Rajput Chetan D, Gore Sanjay B, Ansari Misha K, Shah Swagat M
Department of Skin and VD, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India.
J Cutan Aesthet Surg. 2021 Apr-Jun;14(2):177-183. doi: 10.4103/JCAS.JCAS_65_19.
Acne scar is a distressing psychosocial problem, and it has a negative effect on the quality of life. Although variety of approaches are available, demand of less invasive and more effective ways for their treatment is needed.
This study aimed to assess and compare the clinical safety, efficacy, and tolerability of fractional carbon dioxide (FCO) laser versus fractional microneedling radio frequency (MNRF) in the management of acne scars.
This study was a prospective, observational, nonrandomized, open-labeled study of total 50 patients selected according to Goodman and Baron global qualitative acne scar grading, and they were divided into two groups of 25 each, having Fitzpatrick skin type III-V. A total of four sessions were given for both the groups at an interval of 2 months. The assessment was done by the treating physician as well as by the blinded physician. Both the subjective and the objective assessment was done at the last follow up given at second month of the fourth session.
The mean score of 25 patients in each group of FCO and fractional MNRF, decreased from 29.24 to 10.7 (i.e., 63.41%) and from 33.24 to 13.04 (i.e., 60.72%), respectively, as calculated by Goodman and Baron quantitative grading assessed by the treating physician ( = 0.0001). Grade 4 (>75%) improvement was shown by four patients and Grade 3 improvement (51%-75%) was shown by 14 patients among FCO group, and similarly Grade 4 (>75%) improvement was shown by three patients and Grade 3 improvement (51%-75%) was shown by 12 patients among MNRF group, as observed by a blinded physician ( = 0.689).
Both modalities are equally effective in the treatment of acne scars; however, fractional MNRF having lesser down time and Post inflammatory hyperpigmentation (PIH) among darker skin shades, with good patient satisfaction score, makes it an efficient and safer treatment option as compared to FCO.
痤疮瘢痕是一个令人苦恼的社会心理问题，对生活质量有负面影响。尽管有多种治疗方法，但仍需要创伤性更小、更有效的治疗方式。
本研究旨在评估和比较分次二氧化碳（FCO）激光与分次微针射频（MNRF）治疗痤疮瘢痕的临床安全性、有效性和耐受性。
本研究是一项前瞻性、观察性、非随机、开放标签的研究，共纳入50例根据古德曼和巴伦全球痤疮瘢痕定性分级标准选取的患者，分为两组，每组25例，皮肤类型为菲茨帕特里克III - V型。两组均每隔2个月进行共4次治疗。由治疗医生和盲法医生进行评估。在第四次治疗第二个月的最后一次随访时进行主观和客观评估。
根据治疗医生采用古德曼和巴伦定量分级法计算，FCO组和分次MNRF组每组25例患者的平均评分分别从29.24降至10.7（即63.41%）和从33.24降至13.04（即60.72%）（P = 0.0001）。盲法医生观察发现，FCO组有4例患者改善程度为4级（>75%），14例患者改善程度为3级（51% - 75%）；MNRF组有3例患者改善程度为4级（>75%），12例患者改善程度为3级（51% - 75%）（P = 0.689）。
两种治疗方式在治疗痤疮瘢痕方面同样有效；然而，分次MNRF的停机时间更短，在肤色较深的患者中炎症后色素沉着（PIH）较少，患者满意度评分良好，与FCO相比，它是一种更有效、更安全的治疗选择。
