Background and aim: Subcision is a procedure that has been reported to be beneficial in treatment of ACNE SCARs. The objective of this trial was to assess the efficacy of subcision in the treatment of rolling ACNE SCARs and evaluate a novel subdermal filler" absorbable plain catgut suture" with subcision.Materials and methods: 22 patients with rolling ACNE SCARs underwent subcision, 20 of whom completed treatment and follow-up period. One side of the face underwent subcision and another side subcision with subdermal implant. The patients and investigators' assessments of improvement were both recorded.Results: Subcision showed mild improvement in about 60% of patients and moderate improvement in about 40% of them. The rate of response showed no significant difference with the use of subdermal implant. The side effects of local edema, bruising, and infections were all transient.Conclusion: Subcision appears to be a safe method to correct the rolling ACNE SCARs with long term improvement. However, the subdermal implant led to no significant superior results.

BACKGROUND: ACNE SCARring is treatable by a variety of modalities. Ablative carbon dioxide laser (ACL), while effective, is associated with undesirable side effect profiles. Newer modalities using the principles of fractional photothermolysis (FP) produce modest results than traditional carbon dioxide (CO2) lasers but with fewer side effects. A novel ablative CO2 laser device use a technique called ablative fractional resurfacing (AFR), combines CO2 ablation with a FP system. This study was conducted to compare the efficacy of Q-switched 1064-nm Nd: YAG laser and that of fractional CO2 laser in the treatment of patients with moderate to severe ACNE SCARring.METHODS: Sixty four subjects with moderate to severe facial ACNE SCARs were divided randomly into two groups. Group A received Q-Switched 1064-nm Nd: YAG laser and group B received fractional CO2 laser. Two groups underwent four session treatment with laser at one month intervals. Results were evaluated by patients based on subjective satisfaction and physicians’ assessment and photo evaluation by two blinded dermatologists. Assessments were obtained at baseline and at three and six months after final treatment.RESULTS: Post-treatment side effects were mild and transient in both groups. According to subjective satisfaction (p=0.01) and physicians' assessment (p<0.001), fractional CO2 laser was significantly more effective than Q-Switched 1064- nm Nd: YAG laser.CONCLUSIONS: Fractional CO2 laser has the most significant effect on the improvement of ATROPHIC facial ACNE SCARs, compared with Q-Switched 1064-nm Nd: YAG laser.

Introduction: ACNE SCAR is formed after severe episodes of ACNE in teen and early adult years. Several treatment options have been used for depressed ACNE SCARs such as punch grafting, punch excision carbon dioxide (CO2) laser etc. Moreover, Studies show that laser skin resurfacing such as CO2 fractional can effectively treat depressed ACNE SCARs. We investigated the efficacy of fractional CO2 laser in ACNE SCAR.Methods: In this clinical trial, we used CO2 fractional laser (Unit: eCO2 Lutronic Korea, FDA approved) in 15 female cases with an age range of 20-40 years old.They underwent 3 sessions of laser resurfacing at one month intervals. In the first session we used laser with a density of 150 and fluency of 70 with a 4mm diameter circular spot in static mode on depressed ACNE SCARs, and we exerted laser with density of 100 and fluency 70 with 12 mm diameter square spot in static mode on all involved skin in the other sessions. Photographs were taken before every process.The patients and another dermatologist filled the questionnaire concerning the percent of improvement. Finally, we compared photographs and evaluated the efficacy of CO2 fractional laser in ACNE SCARs.Results: Objective and subjective improvement was estimated about 20-70% and 30-70%, respectively, without any erythema, permanent hyperpigmentation and other adverse effects. The important point is that, participants returned back to work after 4-7 days.Conclusion: The Fractional CO2 laser resurfacing can be used as a safe and efficacious method to treat depressed ACNE SCAR.

ACNE is a very common skin disease. SCARs are seen in 95% of patients with ACNE. Although numerous treatments have been recommended to cure ACNE SCARs, researchers are still searching for a single modality to treat the complication due to its variety in shape and depth. In other words, a combination of available methods is required to reach satisfactory results. We compared the effects of fractional carbon dioxide (CO2) laser alone and in combination with subcision.Methods: This clinical trial study was performed in Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran) during 2011-12. Eligible patients with ATROPHIC ACNE SCARs were treated with fractional CO2 laser alone (five sessions with three-week interval) on right side of the face and fractional CO2 laser plus subcision (one session using both followed by four sessions of fractional CO2 laser, all with three-week intervals) on the left side. The subjects were visited one, two, and six months after the treatment. Patient satisfaction rate was analyzed by SPSS20.Findings: The average of recovery rate was 54.7% using the combination method and 43.0% using laser alone (P<0.001). The mean patient satisfaction rate according to visual analogue scale (VAS) score was significantly higher with the combination method than with laser alone (6.6 vs. 5.2; P<0.001). Bruising was only seen with the combination method and lasted for one week in 57.0% of patients and for two weeks in 43.0%. Erythema was a side effect of both methods. Post-inflammatory pigmentation and hyperpigmentation were only caused by the combination method. None of the patients had persistent side effects after six months.Conclusion: Using a combination of subcision and laser had suitable results regarding SCAR recovery and satisfaction rate. However, bruising, post-inflammatory pigmentation, and hyperpigmentation were the side effects of this method. In general, subcision plus laser can be beneficial in the treatment of ATROPHIC ACNE SCARs.

Background and Aim: ATROPHIC SCARs constitute a common complication of ACNE and various methods have been proposed for their treatment. This study aims at comparing the efficacy of fractional CO2 laser with microneedling in the management of ATROPHIC ACNE SCARs. Methods: Patients with ATROPHIC ACNE SCARs presenting to dermatology clinic of Hamadan’ s Sina hospital between March 2016 and March 2018 were included in the study. Every 3 weeks, each patient received fractional CO2 laser on one side of the face and microneedling on the other side, for a total of 4 sessions. Patient’ s satisfaction and the severity of SCARs (based on Goodman and Baron’ s SCAR scale) were assessed 1, 2 and 6 months thereafter. Results: Overall, 24 participants were included. Prior to intervention, no significant difference was observed between groups in terms of mean SCAR score (P =0. 726). At 1, 2 and 6month follow-up visits, the SCAR score of the side treated with laser was significantly lower than the microneedling side (P for 1, 2 and 6month follow-up visits: 0. 033, 0. 008 and 0. 014). No significant difference was observed between groups in terms of patient’ s satisfaction (P for 1, 2 and 6 month followup visits: 0. 589, 0. 469 and 0. 840). The most prevalent side effect was erythema in 3 patients treated with laser. Due to low prevalence, statistical analysis of side effects between groups was impossible. Conclusion: Compared to microneedling, fractional CO2 laser was more effective in reducing the SCAR score of patients. The prevalence of side effects in both treatments were low.