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Rageh MA, Elrewiny EM, Kadah AS, Zakaria HB, Abdelshakour M, Mohy SM, Mahmoud WA, Suliman AA, Mohamed AA. Fractional CO2 laser with topical insulin versus PRP for atrophic acne scars: a randomized split-face study. Arch Dermatol Res 2025; 317:663. [PMID: 40167803 DOI: 10.1007/s00403-025-04112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Revised: 02/14/2025] [Accepted: 02/25/2025] [Indexed: 04/02/2025]
Abstract
Atrophic acne scarring is a prevalent problem that has been treated with a variety of procedures, each with various degrees of success. For better results, combined regimens of treatment are recommended. Our aim was to compare the efficacy of topical insulin against topical platelet-rich plasma (PRP) as an adjunct treatment to fractional CO2 laser for atrophic acne scars. The study comprised 30 patients with atrophic acne scars. All patients underwent four sessions of fractional CO2 laser on both sides of the face at one-month intervals, followed by topical PRP treatment on one side of the face and topical insulin on the other. Two non-treating dermatologists used the Acne Scar Assessment Scale (ASAS) to assess the outcome. At their last follow-up appointment, patients were asked to assess their improvement on each side of the face in a percentage from 0 to 100%. Prior to treatment, there was no difference in the ASAS scores between the two sides of the face. One month after the last treatment session, ASAS scores improved significantly on both sides of the face. No significant difference (p = 0.794) between both sides were detected. Both techniques helped to improve atrophic acne scars and may have a synergistic outcome regarding efficacy and safety.
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Affiliation(s)
- Mahmoud A Rageh
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
| | - Emad M Elrewiny
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed S Kadah
- Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, New Damietta, Egypt
| | - Hazem B Zakaria
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Abdelshakour
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Sara M Mohy
- Department of Dermatology, Faculty of Medicine, Misr University for Science and Technology (MUST), Giza, Egypt
| | - Waleed Ahmed Mahmoud
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed A Suliman
- Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Lee JH, Yoo JH, Ko JH, Song WJ, Kwon MJ, Park YS, Lee YH, Lee MC. Clinical efficacy of the fractional ablative CO 2 laser stacking method for depressed scars. Lasers Med Sci 2025; 40:65. [PMID: 39907810 DOI: 10.1007/s10103-025-04332-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 01/30/2025] [Indexed: 02/06/2025]
Abstract
Depressed scars, which are unsightly outcomes of trauma or skin lesions, can lead to significant physical and mental stress. Various treatments have been developed to alleviate these burdens, among which the laser stacking method has proven effective. In this study, we compared the outcomes of laser stacking treatments with those of single-pulse ablative laser treatments for depressed scars. Eighty patients with depressed scars were divided into two therapeutic groups: the ablative laser stacking therapy group (Group 1, n = 40) and the single pulse ablative laser therapy group (Group 2, n = 40). The scars were evaluated using the modified Vancouver Scar Scale (mVSS) before and after treatment. Patient-completed questionnaires were also utilized. Comparative analyses were conducted both before and after treatment, as well as between the two groups. Eighty scars from each patient underwent the complete laser treatment protocols. Group 1 showed significantly greater improvement in the mVSS indices for pigmentation, vascularity, pliability, and height than group 2 (P < 0.05). In terms of patient-reported outcomes, group 1 rated better than group 2 across three indices: appearance, alleviation of concavity, and overall improvement (P < 0.05). Ablative laser stacking therapy effectively alleviated depressed scars, demonstrating significant improvement in both observer- and patient-reported outcomes. An energy level of 20-30 mJ was employed, resulting in more favorable outcomes compared to a single pulse laser application of 10-15 mJ. Our findings highlight the benefits of the stacking method, which shows notable improvements while minimizing complications. Further research involving various protocols may optimize clinical outcomes and patient satisfaction.
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Affiliation(s)
- Jung Hwan Lee
- Hangangsoo Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Jung Hwan Yoo
- Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jang Hyu Ko
- Hangangsoo Hospital, Seoul, Republic of Korea
| | | | - Min Ju Kwon
- Hangangsoo Hospital, Seoul, Republic of Korea
| | | | - Yun Hae Lee
- Hangangsoo Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Myung Chul Lee
- Konkuk University Medical Center, Seoul, Republic of Korea.
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Peng H, Ran X, Yang X, Zhou G, Lin X, Shen L, Wu X. Efficacy of a Combination Treatment of Ablative Fractional Carbon Dioxide Laser Therapy and Recombinant Human Epidermal Growth Factor for Atrophic Acne Scars. J Cosmet Dermatol 2024; 23:3986-3992. [PMID: 39212099 PMCID: PMC11626307 DOI: 10.1111/jocd.16552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Atrophic acne scars (AAS) are disfiguring and permanent changes caused by inflammatory acne. Fractional carbon dioxide is a common ablative device used to treat this condition. However, issues such as unclear effectiveness, frequent treatments, and potential side effects exist. In recent years, recombinant human epidermal growth factor (rhEGF) has also been frequently reported for its application in the treatment of acne scars. OBJECTIVE To explore the potential synergistic effect of fractional carbon dioxide laser combined with rhEGF in AAS treatment. METHODS We enrolled 15 patients with AAS. They received fractional carbon dioxide laser treatment and were then randomly assigned to receive either rhEGF or a placebo on one side of the face. The procedure was repeated three times, and the results were evaluated using the échelle d'évaluation clinique des cicatrices d'acné (ECCA) score and analyzed using the CBS camera system, 3D analysis (3DMD). Reflectance confocal microscopy (RCM) examination was also conducted. RESULTS Both sides exhibited significant improvement in the appearance of the acne scars after treatment, as confirmed by the ECCA score, 3DMD data, and CBS texture score. On the rhEGF-treated side, the pore number and epidermal pigment area significantly improved as compared to the control side, whereas no significant differences were observed in the other data. Under RCM, a significant increase in epidermal thickness and appearance of reticular collagen fibers in the dermal layer after treatment was observed. CONCLUSION Compared to the sole use of laser, the combination of fractional carbon dioxide laser and rhEGF does not significantly enhance scar therapeutic effects. However, it does shorten the recovery period after laser treatment and improves the pore appearance.
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Affiliation(s)
- Hao Peng
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Oral and Maxillofacial‐Head and Neck Oncology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Center of Head and Neck Oncology Clinical and Translational ScienceShanghaiChina
| | - Xuehui Ran
- Department of Oral and Maxillofacial‐Head and Neck Oncology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Center of Head and Neck Oncology Clinical and Translational ScienceShanghaiChina
| | - Xia Yang
- Department of Oral and Maxillofacial‐Head and Neck Oncology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Center of Head and Neck Oncology Clinical and Translational ScienceShanghaiChina
| | - Guoyu Zhou
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Oral and Maxillofacial‐Head and Neck Oncology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Center of Head and Neck Oncology Clinical and Translational ScienceShanghaiChina
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Lingyue Shen
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Oral and Maxillofacial‐Head and Neck Oncology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Center of Head and Neck Oncology Clinical and Translational ScienceShanghaiChina
| | - Xianglei Wu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Wang J, Huang L, Li J, Xu R, Guo T, Huang T, Wu Y, Yang Y, Zhang J, Jiang F, Liu H, Liang L, Wang L. Efficacy and safety of sequential treatment with botulinum toxin type A, fractional CO2 laser, and topical growth factor for hypertrophic scar management: a retrospective analysis. Sci Rep 2024; 14:27233. [PMID: 39516539 PMCID: PMC11549097 DOI: 10.1038/s41598-024-78094-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 10/28/2024] [Indexed: 11/16/2024] Open
Abstract
Hypertrophic scars arise from aberrant wound healing and can lead to functional and aesthetic impairments. One of the common interventions for treating hypertrophic scars is fractional carbon dioxide (CO2) laser, which employs narrow laser beams to stimulate dermal collagen deposition. Recent studies and reports have suggested that combining laser therapy with other interventions such as botulinum toxin type A (BTX-A) and topical growth factors may enhance treatment outcomes. Here, we examine the efficacy and safety of a sequential combination of BTX-A, fractional CO2 laser, and topical growth factors, referred to as combined therapy, for treating hypertrophic scars compared with only using fractional CO2 laser and topical growth factors, referred to as monotherapy. Our retrospective study includes 128 patients with hypertrophic scars (56 underwent monotherapy and 72 underwent combined therapy), which were followed-up for up to 15 months after the initiation of treatment to collect demographic and clinical data. Our analysis showed that the combined therapy significantly outperformed monotherapy in improving Vancouver scar scale scores (P < 0.05) and in the reduction of scar thickness (P < 0.05), without increasing adverse complications. Repeated treatments further augmented the efficacy of the combined therapy. Subgroup analysis revealed that combined therapy was notably more effective in reducing Vancouver scar scale scores and scar thickness in early-stage scars compared to late-stage (P = 0.023 and P = 0.045, respectively). Our study suggests that including BTX-A treatment before fractional CO2 laser and topical growth factors offers superior efficacy in reducing hypertrophic scars. We encourage early intervention and repeated treatments for optimal treatment outcomes.
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Affiliation(s)
- Jin Wang
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Lijun Huang
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Juan Li
- Pingluo County People's Hospital, Shizuishan, 753400, China
| | - Rui Xu
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Tao Guo
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Tong Huang
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Yanping Wu
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China
| | - Yang Yang
- Ningxia Medical University, Yinchuan, 750001, China
| | - Jiale Zhang
- Ningxia Medical University, Yinchuan, 750001, China
| | - Feng Jiang
- Department of Genetics, Stanford University , Stanford, 94304, USA
| | - Huan Liu
- Department of Medicine, Aab Cardiovascular Research Institute, University of Rochester School of Medicine and Dentistry, Rochester, 14620, USA
| | - Li Liang
- Department of Laser, General Hospital of Ningxia Medical University, Yinchuan, 750001, China.
| | - Lei Wang
- Department of Vascular Surgery, General Hospital of Ningxia Medical University, 99 Fuan East Ln, Yinchuan, 750001, Ningxia Huizu, China.
- Department of Vascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, China.
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Ding Z, Pan Z, Tang Y, Wang S, Hua H, Hou Z, Zhou B. Effectiveness and safety of the modified multiple mode procedures versus traditional multiple mode procedures on treating facial atrophic acne scars: a propensity score matching retrospective cohort study. Lasers Med Sci 2024; 39:260. [PMID: 39425801 DOI: 10.1007/s10103-024-04211-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 10/10/2024] [Indexed: 10/21/2024]
Abstract
Multiple mode procedures (MMP) of fractional CO2 laser provide higher efficacy and shorter downtime in treating acne scars, compared to traditional fractional CO2 laser therapy. This study aims to evaluate the effectiveness and safety of modified MMP integrated with fractional microneedle radiofrequency (FMR), ultra-pulse CO2 laser and fractional CO2 laser in treating acne scars. A retrospective analysis of 162 acne scar patients treated with MMP or modified MMP was conducted. Acne scars were evaluated using the Echelle d'Evaluation Clinique des Cicatrices d'Acné (ECCA) grading scale, modified Manchester Scar Scale (mMSS), and Global Assessment Scale (GAS). Baseline variables were balanced with propensity score matching (PSM) to improve the comparability of treatment effectiveness and safety between groups. Among 162 patients with facial acne scars, 68 were treated with modified MMP and 94 with traditional MMP. After PSM, both groups had 55 patients with comparable baseline characteristics (P > 0.05). The ECCA score decreased more significantly in the modified MMP group (60%±11%) than in the MMP group (45%±16.6%, P < 0.001). The modified MMP group also had higher mMSS color score (2.6 ± 0.7 vs. 2.1 ± 0.9, P = 0.005), greater reduction in pore size and skin laxity (P < 0.001), shorter postoperative erythema duration (22.2 ± 4.0 vs. 31.3 ± 3.7 days, P < 0.001), but higher pain scores (Visual Analogue Scale, VAS: 6.7 ± 1.6 vs. 3.8 ± 0.8, P < 0.001). Modified MMP is more effective than traditional MMP in treating acne scars, especially for patients with large pores and skin laxity.
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Affiliation(s)
- Ziwei Ding
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhonglan Pan
- Nanjing Yijia Medical Aesthetic Clinic, Nanjing, China
| | - Yanqiu Tang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Sihui Wang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hui Hua
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Zuoqiong Hou
- Department of Plastic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Hua H, Li M, Zhai X, Zhou S, Pan Z, Hou Z, Zhou B. Sleep quality correlates with effectiveness of ultrapulse fractional CO 2 laser in the treatment of facial atrophic acne scars. J Dermatol 2024; 51:1120-1124. [PMID: 38292007 DOI: 10.1111/1346-8138.17112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/22/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024]
Abstract
Ultrapulse fractional CO2 laser is effective for acne atrophic scars. Whether this effectiveness is affected by sleep quality remains unclear. Aiming to investigate the relationship between sleep quality and postoperative effectiveness, a retrospective clinical study was conducted, enrolling 83 patients with atrophic acne scar. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire at 3 months after the end of the first treatment. The ECCA (échelle d'évaluation clinique des cicatrices d'acné) scale was used to evaluate the clinical effectiveness before and at 3 months after treatment. The patients were divided into a mild to moderate improvement group and a good to excellent improvement group, based on whether they achieved a 50% ECCA improvement rate. PSQI score was higher in the mild and moderate improvement group than in the good to excellent improvement group (7.6 ± 4.5 vs 3.8 ± 1.7, p < 0.001). Multivariate logistic regression showed that both PSQI score (odds ratio = 0.6 [95% CI = 0.5-0.8], p < 0.001) and scar type were correlated with postfractional CO2 laser effectiveness. Pearson correlation analysis suggested that PSQI score was negatively correlated with ECCA decline score (r = -0.6139, p < 0.0001). Receiver operating characteristic curve analysis showed that PSQI score (area under the curve = 0.759) and scar type (area under the curve = 0.737) were all closely correlated with postoperative effectiveness, without statistical difference between their accuracies (p = 0.647). Decision curve analysis demonstrated that both PSQI score and scar type correlated with postoperative effectiveness. Our results demonstrated that sleep quality correlates with the postoperative effectiveness of ultrapulse fractional CO2 laser in the treatment of atrophic acne scars.
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Affiliation(s)
- Hui Hua
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Min Li
- Department of Integrated Chinese and Western Medicine, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Xiaoyu Zhai
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Shu Zhou
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Zhonglan Pan
- Nanjing Yijia Medical Aesthetic Clinic, Nanjing, China
| | - Zuoqiong Hou
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Li J, Duan F, Kuang J, Liu X, Wei J, Zhao J. Clinical factors influencing the effectiveness of microplasma fractional radiofrequency treatment for atrophic acne scars: A retrospective analysis. J Cosmet Dermatol 2024; 23:2433-2442. [PMID: 38532647 DOI: 10.1111/jocd.16298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Microplasma fractional radiofrequency (MP FRF) technology has been increasingly used for acne scars. Nevertheless, little evidence has analyzed the factors influencing its effectiveness before and during treatment. AIMS To evaluate the clinical factors affecting the effectiveness of MP FRF therapy for atrophic acne scars. METHODS We analyzed retrospectively the clinical data of 79 acne scar patients treated with MP FRF technology. The outcome of interest included the effectiveness and adverse events after MP FRF treatment. Multivariable logistic regression was utilized to evaluate clinical factors associated with effectiveness after the initial session. RESULTS All patients received 115 sessions of MP FRF therapy (average: 1.5 sessions). Twenty-eight (35.4%) patients improved moderately to excellently after one session. We found that the severe grade before treatment was negatively correlated with the effectiveness according to Goodman-Baron qualitative scores (OR = 0.02, 95% CI [0.001, 0.37], p = 0.009). The presence of icepick scars was also a negative correlation factor for the effectiveness (OR = 0.06, 95% CI [0.004, 1.00], p = 0.049). Furthermore, after excluding the effects of icepick scars and Goodman-Baron scores before treatment, ECCA scores were also correlated with effectiveness (OR = 1.04, 95% CI [1.01, 1.06], p = 0.009). CONCLUSION MP FRF therapy was effective in treating atrophic acne scars with no permanent adverse events. The severity of Goodman-Baron qualitative scores and icepick scars were independent clinical factors affecting effectiveness, suggesting the possible requirement for additional treatments other than MP FRF for severe acne scars and icepick scars.
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Affiliation(s)
- Jing Li
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Fangfang Duan
- Fourth Medical College of Peking University, Beijing, China
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Jie Kuang
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Xiao Liu
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Jia Wei
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Jinghui Zhao
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
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Sun Y, Chen S, Zhang Y, Qi X, Guo D, Feng B, Qi R, Wu Y, Gao X. Filament coating system assists recovery of ablative fCO 2 laser treatment: A split-face clinical observation. J Cosmet Dermatol 2024; 23:1629-1637. [PMID: 38192154 DOI: 10.1111/jocd.16169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND The current nursing procedure after fractional carbon dioxide (fCO2) is complex and needs to be optimized. The present study was conducted to evaluate the assisting effect of filament coating system after fCO2 laser treatment. METHODS Chinese individuals aged from 18 to 65 years diagnosed as photoaging or atrophic acne scar were recruited and each participant was treated with one single pass of fCO2 laser. A split face was randomly assigned as treatment side or control side. For control side, conventional procedure was topically applied respectively, including desonide cream two times for 3 days, fusidic acid cream two times for 7 days, and recombinant human epidermal growth factor (RhEGF) gel four times for 7 days; for treating side, a filament coating system was applied immediately after one application of fusidic acid cream, desonide cream and RhEGF, and removed 3 h later, for 3 days. Erythema, edema, crust, and pain on both sides were scored from 0 to 10 before and 1, 2, 4, and 7 days after fCO2 laser treatment. Stratum corneum hydration (SCH) and sebum of forehead and cheek on both sides were also measured by using Corneometer-Sebumeter. RESULTS Twenty photoaging and 11 atrophic acne scar participants finished the observation. All of them complained of erythema, edema, crust, and pain after fCO2 laser treatment, and the scores decreased as time passed by. There were no statistical significances of erythema, edema, crust, pain, SCH, and sebum between treating side and control side at each observation time. CONCLUSION Filament coating system was effective, safe, convenient, and economic in assisting recovery of ablative fCO2 laser, which might be a new option for additional nursing procedure.
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Affiliation(s)
- Yan Sun
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - ShuYan Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - Ying Zhang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - Xin Qi
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - DeChao Guo
- Department of General Surgery, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Bo Feng
- Liaoning Yanyang Medical Equipment Co., LTD, Shenyang, China
| | - RuiQun Qi
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - Yan Wu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
| | - XingHua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Immunodermatology, Ministry of Education Key Laboratory of Immunodermatology, National Joint Engineering Research Center for Diagnosis and Treatment of Immunologic Skin Diseases, The First Hospital of China Medical University, Shenyang, China
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Ding Z, Guo Y, Guo Y, Tang Y, Yin X, Hua H, Zhou Z, Zhou B. Efficacy and safety of fractional microneedle radiofrequency for atrophic acne scars: A real-world clinical study of 126 patients. Lasers Surg Med 2024; 56:150-164. [PMID: 38282120 DOI: 10.1002/lsm.23759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To analyze the clinical efficacy and safety of fractional microneedle radiofrequency (FMR) for facial atrophic acne scars in a real-world setting. METHODS The clinical data of patients with atrophic acne scars who had received FMR therapy from February 2018 to August 2022 were retrospectively analyzed. The improvement of atrophic acne scars was assessed using the ECCA Grading Scale (échelle d'évaluation clinique des cicatrices d'acné), Global Aesthetic Improvement Scale (GAIS), and modified Manchester Scar Scale (mMSS). Adverse reactions during FMR treatment were also recorded. Univariate and multivariate logistic regression analyses were performed to evaluate the efficacy and safety of FMR for atrophic acne scars. RESULTS A total of 126 patients with facial atrophic acne scars were included. A total of 590 FMR treatment sessions were accomplished, with each of 82 patients receiving 4 or more treatment sessions, and 1 receiving a maximum of 14 sessions. All patients showed improvement in symptoms after FMR treatment, with moderate to significant improvement (ECCA score reduction of 26%-100%) in 92 (73.0%) patients. As the number of treatment sessions increased, the ECCA score gradually decreased from an average of 85.6 before to 35.0 after FMR. The average scores for distortion, color, and visual analogue scale (VAS) of mMSS all showed certain reductions. The change in GAIS score indicated improvement after treatment, with minimal improvement in 16 patients (12.7%), good improvement in 57 patients (45.2%), significant improvement in 45 patients (35.7%), and optimal improvement in 8 patients (6.4%). The univariate and multivariate logistic regression analyses revealed that the long pulse width and the number of FMR treatment sessions were positively associated with clinical efficacy. Compared to the short pulse-width group (200 ms), the longer pulse-width group (300 ms) (odds ratio [OR] = 8.3, p = 0.003) and the even longer pulse-width group (400-500 ms) (OR = 52.6, p < 0.001) demonstrated stronger efficacies. Patients who received more than three treatment sessions had better outcomes compared to those who received three or fewer treatment sessions (OR = 4.0, p = 0.036). All patients experienced posttreatment transient erythema, but no crusting, infection, or blister. Six cases developed grid-like erythema around 1 month posttreatment and one case experienced hyperpigmentation, both of which resolved within 1-3 months after appropriate management. CONCLUSION FMR is a safe and effective treatment modality for improving facial atrophic acne scars, and the number of FMR treatment sessions and pulse width are associated with clinical efficacy.
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Affiliation(s)
- Ziwei Ding
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Cosmetic Dermatology, Dr. Zhou's Cosmetic Dermatological Clinic, Nanjing, China
| | - Yuan Guo
- Department of Cosmetic Dermatology, Dr. Zhou's Cosmetic Dermatological Clinic, Nanjing, China
| | - Yuehong Guo
- Department of Cosmetic Dermatology, Dr. Zhou's Cosmetic Dermatological Clinic, Nanjing, China
| | - Yanqiu Tang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xufeng Yin
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Hua
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, China
| | - Zhanchao Zhou
- Department of Cosmetic Dermatology, Dr. Zhou's Cosmetic Dermatological Clinic, Nanjing, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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10
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Kim EY, Wong JH, Hussain A, Khachemoune A. Evidence-based management of cutaneous scarring in dermatology part 2: atrophic acne scarring. Arch Dermatol Res 2023; 316:19. [PMID: 38059974 DOI: 10.1007/s00403-023-02737-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 12/08/2023]
Abstract
Atrophic acne scars are the most common type of acne scars and are classified into three main types: icepick, boxcar, and rolling scars. Various procedures and techniques for atrophic acne scarring are discussed in detail, with stronger evidence-based support for lasers (non-fractional, fractional, ablative, and non-ablative), platelet-rich plasma as adjunctive treatment, chemical peels (glycolic acid, trichloroacetic acid, and Jessner's solution), dermal fillers such as hyaluronic acid, and microneedling, and lesser quality evidence for microdermabrasion, subcision, and lipoaspirate grafting. Further research is needed to optimize treatment protocols, assess the efficacy of monotherapies, and establish standardized guidelines for clinicians. This paper will provide a comprehensive review of the evidence-based management of atrophic acne scars, including currently commonly utilized therapies as well as more innovative treatment options.
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Affiliation(s)
- Emily Y Kim
- Georgetown University School of Medicine, Washington, DC, USA
| | - Jasmine H Wong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Aamir Hussain
- Galaria Plastic Surgery and Dermatology, LLC, Chantilly, VA, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, SUNY Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA.
- Department of Dermatology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
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11
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Won P, Cooper M, Justin Gillenwater T, Yenikomshian HA. Treatment of Hypertrophic Burn Scars With Laser Therapy: A Review of Adverse Events. Ann Plast Surg 2023; 91:715-719. [PMID: 37856225 PMCID: PMC10840736 DOI: 10.1097/sap.0000000000003712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
ABSTRACT Hypertrophic scarring, characterized by excessive scar tissue formation, is a debilitating outcome that significantly impairs physical and psychosocial recovery after burn injury. Hypertrophic scarring affects a substantial proportion of burn survivors, with reported prevalence as high as 70%. Fractional CO 2 laser (FCL) therapy, a therapy commonly used in acne scar treatment or skin rejuvenation, has become popular in treating hypertrophic scars. Little is known regarding FCL's adverse events for burn scar treatment. We hypothesize that FCL is a safe treatment modality with minimal adverse events in the management of hypertrophic burn scars. This is a retrospective chart review of adverse events after FCL at 2 centers within a single institution. Burn patients undergoing FCL between May 1, 2019, and June 1, 2021 were included. Demographics, injury etiology, laser treatment details, and adverse events were collected. A total of 170 patients, 77 (45.3%) males and 93 (54.7%) females, underwent 544 FCL therapies for burn scars. The average number of treatments per patient was 3 ± 2.23, with a range of 1 to 17 sessions. From the total 544 laser therapy sessions, 13 adverse events (2.4%) were reported. There were 5 reports (0.9%) of increased postprocedural pain and 1 report (0.2%) of increased paresthesia/numbness to laser site. Three instances (0.6%) of increased erythema and 4 reports (0.7%) of epidermal sloughing or blistering were reported. All but 5 patients (2.9%) reported improvements to scar symptoms. This study demonstrates minimal adverse events associated with FCL for hypertrophic burn scar treatment.
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Affiliation(s)
- Paul Won
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael Cooper
- LAC+USC Hospital, University of Southern California, Los Angeles, CA, USA
| | - T. Justin Gillenwater
- Division of Plastic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Haig A. Yenikomshian
- Division of Plastic Surgery, University of Southern California, Los Angeles, CA, USA
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12
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Chen Q, Li L, Song ZQ, Ge L. CO 2 laser combined with ALA-PDT for successful treatment of refractory acne vulgaris: A case report. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:527-528. [PMID: 37073672 DOI: 10.1111/phpp.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/20/2023]
Affiliation(s)
- Qin Chen
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China
| | - Ling Li
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China
| | - Zhi-Qiang Song
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China
| | - Lan Ge
- Department of Dermatology, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China
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13
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Li X, Fan H, Wang Y, Sun C, Yang X, Ma X, Jiao J. Fractional carbon dioxide laser combined with subcision for the treatment of three subtypes of atrophic acne scars: a retrospective analysis. Lasers Med Sci 2023; 38:195. [PMID: 37639055 DOI: 10.1007/s10103-023-03851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023]
Abstract
Fractional carbon dioxide (CO2) laser combined with subcision has been widely used for the clinical treatment, but the efficacy of the combined therapy on three types of atrophic acne scars remains unreported. This retrospective study analyzed the clinical data of 413 patients with atrophic acne scars, treated with fractional CO2 laser combined with subcision in the combined group and with fractional CO2 laser in the control group. The treatment efficacy was evaluated by the Investigator's Global Assessment (IGA) and the Échelle d'évaluation clinique des cicatrices d'acné (ECCA). We reported adverse reactions such as erythema, lump, skin sensitivity, acne recurrence, and hyperpigmentation that occurred in both treatment groups. The treatment efficiency of the combined group was significantly higher than that of the control group (P < 0.001). Among the three subtypes of atrophic acne scars, the ECCA scores in the combined group of boxcar-type and rolling-type scars after treatment were lower than those in the control group (P = 0.041, P < 0.001, respectively), and no statistical difference in scores between the two groups for icepick-type scars was seen (P = 0.062). There was no statistical difference in adverse reactions between the two groups (P = 0.361). Fractional CO2 laser combined with subcision is more effective than fractional CO2 laser in the treatment of boxcar-type and rolling-type scars, but there is no significant difference in the treatment of icepick-type scars.
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Affiliation(s)
- Xiangying Li
- Department of Dermatology, Jinan Central Hospital, Shandong University, Jinan, China
| | - Huiping Fan
- Department of Dermatology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yan Wang
- Department of Dermatology, Jinan Central Hospital, Shandong University, Jinan, China
| | - Chao Sun
- Department of Dermatology, Jinan Central Hospital, 105 Jiefang Street, Jinan, 250013, China
| | - Xi Yang
- Department of Dermatology, Jinan Central Hospital, 105 Jiefang Street, Jinan, 250013, China
| | - Xiaoli Ma
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, China
| | - Jing Jiao
- Department of Dermatology, Jinan Central Hospital, 105 Jiefang Street, Jinan, 250013, China.
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14
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Pan Z, Tang Y, Hua H, Hou Z, Zhou B. "Multiple Mode Procedures" of Ultra-Pulse Fractional CO 2 Laser: A Novel Treatment Modality of Facial Atrophic Acne Scars. J Clin Med 2023; 12:4388. [PMID: 37445422 DOI: 10.3390/jcm12134388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND AND AIM Fractional CO2 laser is therapeutic for acne atrophic scar, but its effect usually is limited after multiple sessions, with occasional adverse reactions. This study aimed to evaluate the efficacy and safety of a new modality combining ultra-pulse CO2 laser and fractional CO2 laser (multiple mode procedures [MMP]) in the treatment of acne atrophic scars. METHOD From December 2017 to January 2023, a total of 103 patients with facial acne atrophic scars treated with MMP technique were retrospectively analyzed. MMP was performed for 1-4 sessions with an interval of approximately three months. Based on photographs taken before and after treatment, overall atrophic scar improvement was assessed according to the ECCA grading scale, the modified Manchester Scar Scale and the 4-point Global Assessment Scale (GAS). The safety was evaluated by the degree of pain during treatment and postoperative adverse reactions. RESULTS All the 103 patients received treatment and completed follow-up, with an average of two sessions. The mean ECCA score decreased from 162.7 to 93.1 with statistically significant difference (p < 0.001). The mean GAS score increased by an average of 2.3 ± 0.9. The GAS improvement more evident for "boxcar" atrophic scars (2.7 ± 0.8) than for "rolling" (2.3 ± 0.8) and "icepick" scars (1.7 ± 0.8) (p < 0.001). The average improvement scores for color, distortion and texture were 2.0 ± 0.9, 2.2 ± 0.9 and 2.3 ± 0.8, respectively. The mean pain score during treatment was 3.9 ± 0.8, and the mean duration of erythema was 30.7 ± 3.5 days. Only three patients developed hyperpigmentation at the treated site within a few months. DISCUSSION Ultra-pulse CO2 fractional laser MMP technique can effectively improve the condition of facial atrophic acne scars with limited adverse reactions.
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Affiliation(s)
- Zhonglan Pan
- Nanjing Yijia Medical Aesthetic Clinic, Nanjing 210029, China
| | - Yanqiu Tang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hui Hua
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong 226000, China
| | - Zuoqiong Hou
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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15
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Yusharyahya SN, Japranata VV, Sitohang IBS, Legiawati L, Novianto E, Suseno LS, Rachmani K. A Comparative Study on Adipose-Derived Mesenchymal Stem Cells Secretome Delivery Using Microneedling and Fractional CO 2 Laser for Facial Skin Rejuvenation. Clin Cosmet Investig Dermatol 2023; 16:387-395. [PMID: 36798539 PMCID: PMC9926994 DOI: 10.2147/ccid.s401839] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023]
Abstract
Background The efficacy of adipose-derived mesenchymal stem cells (ADMSCs) secretome for skin aging has been established, yet no studies hitherto directly investigated the best administration method for such purpose. Purpose We aimed to compare microneedling (MN) versus fractional CO2 laser (FL) as methods of delivery for ADMSCs secretome in the treatment of aging skin. Patients and Methods A single-blind, randomized split-face clinical trial was conducted on 30 Indonesian women (aged 35-59 years old) with signs of facial cutaneous senescence. Their initial aging status was assessed by dermoscopy photoaging scale (DPAS) and Janus-III measurement system. In the second and fourth weeks, all participants were treated with both MN and FL, followed by the application of a four-fold concentrated ADMSC secretome. The assignment of which side of the face received MN or FL was done by computer-based randomization. Skin parameters were reevaluated on the fourth and sixth weeks, along with patient satisfaction, level of comfort, preference for administration techniques, and also adverse events experienced during the study. Appropriate statistical analyses were subsequently performed at a significance level of 0.05. Results Significant improvements in total DPAS and wrinkles were found in the MN and FL groups at the end of the trial. In contrast, no statistical differences in all parameters were observed between groups in the fourth and sixth weeks. FL scored higher than MN for satisfaction and preference, but lower in terms of comfort. Pain, burning sensation, and itch were the side effects experienced by subjects upon treatment. Two patients had prolonged reddish skin succeeding FL treatment, which relieved with moisturizer application. Conclusion Both MN and FL yielded comparable results for improving several skin aging features. However, subjective preference for ADMSCs secretome administration method may differ when considering satisfaction, comfort, and possible adverse events.
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Affiliation(s)
- Shannaz Nadia Yusharyahya
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia,Correspondence: Shannaz Nadia Yusharyahya, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jalan Diponegoro Nomor 71, Kenari, Senen, Jakarta Pusat, 10430, Indonesia, Tel/Fax +62 21 31935383, Email
| | | | - Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Lili Legiawati
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Endi Novianto
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Lis Surachmiati Suseno
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Karin Rachmani
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
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Nobari NN, Tabavar A, Sadeghi S, Dehghani A, Kalantari Y, Ghassemi M, Atefi N, Goodarzi A. A systematic review of the comparison between needling (RF-needling, meso-needling, and micro-needling) and ablative fractional lasers (CO 2, erbium YAG) in the treatment of atrophic and hypertrophic scars. Lasers Med Sci 2023; 38:67. [PMID: 36749436 DOI: 10.1007/s10103-022-03694-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/08/2022] [Indexed: 02/08/2023]
Abstract
The aim of this study is to compare needling (RF-needling, meso-needling, micro-needling) and ablative fractional lasers (CO2, erbium-YAG) in the treatment of atrophic and hypertrophic scars in a systematic review. The database was searched, and 10 articles were selected that were relevant in terms of content, topic, and purpose and met the inclusion criteria. Of all the articles reviewed in this study, there were 2 randomized split-face trials (20%), 1 controlled nonrandomized trial (10%), 1 controlled randomized phase III clinical trial (10%), 1 prospective trial (10%), 1 prospective nonrandomized open-label trial (10%), and 1 randomized comparative trial (10%), with the type of study not reported in 3 articles. We used Endnote X8 to review the articles and extract data. After review, the studies were analyzed and categorized. No statistically significant difference was found between the two methods, laser and micro-needling, in the treatment of atrophic and hypertrophic scars in 60% of the articles studied, and both showed significant improvement (70% or more improvement to complete response). Significant improvement was noted in 20% of the studies reviewed for the laser and micro-needling treatment methods. The results of this study show that needling and ablative fractional lasers are tolerable and safe procedures with no significant difference in the treatment of skin scars in sixty percent of the studies.
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Affiliation(s)
- Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Anahita Tabavar
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Sadeghi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Division of Dermatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Abbas Dehghani
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ghassemi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Najmolsadat Atefi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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17
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Ren K, Liu H, Li B, Zhou B. Fractional microneedle radiofrequency treatment for enlarged facial pores: A real-world retrospective observational study on 75 patients. J Cosmet Dermatol 2022; 21:6742-6753. [PMID: 36038248 DOI: 10.1111/jocd.15339] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study aimed to analyze the clinical results and influencing factors of the fractional microneedle radiofrequency (FMR) treatment for enlarged facial pores on different facial sites. METHODS The clinical data of patients with enlarged facial pores who underwent FMR treatment from January 2019 to December 2020 were collected. The efficacy and complications of FMR for enlarged pores in different facial areas were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to explore the clinical factors related to the efficacy of FMR after the first treatment session. RESULTS Totally, 75 patients with enlarged facial pores were included (full-face FMR for 45, nasal FMR for 58, frontal FMR for 45, and cheek FMR for 72 patients). All patients received more than one treatment session, two patients received five treatment sessions, and the mean number of FMR session was 1.7. The moderate to excellent improvement rates in patients with nasal, frontal and cheek enlarged pores after the first session were 13.8%, 8.9%, and 11.1%, respectively. The improvement rate rose with the increasing number of treatment sessions. Multivariate logistic regression analysis revealed that long pulse-width (300 ms) was positively associated with clinical efficacy after the first session (OR = 22.4, 95% CI [2.0-250.4], p = 0.012), compared with the short pulse-width group (100-200 ms). The main adverse effects after FMR were transient pain, erythema, and edema. A minority of patients developed acneiform eruption. CONCLUSION This study confirms that FMR is safe and effective in improving enlarged facial pores. The pulse width is associated with the improvement of nasal enlarged pores.
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Affiliation(s)
- Kehui Ren
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Houfang Liu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Dermatology, The Fourth people's Hospital of Zhenjiang, Zhenjiang, China
| | - Bingyan Li
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of cosmetic dermatology, Friendship Plastic Surgery Hospital, Nanjing Medical University, Nanjing, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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