Xiao Chang, Zhang Jun, Peng Jing
Department of Dermatology, Wuhan No. 1 Hospital Wuhan 430345, Hubei, China.
Am J Transl Res. 2025 Aug 15;17(8):6391-6402. doi: 10.62347/WTMW1778. eCollection 2025.
Acne vulgaris is a prevalent skin condition that often leads to facial scarring, significantly affecting patients' quality of life. Laser therapies, particularly carbon dioxide (CO) array laser and erbium-doped yttrium aluminum garnet (Er:YAG) laser, are widely used for acne scar management. This study aimed to compare the long-term efficacy and safety of these two laser systems for the treatment of acne scars.
A retrospective analysis was conducted on 254 patients with acne scars who were treated between January 2021 and January 2024. Among them, 124 patients received CO laser treatment, while 130 received Er:YAG laser treatment. Clinical data encompassing demographics, scar improvement, inflammatory markers, and patient satisfaction, were collected over one year. Evaluations were based on Extended Cook's Corrected Acne Scarring (ECCA) scores, VISIA Skin Analysis, and Dermatology Life Quality Index (DLQI).
Er:YAG laser demonstrated significantly lower intraoperative pain (VAS: 3.12 ± 0.23 vs. CO: 3.19 ± 0.21; P = 0.011) and shorter erythema resolution time (2.93 ± 0.64 vs. 3.11 ± 0.7 weeks; P = 0.029). Post-treatment INF-γ levels were higher in the Er:YAG group (853.68 ± 113.56 vs. 815.3 ± 120.28 pg/mL; P = 0.009). CO laser showed superior long-term scar reduction (ECCA), with the most pronounced improvement observed at 12 months (39.84 ± 3.26 vs. Er:YAG: 41.31 ± 4.88; P = 0.005). VISIA analysis revealed better outcomes for CO laser in pore size (7.55 ± 1.86 vs. 8.16 ± 1.14; P = 0.002) and porphyrins (81.33 ± 4.11 vs. 83.24 ± 5.24; P = 0.001). Treatment efficacy favored CO, with significantly lower ineffective response rates (5.65% vs. 16.92%; P = 0.017), although persistent erythema was more common with CO (6.45% vs. 0.77%; P = 0.035). At 12 months, DLQI improvement was superior greater in the CO group (11.25 ± 1.98 vs. 12.01 ± 2.02; P = 0.003).
The CO laser demonstrated superior long-term efficacy for reducing acne scars compared to the Er:YAG laser, at the cost of increased persistent erythema. Conversely, the Er:YAG laser offered a better recovery profile with fewer adverse reactions.
寻常痤疮是一种常见的皮肤疾病，常导致面部瘢痕形成，严重影响患者的生活质量。激光疗法，尤其是二氧化碳（CO）点阵激光和掺铒钇铝石榴石（Er:YAG）激光，被广泛用于痤疮瘢痕的治疗。本研究旨在比较这两种激光系统治疗痤疮瘢痕的长期疗效和安全性。
对2021年1月至2024年1月期间接受治疗的254例痤疮瘢痕患者进行回顾性分析。其中，124例患者接受CO激光治疗，130例接受Er:YAG激光治疗。收集了包括人口统计学、瘢痕改善情况、炎症标志物和患者满意度等在内的临床数据，为期一年。评估基于扩展库克校正痤疮瘢痕（ECCA）评分、VISIA皮肤分析和皮肤病生活质量指数（DLQI）。
Er:YAG激光显示术中疼痛明显更低（视觉模拟评分：3.12±0.23 vs. CO激光：3.19±0.21；P = 0.011），红斑消退时间更短（2.93±0.64 vs. 3.11±0.7周；P = 0.029）。Er:YAG组治疗后INF-γ水平更高（853.68±113.56 vs. 815.3±120.28 pg/mL；P = 0.009）。CO激光在长期瘢痕减轻（ECCA）方面表现更优，在12个月时改善最为明显（39.84±3.26 vs. Er:YAG激光：41.31±4.88；P = 0.005）。VISIA分析显示，CO激光在毛孔大小（7.55±1.86 vs. 8.16±1.14；P = 0.002）和卟啉（81.33±4.11 vs. 83.24±5.24；P = 0.001）方面效果更好。治疗效果倾向于CO激光，无效反应率显著更低（5.65% vs. 16.92%；P = 0.017），尽管CO激光导致的持续性红斑更常见（6.45% vs. 0.77%；P = 0.035）。在12个月时，CO组的DLQI改善更显著（11.25±1.98 vs. 12.01±2.02；P = 0.003）。
与Er:YAG激光相比，CO激光在减少痤疮瘢痕方面显示出更优的长期疗效，但代价是持续性红斑增加。相反，Er:YAG激光具有更好的恢复情况，不良反应更少。
