Successful treatment of acneiform scarring with CO<sub>2</sub>ablative fractional resurfacing

Chapas, Anne; Brightman, Lori; Sukal, Sean A.; Hale, Elizabeth K.; Daniel, David R.; Bernstein, Leonard; Geronemus, Roy G.

doi:10.1002/lsm.20659

Cited by 261 publications

(265 citation statements)

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“…In the present study, it was found that three sessions of ablative fractional CO 2 laser showed significant qualitative and quantitative improvement of atrophic acne scars, which was consistent with previous reports of Chapas et al [32] , Manuskiatti et al [33] and Cho et al [34] . However, Azzam et al reported that patients with boxcar scars showed no improvement using (15 mJ) power by fractional CO 2 laser with appearance of pixilated pattern and acne activation in some cases [24] .…”

Section: Discussionsupporting

confidence: 93%

“…Previous histologic and immunohistologic studies demonstrated a large difference in results between fat grafting and fractional ablative CO 2 laser for the treatment of acne scars, and favored fat grafting [35] . Histologic and immunohistologic experimental study compared biopsies taken from nude mice before and after fat graft, and showed an increased density of extracellular matrix surrounding the fatty tissue and between the fatty tissue and the dermis [32] . In another study on mice, skin changes with fat grafting were investigated in skin biopsies eight weeks after the graft, which revealed that fat graft caused increased collagen fibers neosynthesis at the recipient site and thickened the dermis.…”

Section: Discussionmentioning

confidence: 99%

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Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Mohammad

Elgarhy

Saad³

et al. 2016

J Surg Dermatol

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There are different modalities for management of atrophic acne scars which include lasers. Ablative fractional CO 2 laser was developed to address the shortcomings of traditional ablative lasers, with superior results to non-ablative fractional lasers. Autologous fat transfer has been utilized for nearly a decade in tissue augmentation and reconstruction. Present studies were designed to compare ablative fractional CO 2 laser treatment with scar subcision and autologous fat transfer in the treatment of atrophic acne scars. 20 patients with atrophic acne scars were recruited: 10 patients were treated by three sessions of ablative fractional CO 2 laser therapy, and 10 patients treated by subcision and autologous fat transfer. All patients were followed up for three months, and were assessed by digital photograph before and after treatment through the application of Goodman and Baron quantitative and qualitative grading systems, in addition to reports by three physicians committees and reports of patients' satisfaction. Analysis of both groups showed significant improvements in all types of atrophic acne scars. The mean percentage of total quantitative improvement was more significant in the case of autologous fat transfer with regard to ice-pick and total number of scars. Therefore, scar subcision with autologous fat transfer proved to be as effective as, or even more effective than, ablative fractional CO 2 laser in the treatment of atrophic acne scars with regard to the total number of scars as well as ice-pick type.Keywords: Acne scars; laser; fat transfer Citation: Mohammad LM, Elgarhy LH, Saad DG, Mostafa WA. Fractional ablative CO 2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Mohammad

Elgarhy

Saad³

et al. 2016

J Surg Dermatol

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“…Fractional ablative procedures are available with carbon dioxide laser (CO 2 laser, 10,600 nm) and erbium YAG laser (Er:YAG laser, 2,940 nm) [3][4][5]. The concept of AFR has so far been used for dermal remodeling in the treatment of photodamaged facial skin, rhytides, acneiform scarring, and burn scar remodeling [3,[6][7][8][9][10]. Theoretically, AFR may also facilitate penetration and distribution of topically applied drugs, since the ablated laser holes extend into dermis, thereby possibly acting as channels for drug uptake.…”

Section: Introductionmentioning

confidence: 99%

Fractional CO₂ laser‐assisted drug delivery

et al. 2010

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Background and Objectives: Ablative fractional resurfacing (AFR) creates vertical channels that might assist the delivery of topically applied drugs into skin. The purpose of this study was to evaluate drug delivery by CO 2 laser AFR using methyl 5-aminolevulinate (MAL), a porphyrin precursor, as a test drug. Materials and Methods: Two Yorkshire swine were treated with single-hole CO 2 laser AFR and subsequent topical application of MAL (Metvix 1 , Photocure ASA, Oslo, Norway), placebo cream and no drug. MAL-induced porphyrin fluorescence was measured by fluorescence microscopy at skin depths down to 1,800 mm. AFR was performed with a 10.6 mm wavelength prototype CO 2 laser, using stacked single pulses of 3 millisecond and 91.6 mJ per pulse. Results: AFR created cone-shaped channels of approximately 300 mm diameter and 1,850 mm depth that were surrounded by a 70 mm thin layer of thermally coagulated dermis. There was no porphyrin fluorescence in placebo cream or untreated skin sites. AFR followed by MAL application enhanced drug delivery with significantly higher porphyrin fluorescence of hair follicles (P<0.0011) and dermis (P<0.0433) versus MAL alone at skin depths of 120, 500, 1,000, 1,500, and 1,800 mm. AFR before MAL application also enhanced skin surface (epidermal) porphyrin fluorescence. Radial diffusion of MAL from the laser-created channels into surrounding dermis was evidenced by uniform porphyrin fluorescence up to 1,500 mm from the holes (1,000, 1,800 mm depths). Skin massage after MAL application did not affect MAL-induced porphyrin fluorescence after AFR. Conclusions: Ablative fractional laser treatment facilitates delivery of topical MAL deeply into the skin. For the conditions of this study, laser channels approximately 3 mm apart followed by MAL application could produce porphyrins throughout essentially the entire skin. AFR appears to be a clinically practical means for enhancing uptake of MAL, a photodynamic therapy drug, and presumably many other topical skin medications. Lasers Surg.

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“…These abrade the surface and help tighten the collagen fibers beneath (5) . All ablative lasers showed high risk of complications (5) , the high risk of complications following traditional CO 2 resurfacing has warranted the development of new treatment modalities (4,15) . This modality was the fractional photo thermolysis (16,17) .…”

Section: Introductionmentioning

confidence: 99%

Combined Effect of Fractional Co2 Laser and Topical Application of Growth Factor Complex Solution on Old Facial Acne Scar

2016

IJMS

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Successful treatment of acneiform scarring with CO₂ablative fractional resurfacing

Abstract: Successfully combining ablative technology with FP, AFR treatments constitute a safe and effective treatment modality for acneiform scarring.

Cited by 261 publications

References 14 publications

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Fractional CO₂ laser‐assisted drug delivery

Combined Effect of Fractional Co2 Laser and Topical Application of Growth Factor Complex Solution on Old Facial Acne Scar

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Successful treatment of acneiform scarring with CO2ablative fractional resurfacing

Abstract: Successfully combining ablative technology with FP, AFR treatments constitute a safe and effective treatment modality for acneiform scarring.

Cited by 261 publications

References 14 publications

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

Fractional CO2 laser‐assisted drug delivery

Combined Effect of Fractional Co2 Laser and Topical Application of Growth Factor Complex Solution on Old Facial Acne Scar

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Successful treatment of acneiform scarring with CO₂ablative fractional resurfacing

Fractional CO₂ laser‐assisted drug delivery