Yan Chadakan, Phinyo Phichayut, Yogya Yuri, Chuamanochan Mati, Wanitphakdeedecha Rungsima
Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Dermatol Ther (Heidelb). 2025 Jul 13. doi: 10.1007/s13555-025-01486-z.
Acne scarring is a prevalent complication of acne vulgaris, often resulting in significant psychosocial distress. While energy-based devices (EBDs), including fractional laser (FL) and fractional radiofrequency (FRF), are increasingly used for atrophic acne scars, limited data exist on prognostic factors predicting treatment outcomes, particularly in Asian populations. The study aims to identify clinical predictors of graded clinical improvement in patients with atrophic acne scars treated with FL and FRF.
This retrospective cohort study was conducted at a university hospital in Bangkok, Thailand, from 2012 to 2023. Clinical improvement was assessed using standardized photographic evaluations and categorized into four levels: < 25%, 25-50%, 51-75%, and > 75% improvement. Univariable and multivariable ordinal logistic regression models were used to determine prognostic factors. Sensitivity analyses were performed to confirm the robustness of the findings.
A total of 397 patients were included, of whom 254 received FL and 143 received FRF treatments. Older age (per 5-year increase) (mOR: 1.24; 95% CI: 1.07-1.43), male sex (mOR: 1.29; 95% CI: 1.06-1.57), shorter scar duration (per 5 years) (mOR: 0.73; 95% CI: 0.56-0.97), lower Fitzpatrick skin phototypes, and completion of at least three treatment sessions (mOR: 1.33; 95% CI: 1.16-1.53) were independently associated with greater clinical improvement. Sensitivity analyses confirmed the robustness of these associations.
Key clinical factors, including patient age, sex, scar duration, skin phototype, and completion of at least three treatment sessions, significantly influence treatment outcomes with EBDs. These findings support the development of personalized treatment strategies to optimize outcomes, particularly in patients with severe scarring.
TCTR20240512006.
痤疮瘢痕是寻常痤疮的一种常见并发症，常导致严重的心理社会困扰。虽然包括剥脱性激光（FL）和射频微针（FRF）在内的能量源设备越来越多地用于治疗萎缩性痤疮瘢痕，但关于预测治疗效果的预后因素的数据有限，尤其是在亚洲人群中。本研究旨在确定接受FL和FRF治疗的萎缩性痤疮瘢痕患者临床分级改善的临床预测因素。
本回顾性队列研究于2012年至2023年在泰国曼谷的一家大学医院进行。使用标准化的照片评估来评估临床改善情况，并将其分为四个等级：改善<25%、25%-50%、51%-75%和>75%。采用单变量和多变量有序逻辑回归模型来确定预后因素。进行敏感性分析以确认研究结果的稳健性。
共纳入397例患者，其中254例接受了FL治疗，143例接受了FRF治疗。年龄较大（每增加5岁）（多变量调整比值比[mOR]：1.24；95%置信区间[CI]：1.07-1.43）、男性（mOR：1.29；95%CI：1.06-1.57）、瘢痕持续时间较短（每5年）（mOR：0.73；95%CI：0.56-0.97）、较低的Fitzpatrick皮肤分型以及完成至少三次治疗疗程（mOR：1.33；95%CI：1.16-1.53）与更大的临床改善独立相关。敏感性分析证实了这些关联的稳健性。
关键的临床因素，包括患者年龄、性别、瘢痕持续时间、皮肤分型以及完成至少三次治疗疗程，显著影响能量源设备的治疗效果。这些发现支持制定个性化治疗策略以优化治疗效果，尤其是对于严重瘢痕患者。
TCTR20240512006。
