The efficacy of fractional CO ₂ laser in acne scar treatment: A meta‐analysis

Abstract

Fractional CO2 laser is a good option for treating acne scars. However, the clinical efficacy of this treatment modality requires further evidence. To perform a meta‐analysis to assess clinical improvements in acne scars with fractional CO2 laser and non‐CO2 laser therapies. Databases (PubMed, Embase, Cochrane Library) were searched using the search strategy to identify eligible studies. All statistical analyses were performed using the Review Manager 5.0, and a meta‐analysis was conducted to assess the effects of fractional CO2 laser used as a treatment for acne scars. Eight studies were included for further analysis. There was no significant difference between fractional CO2 laser and non‐CO2 laser therapies in terms of clinical improvement, observer assessment (P = .19), patient assessment (P = .91), and incidence of post‐inflammatory hyperpigmentation (P = .69). The subgroup analyses showed that the duration of follow‐up had little effect on the evaluation of treatment effect. The efficacy of fractional CO2 laser therapy in acne scars appeared to be equal to that of non‐CO2 laser therapies. More well designed randomized controlled trials and more credible and standard evaluation criteria are needed, and the efficiency of combination therapy requires further analysis.

Microneedling combined with botulinum toxin-A versus microneedling combined with platelet-rich plasma in treatment of atrophic acne scars: a comparative split face study

“…Different treatment modalities have been under trial for treating them such as chemical peels, laser-assisted resurfacing, dermabrasion and microneedling (MN). However, none of them has proved optimal efficacy and many combinations are still under investigation [ 3 ].…”

Rapid Wound Healing and Acne Scar Improvement After Ablative Fractional Carbon Dioxide Laser Treatment Combined with the Application of Platelet-Lyophilized Treatment (PLT)

“…However, adverse effects of ablative laser treatments were reported, such as prolonged erythema, edema, and post inflammatory hyperpigmentation (PIH). 15 , 16 Wound care after CO 2 laser treatment may cause stress and may affect a patient’s daily activities 17 . Recent clinical studies have also focused on exploring the combination of a CO 2 laser with other therapies, such as PRP and adipose tissue stem cells, to enhance the effectiveness and safety and decrease the incidence of adverse reactions to acne scar treatment.…”

An overview on the role of CO 2 laser in general dermatology

“…Conversely, recent studies showed a superiority of efficacy when this procedure is associated with platelet rich plasma (PRP) or Lyophilized-growth factors (L-GFs). 29,30 Regarding photorejuvenation and resurfacing, a recent systemic review of 1093 patients has demonstrated the effectiveness of ablative lasers in several indications, highlighting their superiority if compared to nonablative lasers in the field of resurfacing.…”

“…Finally, much more rarely, there may be adverse effects such as hypertrophic scarring or infections of the treated site that are often linked more to poor wound management than to treatment. [29][30][31]…”