Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan.
Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Aesthet Surg J. 2019 Jun 21;39(7):NP279-NP287. doi: 10.1093/asj/sjz048.
Acne scars are common and challenging clinical complications of acne vulgaris. Ablative fractional carbon dioxide (CO2) laser is a well-established treatment for acne scars; however, some postlaser adverse effects have been noted. Autologous platelet-rich plasma (PRP) can improve tissue regeneration. Several studies have investigated the efficacy of combination therapy of CO2 laser and PRP for acne scars.
The authors sought to conduct a meta-analysis of the efficacy of PRP combined with ablative fractional CO2 laser for treating acne scars by examining clinical trial results.
A systematic review was performed by searching PubMed, Embase, Cochrane Library, and Web of Science, and a meta-analysis was conducted to assess the clinical outcomes after combination therapy of PRP and ablative fractional CO2 laser compared with laser alone.
We identified 4 eligible studies for the meta-analysis, including 3 randomized controlled trials. Our results demonstrated that clinical improvement after combination therapy was significantly higher than that after laser alone (odds ratio = 2.992, P = 0.001). Regarding major side effects, patients who underwent combination therapy experienced significantly shorter duration of crust compared with CO2 laser alone (standard mean difference = -1.140, P < 0.001); relatively shorter durations of erythema and edema were also noted after combination therapy. Furthermore, patient satisfaction rates were significantly higher after combination therapy than after laser alone (odds ratio = 3.169, P = 0.002).
The combination of autologous PRP and ablative fractional CO2 laser has synergistic positive effects on the clinical outcomes for acne scars and can accelerate the recovery of laser-damaged skin.
痤疮瘢痕是寻常型痤疮常见且具有挑战性的临床并发症。剥脱性点阵二氧化碳（CO2）激光是治疗痤疮瘢痕的成熟方法；然而，已经注意到一些激光后不良反应。富血小板血浆（PRP）可改善组织再生。一些研究已经调查了 CO2 激光联合 PRP 治疗痤疮瘢痕的疗效。
作者通过检查临床试验结果，旨在对 PRP 联合剥脱性点阵 CO2 激光治疗痤疮瘢痕的疗效进行荟萃分析。
通过检索 PubMed、Embase、Cochrane 图书馆和 Web of Science 进行系统评价，并进行荟萃分析，以评估 PRP 联合剥脱性点阵 CO2 激光治疗与单独激光治疗后的临床疗效。
我们确定了 4 项符合条件的荟萃分析研究，包括 3 项随机对照试验。我们的结果表明，联合治疗后的临床改善明显高于单独激光治疗（优势比=2.992，P=0.001）。关于主要副作用，与单独 CO2 激光治疗相比，联合治疗的患者结痂持续时间明显缩短（标准均数差=-1.140，P<0.001）；联合治疗后红斑和水肿的持续时间也相对较短。此外，联合治疗后的患者满意度明显高于单独激光治疗（优势比=3.169，P=0.002）。
自体 PRP 与剥脱性点阵 CO2 激光联合使用对痤疮瘢痕的临床疗效有协同的积极作用，并能加速激光损伤皮肤的恢复。
