Efficacy of a combination approach using subcision, fillers, and fractional carbon dioxide laser for the treatment of facial acne scars in Fitzpatrick skin types IV–VI

Abstract

AbstractIntroductionAcne is one of the most common skin diseases, causing scars as a common and persistent complication. A single modality of treatment is not completely effective, and hence a combination of therapeutic modalities is required for the treatment. As the condition is very distressing in nature and leaves an impact at a psychological level, the patient often seeks quick results.AimsEfficacy of combined approach using subcision and fillers followed by fractional carbon dioxide laser for the treatment of facial acne scars in Fitzpatrick IV–VI skin types.MethodsOne hundred sixty‐five patients with Fitzpatrick IV–VI skin types and Grades 2–4 acne scars, as per Goodman and Baron Acne Grading Scale, were enrolled. Subcision followed by hyaluronic acid filler was performed initially, followed by fractional carbon dioxide laser 2 weeks later. Standardized digital global photographs were obtained before treatment, before every laser session, and 6 months after the last laser session.ResultsUsing Goodman and Baron's Global Acne Scarring System, the patients showed significant improvement of both clinician and subjective scores in all grades of acne scars. No significant adverse events were noted.ConclusionTo the best of our knowledge, this is the first study to date which involves the combined approach of subcision and fillers, followed by fractional carbon dioxide laser sessions for the treatment of acne scars. The results show significant and persistent improvement, without considerable complications, in Fitzpatrick's skin types IV–VI. This protocol should thus be considered for the management of acne scars of the face.