Agrawal Kopal, Belgaumkar Vasudha Abhijit, Chavan Ravindranath Brahmadeo, Pradhan Shekhar N
Department of Dermatology, Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India.
Department of Dermatology, Government Medical College and General Hospital, Satara, Maharashtra, India.
Indian Dermatol Online J. 2024 Oct 28;15(6):942-948. doi: 10.4103/idoj.idoj_96_24. eCollection 2024 Nov-Dec.
Post-acne scarring causes severe physical and psychological distress. Multiple treatment modalities are available with no single gold standard treatment.
To assess and compare the efficacy and safety of fractional CO2 laser and microneedling in atrophic acne scars and corelate with variables like scar type, duration, and Fitzpatrick skin types.
Thirty patients (aged 20-40 years) with facial post-acne atrophic scars with the same Goodman and Baron (GB) grade on both sides of the face were included in the study after written informed consent. After priming skin, four monthly sessions of fractional CO2 laser on the right and microneedling on the left side were performed with 2 months follow-up.
GB (3.53 to 2.37) grade and patient's subjective score (8.63 to 4.37) showed 32.9% and 49.4% improvement over the fractional CO2 laser side and 9.3% (3.53 to 3.20) and 19.7% (8.63 to 6.93) improvement over the microneedling side, respectively, and the difference between the two modalities being statistically significant. Rolling (42.90% vs. 16.18%) and boxcars (36.18% vs. 3.74%) also showed more improvement with fractional CO2 laser. Ice-pick scars responded the least with both modalities. Scars of less than 10 years duration responded better to both modalities with sustained improvement during the study. However, postinflammatory hyperpigmentation (30% vs. 6.67%) was greater with fractional CO2 laser (more in higher Fitzpatrick skin types).
Small sample size, short follow-up period, and subjective assessment methods.
Both microneedling and fractional CO2 laser improve the overall appearance of atrophic post-acne scars. The latter was more effective than the former but with a slightly longer healing time and greater post-procedure hyperpigmentation.
痤疮后瘢痕会导致严重的身心困扰。有多种治疗方式，但没有单一的金标准治疗方法。
评估和比较剥脱性二氧化碳激光和微针治疗萎缩性痤疮瘢痕的疗效和安全性，并与瘢痕类型、病程和菲茨帕特里克皮肤类型等变量相关联。
经书面知情同意后，纳入30例年龄在20 - 40岁、面部两侧痤疮后萎缩性瘢痕具有相同古德曼和巴伦（GB）分级的患者。皮肤预处理后，右侧进行4次每月一次的剥脱性二氧化碳激光治疗，左侧进行微针治疗，并进行2个月的随访。
GB分级（从3.53降至2.37）和患者主观评分（从8.63降至4.37）在剥脱性二氧化碳激光治疗侧分别改善了32.9%和49.4%，在微针治疗侧分别改善了9.3%（从3.53降至3.20）和19.7%（从8.63降至6.93），两种治疗方式之间的差异具有统计学意义。滚轮状瘢痕（42.90%对16.18%）和箱车型瘢痕（36.18%对3.74%）在剥脱性二氧化碳激光治疗下改善也更明显。冰锥样瘢痕对两种治疗方式反应最差。病程小于10年的瘢痕对两种治疗方式反应更好，在研究期间持续改善。然而，剥脱性二氧化碳激光治疗后炎症后色素沉着（30%对6.67%）更严重（在较高菲茨帕特里克皮肤类型中更明显）。
样本量小、随访期短以及主观评估方法。
微针治疗和剥脱性二氧化碳激光治疗均能改善萎缩性痤疮后瘢痕的整体外观。后者比前者更有效，但愈合时间稍长且术后色素沉着更严重。
