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Background <p>Persistent scarring, which significantly affects quality of life, is highly prevalent among acne patients, with some estimates reaching as high as 95%. The fractional ablative laser is a well-established technology for scar management, with numerous recent studies focusing on improving outcomes and reducing adverse effects. Latin Americans' skin types represent a challenge due to the risk of postinflammatory hyperpigmentation (PIH). This retrospective data collection presents findings from acne scarstreated with melanogenesis inhibitors before and after treatment, the post-treatment satisfaction level, and the complication rate in the Argentinian skin population treated with a fractional carbon dioxide (CO<sub>2</sub>) laser device.</p> Methods <p>Data from adolescents and adults with facial acne scars treated with a fractional CO<sub>2</sub> laser with two different handpieces, higher parameters, and several passes between April 2010 and April 2024 were retrospectively analyzed. Tranexamic acid 5% with glycolic acid 10% cream was indicated 1&#xa0;month before and 3 to 6&#xa0;months after treatment for patients with Fitzpatrick III to V. The primary endpoint was the baseline change in qualitative Goodman and Baron (GB) acne scores. The secondary endpoints included the general aesthetic improvement scale (GAIS) score and patient satisfaction score, both of which are measured on a 5-point scale (1 [low] to 5 [high]). Additionally, several factors were evaluated as potential predictors. The occurrence and frequency of adverse events (AEs) were monitored for safety assessment.</p> Results <p>Forty-one&#xa0;patients, 25 males and 19 females, with an average age of 30 y.o. (16 youngest y.o., 56 oldest y.o.) were treated and included in this study. Following treatment, 81% of patients (33 patients) presented a reduction in GB score which was significantly different from baseline value (Wilcoxon signed-ranke test,, p &lt; 0.001). The mean patient satisfaction score was 4.09, and the mean GAIS score was 3.95. No statistically significant relationships were found between any potential predictive factors and outcomes. Nearly 70% of patients (28) did not experience any AEs. The remaining patients experienced temporary and anticipated postinflammatory hyperpigmentation (PIH) and erythema. No scars or permanent side effects resulting from laser treatment were observed.</p> Conclusions <p>This study demonstrated the high level of satisfaction, safety, and efficacy of fractional CO<sub>2</sub> laser with relative high parameters and several passes associated with two different handpieces for treating acne scars over Argentinien skin types with only one or two sessions, including those with relatively high Fitzpatrick skin types, and the importance of using pre- and posttreatment melanogenesis inhibitors to prevent and treat PIH.</p> Level of evidence <p>Level&#xa0;IV, Risk / Prognostic Study.</p>

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Laser CO2 scar treatment for moderate to high Fitzpatrick skin types in patients with acne sequelae from Argentina: treatment characteristics, evaluation of results and satisfaction

  • 期刊论文

  • 发表日期：

    2025年1月7日

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  • Fabián Pérez Rivera

摘要

Background

Persistent scarring, which significantly affects quality of life, is highly prevalent among acne patients, with some estimates reaching as high as 95%. The fractional ablative laser is a well-established technology for scar management, with numerous recent studies focusing on improving outcomes and reducing adverse effects. Latin Americans' skin types represent a challenge due to the risk of postinflammatory hyperpigmentation (PIH). This retrospective data collection presents findings from acne scarstreated with melanogenesis inhibitors before and after treatment, the post-treatment satisfaction level, and the complication rate in the Argentinian skin population treated with a fractional carbon dioxide (CO2) laser device.

Methods

Data from adolescents and adults with facial acne scars treated with a fractional CO2 laser with two different handpieces, higher parameters, and several passes between April 2010 and April 2024 were retrospectively analyzed. Tranexamic acid 5% with glycolic acid 10% cream was indicated 1 month before and 3 to 6 months after treatment for patients with Fitzpatrick III to V. The primary endpoint was the baseline change in qualitative Goodman and Baron (GB) acne scores. The secondary endpoints included the general aesthetic improvement scale (GAIS) score and patient satisfaction score, both of which are measured on a 5-point scale (1 [low] to 5 [high]). Additionally, several factors were evaluated as potential predictors. The occurrence and frequency of adverse events (AEs) were monitored for safety assessment.

Results

Forty-one patients, 25 males and 19 females, with an average age of 30 y.o. (16 youngest y.o., 56 oldest y.o.) were treated and included in this study. Following treatment, 81% of patients (33 patients) presented a reduction in GB score which was significantly different from baseline value (Wilcoxon signed-ranke test,, p < 0.001). The mean patient satisfaction score was 4.09, and the mean GAIS score was 3.95. No statistically significant relationships were found between any potential predictive factors and outcomes. Nearly 70% of patients (28) did not experience any AEs. The remaining patients experienced temporary and anticipated postinflammatory hyperpigmentation (PIH) and erythema. No scars or permanent side effects resulting from laser treatment were observed.

Conclusions

This study demonstrated the high level of satisfaction, safety, and efficacy of fractional CO2 laser with relative high parameters and several passes associated with two different handpieces for treating acne scars over Argentinien skin types with only one or two sessions, including those with relatively high Fitzpatrick skin types, and the importance of using pre- and posttreatment melanogenesis inhibitors to prevent and treat PIH.

Level of evidence

Level IV, Risk / Prognostic Study.