Comparison of Nonablative Fractional Erbium Laser 1,340 nm and Microneedling for the Treatment of Atrophic Acne Scars

Cachafeiro, Thaís Hofmann; Escobar, Gabriela Fortes; Maldonado, Gabriela; Cestari, Tânia Ferreira; Corleta, Oly Campos

doi:10.1097/dss.0000000000000597

Cited by 50 publications

(34 citation statements)

References 21 publications

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“…Subcision, needling and PRP are minimally invasive modalities and have the advantages of short downtime and low cost . The combination treatment used in the present study is effective in severe (grade 4) acne scarring and well tolerated in Fitzpatrick skin types III to V. To our knowledge, this is the first study that has combined these minimally invasive modalities.…”

Section: Discussionmentioning

confidence: 99%

Combination therapy using subcision, needling, and platelet‐rich plasma in the management of grade 4 atrophic acne scars: A pilot study

Bhargava

Kroumpouzos

Varma

et al. 2019

J of Cosmetic Dermatology

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Summary Background Multimodality therapies including minimally invasive modalities are increasingly used in atrophic scarring. Objective To evaluate the role of platelet‐rich plasma (PRP) as adjunctive therapy to a combined subcision and needling treatment in severe (grade 4) atrophic acne scarring. Methods A total of 30 patients with grade 4 acne scars were randomly divided into two groups, 15 patients each: Group A underwent three sequential treatments of subcision and needling while Group B, three sequential treatments of subcision, needling, and topical application of PRP that were performed at 3‐week intervals. Scar grading was assessed 3 months following the final session. Participant's assessment of treatment response was registered. Results Scar improvement ≥50% was reported significantly more often by Group B than Group A patients (P = 0.025). Regarding physician‐based assessment of scar grading post‐therapy (number of patients with two grades improvement vs one grade or no improvement), there was a trend toward more improvement in Group B (P = 0.195). Physician's evaluation of acne scar improvement correlated with the patient's assessment of improvement: 60% of Group A and 66.6% of Group B patients appreciated an improvement of 25%‐49% and 50%‐74%, respectively. Mean duration of postprocedure erythema/edema was shorter among Group B than Group A patients (16.1 vs 32.9 hours, respectively). Overall, substantial improvement was noticed in rolling and boxcar scars with only a mild change in icepick scars. Conclusion Platelet‐rich plasma appears to add to the improvement of grade 4 atrophic acne scars when combined with needling and subcision. These findings require further evaluation by future studies.

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Section: Discussionmentioning

confidence: 99%

Combination therapy using subcision, needling, and platelet‐rich plasma in the management of grade 4 atrophic acne scars: A pilot study

Bhargava

Kroumpouzos

Varma

et al. 2019

J of Cosmetic Dermatology

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“…17 Cachafeiro et al compared MN and non-ablative fractional erbium laser1, 340 nm treated atrophic skin scars with no statistically significant difference. 18 Dogra et al reported utility of MN for treating atrophic acne scars in Asian population. 19 Sharad 2011 studied MN and 35% glycolic acid peels for treatment of atrophic box type, rolling type with PIH in dark skin showed significant improvement.…”

Section: Scarsmentioning

confidence: 99%

Dermaroller in dermatology and cosmetology

Mohan¹,

Mohan

Sangal³

et al. 2020

Int J Res Dermatol

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Dermaroller is a novel therapeutic modality in dermatology. Through physical trauma from needle penetration, dermaroller induces a wound healing cascade with mild temporary damage to the epidermis. This allows for the enhancement in the absorption of topical therapies across the thick stratum corneum. Dermaroller has become increasingly utilized over the last several years as it is a relatively simple procedure that is cost effective, well tolerated and offers cosmetic and therapeutic benefits. The ability to treat localized areas of disease made it popular in acne scars, alopecia, striae, melasma, actinic keratoses. The procedure has few adverse sequelae compared to other therapies, is highly effective and a viable resurfacing option for color of skin.

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“…101 Numerous studies support the utility of microneedling without the augmentation of an energy-based device in the treatment of acne and other scar types. [102][103][104][105] In 3 studies involving 91 patients (skin types III-V) investigating RFM in atrophic acne, various acne scar scoring systems consistently reported a moderate improvement in scar appearance after treatment. 100,106,107 RFM offers superior results for ice-pick and boxcar acne scars than rolling scars 108 and appears to offer a more dramatic improvement in acne scarring than bipolar RF alone.…”

Section: Fractional Radiofrequencymentioning

confidence: 99%

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

2017

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I n recent decades, there has been a revolution in energy-based treatment options for skin scarring, rejuvenation, and tightening. One of the most promising developments has been the introduction of fractional photothermolysis, developed by Anderson and Manstein in 2004. Fractionated systems deliver laser energy in a grid-like pattern, creating microscopic columns of ablative and/or coagulative damage termed microthermal zones (MTZs), which stimulate collagen remodeling.1 The incorporation of fractional photothermolysis into energy-based devices has allowed less destruction to surrounding tissue, leading to desired results with the minimization of unwanted side effects, leading to both ablative and nonablative laser devices becoming desirable treatment options for cutaneous scarring and rejuvenation. Given their impressive results, newer fractional laser treatment options, including picosecond lasers, quality-switched (QS) lasers, and combined ablative and nonablative lasers, are being investigated for the treatment of these common skin conditions.The following review addresses the current and emerging topics on fractional laser treatment of skin scarring and rejuvenation based on the device type, including ablative, nonablative, QS, picosecond, and hybrid fractional lasers (HFLs). Additionally, newer energy-based fractional devices, such as radiofrequency (RF) with and without microneedling and the use of fractionated technology for drug delivery, are discussed in the context of these common skin conditions. Fractionated lasersTreatment options for cutaneous scars and skin rejuvenation have evolved significantly since the rise in popularity of ablative lasers in the 1990s. Newer treatment options, including ablative fractional lasers (AFL) and nonablative fractional lasers (NAFL), have garnered favor, given the milder side effect profile in comparison with traditional fully ablative lasers. Ablative fractional lasersAcne scarring AFLs were developed in an attempt to achieve the efficacy of traditional ablative lasers with the milder side effect profile of fractional technology. Although a single treatment produces less dramatic, albeit noticeable, results than traditional fully ablative lasers can, multiple treatments result in greater clinical improvement.2 Currently, there are 3 types of AFLs available for scar treatment: the 10600-nm carbon dioxide (CO2), the 2940-nm erbium:yttrium aluminum garnet (Er:YAG), and the 2740-nm yttrium scandium gallium garnet (YSGG) lasers. AFL is associated with the increased risk of both protracted erythema and postinflammatory hyperpigmentation (PIH) in darker skin types, which has led many clinicians to prefer a longer series of NAFL treatments over AFL treatments to achieve similar results with a lower risk of side effects.Multiple studies support the efficacy of the fractional CO2 laser in acne scars. The overwhelming majority of these studies investigate the utility of these lasers in atrophic facial scars. While NAFLs typically require multiple sessions to achieve modest ...

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Comparison of Nonablative Fractional Erbium Laser 1,340 nm and Microneedling for the Treatment of Atrophic Acne Scars

Abstract: This study shows that both nonablative fractional laser 1,340 nm and microneedling are comparable and effective in the treatment of atrophic acne scars. Microneedling is well tolerated, with fewer side effects and lower down time.

Cited by 50 publications

References 21 publications

Combination therapy using subcision, needling, and platelet‐rich plasma in the management of grade 4 atrophic acne scars: A pilot study

Combination therapy using subcision, needling, and platelet‐rich plasma in the management of grade 4 atrophic acne scars: A pilot study

Dermaroller in dermatology and cosmetology

Advances in fractional technology for skin rejuvenation, skin tightening, drug delivery, and treating scars and skin defects

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