35101 Combination treatment of transdermal micro-jet using Er:YAG laser and ablative fractional 10,600-nm carbon dioxide laser for acne scar

Abstract

Background: Various treatment modalities have been used to treat acne scars. Transdermal micro-jet using Er:YAG laser is a new concept called TDDS (Trans-Dermal Drug Delivery System) that sprays small amounts of drugs into the dermis without needles. Carbon dioxide (CO2) fractional laser is one of the most effective and commonly used tool for acne scar. This study aimed to evaluate the efficacy and safety of combination therapy transdermal micro-jet using Er:YAG laser and CO2 fractional laser for acne scar. Materials and methods: Fourteen patients with acne scars were treated 3 sessions of combining transdermal micro-jet using Er:YAG and CO2 fractional laser with 3∼4 week interval. Patients treated with a spot size of 4 mm, fluence of 2.0∼4.8 J/cm2 was performed by transdermal micro-jet using Er:YAG laser. Then CO2 fractional laser was performed. A punch biopsy was performed before and after treatment in 4 patients for histologic analysis. Clinical photographs were obtained before treatment and at follow-up. Two blinded dermatologists assessed the clinical improvement in terms of acne scar using a quartile grading scale. Results: All patients experienced both subjective and objective improvement. The patient satisfaction surveys showed that 12 patients (85.7%) perceived a moderate to excellent improvement (>50%) in their condition. No adverse reactions were reported. Histopathologic evaluation with hematoxylin and eosin staining showed new collagen generation in the dermis. Conclusion: Our preliminary findings suggest a safe therapeutic alternative for acne scars.