Hang Xiaozhun, Lim Davin Sui
Queensland Institute of Medical Research Berghofer, Herston, Queensland, Australia.
Cutis Clinic, Indooroopilly, Queensland, Australia.
J Cosmet Dermatol. 2025 Aug;24(8):e70366. doi: 10.1111/jocd.70366.
Atrophic acne scars are a common dermatological concern, often requiring fractional carbon dioxide (CO) laser resurfacing for effective treatment. However, in darker skin types (Fitzpatrick III-V), the high risk of post-inflammatory hyperpigmentation (PIH) remains a significant limitation, affecting treatment outcomes.
This study evaluates the efficacy of a novel pre- and post-treatment peel in reducing PIH following fractional CO laser resurfacing, particularly in higher Fitzpatrick skin types. The primary outcome was the incidence and severity of PIH, while secondary outcomes included healing time and changes in acne scar grading.
Twenty-nine patients underwent fractional CO laser resurfacing, with the study group (n = 15) receiving adjunctive peeling treatment before and after the procedure. PIH severity was assessed using the Post-Inflammatory Hyperpigmentation Area and Severity Index (PIHASI) at Week 6. Healing time and changes in acne scar grading (Goodman and Baron scale) were also analyzed.
The peel-treated group had a lower median PIHASI score (0.0 [IQR: 0.0-0.2]) than the no-peel group (0.2 [IQR: 0.2-0.4]) at Week 6. The Mann-Whitney U test showed a statistically significant difference (z = 2.427, p = 0.015, exact p = 0.016). Re-epithelialization time was comparable (Day 6.4 in peel group vs. Day 6.2 in control group), and no significant difference was observed in acne scar improvement (scar reduction: 1.27 ± 0.59 vs. 1.36 ± 0.63, p = 0.694). No adverse events were reported.
The novel peel effectively reduces PIH risk following fractional CO laser resurfacing without affecting scar outcomes. While it offers a promising approach for Fitzpatrick III-V patients, further studies with larger cohorts are needed to validate its long-term efficacy.
萎缩性痤疮瘢痕是常见的皮肤问题，通常需要分次二氧化碳（CO₂）激光换肤术进行有效治疗。然而，对于较深肤色类型（菲茨帕特里克III - V型），炎症后色素沉着（PIH）的高风险仍然是一个重大限制，影响治疗效果。
本研究评估一种新型的治疗前和治疗后剥脱术在减少分次CO₂激光换肤术后PIH方面的疗效，特别是在较高菲茨帕特里克皮肤类型中。主要结局是PIH的发生率和严重程度，次要结局包括愈合时间和痤疮瘢痕分级的变化。
29例患者接受了分次CO₂激光换肤术，研究组（n = 15）在手术前后接受辅助剥脱治疗。在第6周使用炎症后色素沉着面积和严重程度指数（PIHASI）评估PIH严重程度。还分析了愈合时间和痤疮瘢痕分级（古德曼和巴伦量表）的变化。
在第6周时，接受剥脱治疗的组的PIHASI中位数得分（0.0 [四分位间距：0.0 - 0.2]）低于未接受剥脱治疗的组（0.2 [四分位间距：0.2 - 0.4]）。曼 - 惠特尼U检验显示差异有统计学意义（z = 2.427，p = 0.015，确切p = 0.016）。重新上皮化时间相当（剥脱组为第6.4天，对照组为第6.2天），痤疮瘢痕改善情况无显著差异（瘢痕减少：1.27 ± 0.59对1.36 ± 0.63，p = 0.694）。未报告不良事件。
这种新型剥脱术有效降低了分次CO₂激光换肤术后的PIH风险，且不影响瘢痕治疗效果。虽然它为菲茨帕特里克III - V型患者提供了一种有前景的方法，但需要更大样本量的进一步研究来验证其长期疗效。
