Comparison Of Ablative CO₂ Fractional Laser And 1565nm Non-ablative Fractional Laser Treatments In Acne Scars

Background Acne is a common condition in society experienced by up to 90% of people between 16 and 28 years of age.With the Increased pressure,the morbidity is increasing year after year.Acne often results in secondary damage in the form of scarring,However,even with the best efforts,scars will certainly arise.Acne scars is a devastating disease,which cause enormous pressure to patients.severe acne scars can lead to psychologic depression,psychiatric problems,social ostracism,withdrawal from society.Non-ablative fractional laser systems?NFL?and 10 600-nm carbon ioxide fractional laser systems?CO₂ AFL?have been efficaciously used to treat acne scars,but the results are different.To the best of our knowledge,comparative studies evaluating clinical utility and side reaction of CO₂ AFL and NFL therapeutic method for Atrophic acne scars are rare,and whether the effect differences is controversial.There is no confirmative conclusion that which is better.Besides,there is no report on the treatment of acne scar with 1565 nm non-ablative fractional laser in the world at present.VISIA skin detection is a new method,which can be used to quantify the improvement of acne scar,and has been used as a standard for quantitative assessment of acne scar in the world.Therefore,we evaluated the clinical efficacy and safety of CO₂ AFL and 1565 nm NFL for acne scars.It can provide a reference for the clinical treatment of acne scar,in order to achieve a perfect therapeutic effect.Objective To evaluate the efficacy and side reaction of 1565 nm NFL and CO₂ AFL in the treatment of acne scars.Methods nineteen patients?16 females and 3 males,ages 18³5 years,Fitzpatrick skin types ?^??were selected from December 2015 to June 2016 in Plastic Surgery Clinic of Xijing Hospital in this study.They were diagnosed with mild to moderate atrophic acne scars on both cheeks.The patients were treated three times in a split-face randomized approach: on one side with CO₂ AFL and on the other side with 1565 nm NFL following a standardized protocol.The treatment parameters were adjusted according to the age,skin color,skin lesions and damage range.Treatment options were the same as the first and each treatment interval 6 weeks.At 3 months after the last treatment,we compared the improvement of clinical photos,VISIA skin detection index,overall patients satisfaction levels,adverse events?pain,erythema,erythema duration,callus duration,pigmentation,infection,hypopigmentation etc?by two blinded investigators.The results were displayed as mean values±SD.repeated measures data ANOVA for comparison in the same group,paired t-test for comparison between groups,The Wilcoxon signed rank test for ranked data.The statistical tests were two sided,and a p-value of less than 5% was considered statistically significant.And correlations with Statistical Package for the Social Sciences version 19.0.Results 1.Photo evaluation before and after treatment: Two kinds of laser were effective in treating acne scars,The effective rate of CO₂ AFL and 1565 nm NFL was 68.4% and 57.9%,with no significant difference?P > 0.05?.2.the mean grade of overall patients satisfaction levels based on clinical assessment was 6.68±1.34 for CO₂ AFL,and 6.11±1.29 for 1565 nm NFL,with no significant difference?P > 0.05?.3.VISIA skin detection index: After laser treatment,both lasers had no obvious effect on wrinkles,texture and brown spots?P > 0.05?,and there was no obvious difference absolute value between CO₂ AFL and 1565 nm NFL?P > 0.05?.Both lasers had obvious effect on pore?UV pigment and Porphyria?P ? 0.05?,and there was no obvious difference absolute value between CO₂ AFL and 1565 nm NFL?P > 0.05?.1565 nm NFL have obvious effect on pigment spot and CO₂ AFL had no curative effect,there was no obvious difference absolute value between CO₂ AFL and 1565 nm NFL?P > 0.05?.1565 nm NFL had Significant effect on red area and CO₂ AFL had no curative effect,improvement effect of 1565 nm NFL side was better than CO₂ AFL side?P ? 0.05?.4.Clinical adverse event evaluation: it was Heavier erythema and more painful on CO₂ AFL side than 1565 nm NFL side.In the duration of erythema and crusting,CO₂ AFL side was longer than1565 nm NFL side.In addition,there were 2 cases of pigmentation and 1 case of rash occured after CO₂ AFL treatment.Conclusion CO₂ AFL and 1565 nm NFL had definite curative effect on the treatment of atrophic acne scars and clinical improvement was not significantly different between them.The side treated by CO₂ AFL was more serious than that of 1565 nm NFL.Both CO₂ AFL and 1565 nm NFL had Significant effect on pore?UV pigment and Porphyria,1565 nm NFL also had Significant effect on pigment spot and red area.