Alster T S, West T B
Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA.
Dermatol Surg. 1996 Feb;22(2):151-4; discussion 154-5. doi: 10.1111/j.1524-4725.1996.tb00497.x.
Treatment of atrophic acne scars has been limited to the use of such traditional treatments as dermabrasion and chemical peels for many years. Recently, the addition of high-energy, pulsed carbon dioxide (CO2) lasers to the treatment armentarium has created renewed enthusiasm for cutaneous resurfacing due to their ability to create specific thermal injury with limited side effects.
To determine the effectiveness of a high-energy, pulsed CO2 laser in eliminating atrophic facial scars and to observe for side effects.
Fifty patients with skin phototypes I-V and moderate to severe atrophic facial acne scars were included in the study. Each patient received one high-energy, pulsed CO2 laser treatment using identical laser parameters by the same experienced laser surgeon. Baseline and 1-, 4-, 8-, 12-, and 24-week postoperative photographs and clinical assessments were obtained in all patients. Textural analysis of skin before and after laser irradiation were obtained in 10 patients to confirm clinical impressions. Clinical evaluations were conducted independently by two blinded assessors.
There was an 81.4% average clinical improvement observed in acne scars following laser treatment. Skin texture measurements of laser-irradiated scars were comparable to those obtained in normal adjacent skin. Side effects were limited to transient hyperpigmentation lasting an average of 3 months in 36% of patients. Prolonged erythema (2 months average) was usual and considered to be a normal healing response. No hypertrophic scarring was observed following laser treatment.
High-energy, pulsed CO2 laser treatment can safely and effectively improve or even eliminate atrophic facial scars and provides many benefits over traditional treatment methods.
多年来，萎缩性痤疮瘢痕的治疗一直局限于使用诸如磨皮术和化学剥脱术等传统治疗方法。最近，高能量脉冲二氧化碳（CO2）激光被纳入治疗手段，因其能够造成特定的热损伤且副作用有限，这为皮肤磨削术带来了新的热潮。
确定高能量脉冲CO2激光在消除面部萎缩性瘢痕方面的有效性，并观察其副作用。
本研究纳入了50例皮肤光型为I - V型且患有中度至重度面部萎缩性痤疮瘢痕的患者。每位患者均由同一位经验丰富的激光外科医生使用相同的激光参数接受一次高能量脉冲CO2激光治疗。所有患者均拍摄了基线照片以及术后1周、4周、8周、12周和24周的照片，并进行了临床评估。对10例患者进行了激光照射前后皮肤的纹理分析，以证实临床观察结果。临床评估由两名盲法评估者独立进行。
激光治疗后痤疮瘢痕平均临床改善率为81.4%。激光照射瘢痕的皮肤纹理测量结果与相邻正常皮肤相当。副作用仅限于36%的患者出现平均持续3个月的短暂色素沉着。通常会出现平均持续2个月的红斑延长，这被认为是正常的愈合反应。激光治疗后未观察到增生性瘢痕形成。
高能量脉冲CO2激光治疗可安全有效地改善甚至消除面部萎缩性瘢痕，与传统治疗方法相比具有诸多优势。
