05) seen in boxcar scars after four sessions. Overall VAS scores revealed significant improvement (p < .001).
Using an objective evaluation tool, an erbium-doped glass laser was found to improve atrophic acne scars, markedly so for boxcar and rolling scars. The VAS score overestimated improvement because of its subjective nature.
很少有研究使用客观评估工具在深色皮肤中研究 1540nm 激光对个别痤疮疤痕（冰凿、箱车、滚动）的作用。
评估 1540nm 激光对个别痤疮疤痕的疗效。
对 35 例患者进行前瞻性干预研究，使用 1540nm 激光。每个患者进行 6 次治疗，每次治疗 4 个脉冲，剂量为 70-100mJ，以最大限度地提高 DWR。使用一种自行设计的客观评估工具，根据剂量设置优化深度-宽度比（DWR）和视觉模拟评分（VAS），以计算单个萎缩性疤痕的数量。在最后一次激光治疗后 6 个月评估最终结果。
使用痤疮疤痕减少效率来验证个别疤痕的改善情况，认为 51%或更高的改善为有意义的差异。箱车疤痕（52.9%）的反应优于滚动（43.1%）和冰凿疤痕（25.9%），箱车疤痕在 4 次治疗后有统计学意义的改善（p<.05）。总体 VAS 评分显示有显著改善（p<.001）。
使用客观评估工具，发现掺铒玻璃激光可改善萎缩性痤疮疤痕，箱车和滚动疤痕改善明显。VAS 评分由于其主观性而高估了改善程度。
