Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Department of Dermatology, Aaarhus University Hospital, Aarhus, Denmark.
Lasers Surg Med. 2023 Apr;55(4):335-343. doi: 10.1002/lsm.23655. Epub 2023 Mar 19.
Ablative fractional CO laser (AFL) is an established first-line energy-based treatment for acne scars. Microneedle radiofrequency (MNRF) is an emerging treatment, also targeting the skin in fractions. No studies have so far compared AFL with MNRF for acne scars in a direct controlled, side-by-side comparison. In this study, we compared AFL and MNRF treatments for acne scars in a randomized split-face trial with blinded response evaluation, objective measures, and patient-reported outcomes.
STUDY DESIGN/MATERIALS AND METHOD: Fifteen patients with moderate to severe acne scars were included. At baseline each patient had two similar test areas identified, these were randomized to receive a single treatment with either AFL or MNRF. Standardized multilayer techniques were applied with AFL and MNRF, first targeting the scar base, thereafter the entire scar area. Outcome measures included blinded evaluation of clinical improvement of scar texture (0-10 scale) at 1- and 3-months follow-up, local skin reactions (LSR), pain according to Visual Analogue Scale (VAS), skin integrity quantified by transepidermal water loss, and patient satisfaction.
Fifteen patients completed the study with a median test area size of 24.6 cm (interquartile range [IQR] 14.9-40.6). A single treatment with AFL or MNRF equally resulted in a median 1-point texture improvement after 3 months follow-up (p < 0.001). Best responders achieved up to a 3-point improvement (n = 3 test areas, 10% of treatment areas). Erythema and loss of skin integrity was more intense after AFL compared with MNRF after 2-4 days (p < 0.001). Patients reported MNRF (VAS 7.0) to be significantly more painful than AFL (5.5) (p = 0.009). Patients were generally satisfied with the overall outcome on a 10-point scale at median 6 for both treatments (IQR 5-7).
AFL and MNRF treatments are equally effective at improving texture in skin with acne scars. AFL resulted in more pronounced LSRs whereas MNRF was more painful. Patients were generally satisfied with the overall outcome.
消融性微剥脱 CO2 激光（AFL）是一种成熟的一线痤疮瘢痕的能量治疗方法。微针射频（MNRF）是一种新兴的治疗方法，同样针对皮肤的多个部位。目前尚无研究对 AFL 和 MNRF 治疗痤疮瘢痕进行直接的、对照的、平行的比较。本研究采用随机、半脸对照、盲法评估的方法，对 AFL 和 MNRF 治疗痤疮瘢痕进行了比较，同时评估了客观指标和患者报告的结局。
研究设计/材料和方法：纳入了 15 例中重度痤疮瘢痕患者。每位患者在基线时确定了两个相似的测试区域，将这些区域随机分为接受 AFL 或 MNRF 单次治疗。采用 AFL 和 MNRF 进行标准化的多层技术，首先针对瘢痕基底，然后针对整个瘢痕区域。评估指标包括：治疗后 1 个月和 3 个月的瘢痕纹理改善的盲法评估（0-10 分）、局部皮肤反应（LSR）、根据视觉模拟评分（VAS）评估的疼痛、经表皮水分丢失定量的皮肤完整性和患者满意度。
15 例患者完成了研究，平均测试区域大小为 24.6cm（四分位距[IQR]14.9-40.6）。单次 AFL 或 MNRF 治疗后 3 个月，平均纹理改善 1 分（p<0.001）。最佳应答者可获得高达 3 分的改善（n=3 个测试区域，占治疗区域的 10%）。2-4 天后，AFL 后的红斑和皮肤完整性丧失比 MNRF 更明显（p<0.001）。患者报告 MNRF（VAS 7.0）比 AFL（5.5）更痛（p=0.009）。在 10 分制的总体满意度评分中，患者对两种治疗方法的满意度中位数为 6（IQR 5-7）。
AFL 和 MNRF 治疗痤疮瘢痕的改善纹理效果相当。AFL 导致更明显的 LSR，而 MNRF 更痛。患者对总体结果普遍满意。
