Facial Acne Scars Research Articles

Application of Fractional Microneedling Radiofrequency and Autologous Platelet-Rich Plasma in Managing Facial Acne Scars

Background: Many treatment modalities were tried to treat acne scar & still big challenge for dermatologists. Radiofrequency is a non-ionizing electromagnetic radiation used in medicine for nearly 75 years and the application of autologous Platelet-Rich Plasma has been safely used and documented in many fields of medicine. In dermatology and cosmetics they also are used in treating different conditions. Aim of Study: To evaluate the clinical efficacy of fractional microneedling radiofrequency (FMR) and autologous Platelet-Rich Plasma (PRP) a for treatment of facial acne scars . Patients and Methods: A therapeutic comparative study carried out in Dermatology Sulaimani Private Center for period from 1 st of November, 2014 to end of June, 2015. Forty patients with acne scar were included, we divided these patients into 2 groups; group ‐A (22 patients were treated with FMR alone) & group- B (18 patients treated with both FMR & autologous PRP). Both groups were treated by 3 sessions at 4 weeks interval in between sessions. Clinical assessment of improvement

Comparison of four different lasers for acne scars: Resurfacing and fractional lasers

Acne scars are common and cause cosmetic problems. There is a multitude of treatment options for acne scars, including dermabrasion, chemical peeling, and fillers, but the advent of laser technology has greatly improved the treatment of acne scars. Although several laser systems are available, studies comparing their efficacy are limited. This study compares the results of treatments using resurfacing (carbon dioxide, CO2; erbium-doped yttrium aluminum garnet, Er:YAG) versus fractional (nonablative fractional laser, NAFL; ablative fractional laser, AFL) lasers. A retrospective photographic analysis of 58 patients who underwent laser treatment for facial atrophic acne scars was performed. Clinical improvement was assessed by six blinded investigators with a scale graded from 0 to 10. Adverse events were also noted. Mean improvement scores of the CO2, Er:YAG, NAFL, and AFL groups were 6.0, 5.8, 2.2, and 5.2, respectively. The NAFL group showed a significantly lower score than the other groups. The mean number of treatments was significantly greater in the fractional laser groups than in the resurfacing laser groups. The resurfacing laser groups had a prolonged recovery period and high risk of complications. The Er:YAG laser caused less erythema or pigmentation compared to the CO2 laser. Although the CO2 laser, Er:YAG laser, and AFL improved the acne scars, the CO2 laser had a greater downtime. Three consecutive AFL treatments are as effective as a single treatment with resurfacing lasers, with shorter social downtime periods and less adverse effects.

Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial.

Autologous platelet-rich plasma has recently attracted significant attention throughout the medical field for its wound-healing ability. This study was conducted to investigate the potential of platelet-rich plasma combined with fractional laser therapy in the treatment of acne scarring. Sixteen patients (12 women and 4 men) who underwent split-face therapy were analyzed in this study. They received ablative fractional carbon dioxide laser combined with intradermal platelet-rich plasma treatment on one half of their face and ablative fractional carbon dioxide laser with intradermal normal saline on the other half. The injections were administered immediately after laser therapy. The treatment sessions were repeated after an interval of one month. The clinical response was assessed based on patient satisfaction and the objective evaluation of serial photographs by two blinded dermatologists at baseline, 1 month after the first treatment session and 4 months after the second. The adverse effects including erythema and edema were scored by participants on days 0, 2, 4, 6, 8, 15 and 30 after each session. Overall clinical improvement of acne scars was higher on the platelet-rich plasma-fractional carbon dioxide laser treated side but the difference was not statistically significant either 1 month after the first treatment session (P = 0.15) or 4 months after the second (P = 0.23). In addition, adverse effects (erythema and edema) on the platelet-rich plasma-fractional carbon dioxide laser-treated side were more severe and of longer duration. Small sample size, absence of all skin phototypes within the study group and lack of objective methods for the evaluation of response to treatment and adverse effects were the limitations. This study demonstrated that adding platelet-rich plasma to fractional carbon dioxide laser treatment did not produce any statistically significant synergistic effects and also resulted in more severe side effects and longer downtime.

Efficacy of autologous platelet rich plasma combined with fractional ablative carbon dioxide laser therapy in the treatment of facial atrophic acne scars

Efficacy of autologous platelet rich plasma combined with fractional ablative carbon dioxide laser therapy in the treatment of facial atrophic acne scars

Evaluation of efficacy and safety of a focal fractional laser for the treatment of atrophic acne scars

Objective To evaluate the efficacy and safety of focal fractional laser treatment (FFLT) for atrophic acne scars. Methods A randomized, self-controlled study was performed. A total of 20 patients with atrophic facial acne scars were enrolled into this study. Treatments were randomly administered in a split-face manner. Half of each subject's face received FFLT (FFLT side) , and the other half underwent full-face fractional CO2 laser resurfacing (control side) , for one session. All the patients were followed up for 3 months after the treatment. Evaluation was based on the ECCA grading scale (echelle d'evaluation clinique des cicatrices d'acne) and patient satisfaction score. A VISIA skin detector was used to take photographs and evaluate skin texture. Moreover, physical parameters of the skin, including erythema index, melanin index and transepidermal water loss (TEWL) , were measured. Adverse effects were recorded and evaluated. Statistical analysis was carried out by paired t test, Wilcoxon paired rank test, Fisher's exact test and repeated-measure analysis of variance. Results The ECCA score decreased from 51.24 ± 17.61 at the baseline to 34.46 ± 14.99 at 3 months after the treatment at the FFLT side (t= 7.886, P 0.05). Compared with those before the treatment, skin texture scores decreased in both sides (both P 0.05) from 2 weeks to 3 months after the treatment (all P> 0.05). Conclusion FFLT can improve therapeutic outcomes in atrophic acne scars with reduced adverse reactions. Key words: Cicatrix; Acneiform eruptions; Lasers, gas; Treatment outcome; Drug toxicity

Current Concepts in the Use of Bellafill.

As demonstrated by American Society of Plastic Surgeons statistics (2013), patients seeking nonsurgical facial rejuvenation are increasing. A variety of temporary and semipermanent soft-tissue fillers, such as hyaluronic acid, poly-L-lactic acid, and calcium hydroxylapatite, are readily available; however, they have not been proven effective in treating facial acne scarring. Patient tolerance for the inconvenience and repeat cost of short-term, temporary fillers is waning as newer generation fillers with longer durations are coming on the market. Permanent injectable fillers, such a Bellafill (Suneva Medical Inc., San Diego, Calif.), represent a desirable solution for patients who want a long-term result. With the recent Food and Drug Administration approval for the treatment of moderate-to-severe, atrophic, distensible facial acne scars on the cheek(s) in patients over the age of 21 years, Bellafill (polymethylmethacrylate collagen) represents an effective solution for the treatment of facial acne scarring of the face while maintaining an excellent safety profile.

Clinical efficacy of fractionated ultrapulse carbon dioxide laser combined with microneedle for the treatment of acne scars

Objective To investigate the clinical efficacy of fractionated ultrapulse carbon dioxide laser combined with microneedle for depressed acne scars. Methods Totally 86 patients with depressed acne scar were randomly divided into 2 groups: the treatment group received fractionated ultrapulse carbon dioxide laser combined with microneedle technology and the control group only received fractionated ultrapulse carbon dioxide laser. The treatment interval was 1 to 3 months, and the whole course was 2-8 times. The total effective rate and the adverse reaction were analyzed in the facial acne scar. Results The surface of depressed acne scars was significantly improved. ECCA score of all patients declined obviously after treatment, the score of the treatment group declined from 61±11 to 45±15, and the control group declined from 57±14 to 40±16. There were significantly statistical differences in the results of each group (P<0.05). More treatment times resulted in better surface improvement. The total effective rate were 81.8% (18/22) and 100% (24/24) in the treatment group, and 80.0% (16/20) and 100% (20/22) in the control group. The course was 6.8±1.6 months in the treatment group and 20.8±4.6 months in the control group (P<0.05) to get a similar satisfied result. There were no obvious adverse reactions except two cases of erythema and pigmentation in the treatment group and 5 cases in the control group. The former was with less adverse reactions. Conclusions Ultrapulse carbon dioxide laser combined with microneedle technique is effective for facial acne scars, with less complications and shorten treatment course. Key words: Fractional laser; Micro needle; Acne scars

SKIN NEEDLING THERAPY IS AN EFFECTIVE TREATMENT FOR ATROPHIC FACIAL ACNE SCARS

Background&#x0D; Acne is a common condition seen in up to 80% of people between 11 and 30 years of age. In some patients, the severe inflammatory response results in permanent scars. Atrophic facial scars are always a challenge to treat. Skin needling therapy is a new, simple and an effective treatment for such scars.&#x0D; Objective&#x0D; To assess the ef cacy of skin needling in the management of grade 2 and 3 atrophic facial acne scars.&#x0D; Patients and Methods&#x0D; Twenty five patients with facial acne scars were enrolled in the study (17 female and 8 male patients; age range 14–42 years). The severity of the lesions in each patient was scored on a 10-point scale (0 = no lesions; 10 = maximum severity) by the researcher involved in the study. Three groups of patients were identified and patients with Grade 2 and 3 atrophic facial acne scars were included. Patients were treated with skin needling procedure. Four photographs were taken for each patient by the researcher; one before, one immediately after the procedure done and another one after one month from the first session then one month after the second session of the treatment. At every follow-up, the same researcher evaluated the scars, scoring them using the same scale as previously, to assess any clinical improvement in the severity of the lesions. The last follow-up was conducted one month after the second treatment then the photographs were compared with the photographs taken before the first treatment and each patient was given a new severity score.&#x0D; Results&#x0D; One month after the rst session of skin needling; all patients had smoother facial skin and a slight reduction in lesion severity. One month after the second session of skin needling, the improvement in the acne rolling scars was evident as photographic comparison in each group of patients showed that the skin became thicker; and independent of the lesion grading the relative rolling scar depth was significantly reduced&#x0D; Conclusion&#x0D; Skin needling therapy is a simple, cheap, office method and an effective treatment for atrophic facial acne scars.

Microstructural and molecular considerations in the treatment of scars with ablative fractional lasers.

Fractional ablative lasers have recently proven to be an effective modality for improving the clinical appearance and minimizing the morbidity associated with restrictivetype scars. Their tolerable safety profile on nonfacial sites and darker Fitzpatrick skin types provides an advantage over its fully ablative counterpart in treating facial rhytides, photodamaged skin, and acne scars. However, despite its increasing usage in clinical practice, the mechanism behind the observed clinical benefit remains complex and has yet to be fully elucidated. This paper reviews the work on the histological mechanism of action of ablative fractional lasers, and the molecular changes that occur posttreatment on restrictive scars, with an emphasis on mature burn and postsurgical scars. As the majority of research has been on the carbon dioxide laser, a natural focus on this wavelength is presented.

Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study.

Background:A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO2) laser resurfacing combined with punch elevation with fractional CO2 laser resurfacing alone in the treatment of atrophic acne scars.Materials and Methods:Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment.Results:The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO2 laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO2 laser treatment was significant on both treatment sides (P < 0.05).Conclusion:Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring.

Clinical efficacy of Er ∶ YAG laser associated with pulsed dye laser on facial acne scars

Objective To observe the efficacy of Er ∶ YAG laser and pulsed dye laser (PDL) in treating facial acne scars.Methods A total of 78 cases with facial acne scars were divided into two groups.The test group included 40 patients that were treated by Er ∶ YAG laser (total three treatments,once three months)and irradiated by PDL (total four times,once per month),while the control group included 38 patients treated by Er ∶ YAG laser only.After three months of the last treatment,the effective rate and side effects were recorded and compared.Results The efficacy of the test group reached 92.5％ (37/40) and 77.5％ (31/40) for acne scars and post-acne erythema,respectively.However,the effective rate of the control group was 73.7％ (28/38) and 47.4％ (18/38).There were statistically significant differences between two groups (P＜0.05).Regarding reported adverse effects,there were four cases in the test group and two cases in the control group that appeared mild pigmentation.After symptomatic treatment,the skin color recovered.There was no other side effect in both two groups.Conclusions The effectiveness of Er ∶ YAG laser and PDL is better than Er ∶ YAG laser only in treating facial acne scars,and thus it is worthwhile for popularization and application in acne scars. Key words: Laser; Acne; Scar

The safe delivery of fractional ablative carbon dioxide laser treatment for acne scars in Asian patients receiving oral isotretinoin.

Because acne scarring is associated with substantially reduced quality of life, early initiation of effective treatment is desirable. In previous reports, isotretinoin treatment was associated with increased scarring after cosmetic procedures, such as laser treatment, dermabrasion, and chemical peeling. To evaluate wound healing after ablative carbon dioxide (CO2) fractional resurfacing for acne scarring conducted during and/or within 1 to 3 months of oral isotretinoin treatment. The records of 20 patients with facial acne scars were included in this retrospective study. All patients were receiving isotretinoin treatment or had completed it within the previous 1 to 3 months. All patients received full-face fractional ablative CO2 laser treatment. Follow-up was for at least 6 months to evaluate side effects. All patients showed normal reepithelialization and were satisfied with the results of the laser treatments. All adverse events were minor, and there were no hypertrophic scars or keloids. Ablative CO2 fractional laser treatment for acne scarring seems to be safe regardless of isotretinoin use (10-60 mg/d). The authors' findings contribute to the discussion of whether oral isotretinoin treatment impairs wound healing after ablative laser treatment.

Comparing the Healing Effects of Arnebia euchroma Ointment With Petrolatum on the Ulcers Caused by Fractional CO2 Laser: A Single-Blinded Clinical Trial.

Background:Arnebia euchroma ointment (AEO) has been used in Iranian traditional medicine for burn wound healing.Objectives:The aim of this study is to evaluate wound healing efficacy of AEO in burn wounds after fractional Co2 laser.Patients and Methods:This split-face, single-blinded, single-center clinical study was performed in Shohada-e-Tajrish Hospital, Tehran, Iran. A total of 26 subjects with facial acne scar, who were to receive fractional CO2 laser resurfacing were recruited. After laser procedure, AEO was applied to one side of the face and petrolatum on the other side for wound healing. Digital photographs were taken from acne scar area before resurfacing and on each of the assessment sessions. Three researchers, who were unaware of the applied medications, assessed these digital photographs for erythema, edema, epithelial confluence, crusting/scabbing, and general wound appearance. Subject’s irritations such as dryness and itching were evaluated on the second, fifth, and seventh days.Results:Our study indicated higher epithelial confluence and general wound appearance scores (P = 0.045 for both) and less erythema and edema on fifth day in petrolatum (P = 0.009 and P = 0.034, respectively). The results showed less crusting and erythema (P = 0.016 and P = 0.035, respectively) and higher general wound appearance scores in petrolatum on the second day (P = 0.035 and P = 0.001, respectively). Dryness was the most common subjective complaint in both groups; however, it was more severe in AEO, especially on the second day (P = 0.023).Conclusions:Despite the healing effects of AEO in burn wounds, petrolatum was more effective than AEO in post-laser wound.

Microneedling for acne scars in Asian skin type: an effective low cost treatment modality.

Postacne scarring is disfiguring, both physically as well as psychologically. Over the past two decades, multiple modalities for treatment of acne scars have emerged and microneedling with dermaroller is one of them. To evaluate the efficacy and safety of microneedling treatment for atrophic facial acne scars. Thirty-six patients (female--26, male--10) of postacne atrophic facial scars underwent five sittings of dermaroller under topical anesthesia at monthly intervals. Objective evaluation of improvement was performed by recording the acne scar assessment score at baseline and thereafter at every visit. Pre- and posttreatment photographs were compared, and improvement was graded on quartile score. Final assessment was performed 1 month after the last sitting. Patients were asked to grade the improvement in acne scars on visual analog scale (VAS, 0-10 point scale) at the end of study. Of 36 patients, 30 completed the study. The age group ranged from 18 to 40 years, and all patients had skin phototype IV or V. There was a statistically significant decrease in mean acne scar assessment score from 11.73 ± 3.12 at baseline to 6.5 ± 2.71 after five sittings of dermaroller. Investigators' assessment based on photographic evaluation showed 50-75% improvement in majority of patients. The results on visual analog scale (VAS) analysis showed "good response" in 22 patients and "excellent response" in four patients, at the end of study. The procedure was well tolerated by most of the patients, and chief complications noted were postinflammatory hyperpigmentation in five patients and tram-trek scarring in two patients. Microneedling with dermaroller is a simple and cheap, means of treatment modality for acne scars remodulation with little downtime, satisfactory results and peculiar side effects in Asian skin type.

Autologus bone marrow stem cells in atrophic acne scars: A pilot study

Background: Acne scar is a very distressing and difficult problem for physicians and patients. Management of cutaneous scarring from acne can be challenging and confusing. The available modalities may be effective, having considerable morbidity and long downtime. Besides, they may not have the same efficacy in different skin types or acne scar types.Objective: To evaluate the short-term safety and efficacy of autologous bone marrow (BM) stem cells (SCs) in treating atrophic acne scars.Methods: Fourteen patients with moderate to severe atrophic acne scars were included. All patients were subjected to single session of autologous BMSCs therapy. Each patient received 5 μg/kg/day granulocyte colony-stimulating factor (G-CSF) as a single subcutaneous dose for 2 successive days before BM aspiration. The SC-containing solution was injected under each scar intradermally. The scars of the patients were clinically assessed both qualitatively and quantitatively before and after 6 months. The patients were given a preformed questionnaire Cardiff acne disability index (CADI) before and after treatment.Results: After 6 months of the injection, there was significant improvement in the qualitative grading, quantitative grading and CADI scores. All types of scars showed significant improvement. No significant adverse effects were reported in any patient.Conclusion: Autologous BMSCs seem to be a safe and effective treatment option for the management of all types of atrophic facial acne scars.

Histological studies of facial acne and atrophic acne scars treated with a bipolar fractional radiofrequency system.

Various fractional radiofrequency (FRF) treatments have demonstrated significant beneficial effects and minor side-effects on atrophic acne scars and acne vulgaris by creating micro-thermal injuries in the skins. However, histological studies to identify the precise mechanism responsible for the success of bipolar FRF treatments are lacking. In this study, six human subjects with these diseases were histologically analyzed after treatment with a bipolar FRF system (eMatrix; Syneron, Yokneam, Israel) and the effects of multiple passes were compared. Histopathological results showed that two-pass FRF treatment created deeper dermal thermal injury zones compared to one-pass treatment. Periadnexal collagen was coagulated, as well as that in the sebaceous glands, as evaluated in all cases with two-pass FRF treatment. No severe side-effects were observed after treatment. Our experience suggests that the level of dermal thermal injury is directly related to the number of passes, and that a large benefit of this treatment for these diseases is the preservation of adnexal structures.

A double-blind, randomized, multicenter, controlled trial of suspended polymethylmethacrylate microspheres for the correction of atrophic facial acne scars

Acne scarring remains a stubborn clinical problem. Few treatments have been shown to bedefinitely effective for this problem. Polymethylmethacrylate (PMMA) microspheres in collagen (ArteFill, Suneva Medical Inc, Santa Barbara, CA) have shown long-term benefit for nasolabial fold treatment. A pilot study has shown benefit for PMMA-collagen in atrophic acne scarring. We sought to demonstrate the safety and effectiveness of PMMA-collagen for acne scarring in a controlled, blinded trial. Subjects with at least 4 moderate to severe rolling, atrophic scars randomly received PMMA-collagen or saline injections. Subjects underwent up to 2 injection sessions and were followed up for 6 months. Efficacy was assessed using a validated rating scale for each scar. In all, 147 subjects underwent injections. Success was achieved by 64% of those treated with PMMA-collagen compared with 33% of control subjects (P= .0005). The treatment showed excellent safety with generally mild, reversible adverse events. No significant differences in efficacy or safety were noted between genders, for darker skin types, or in older age groups. Subjects were followed up for only 6 months. PMMA-collagen demonstrates substantial effectiveness in the treatment of atrophic acne scars of the face while maintaining an excellent safety profile. Further follow-up should be undertaken to demonstrate longer-term benefit and safety.

Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars.

Background:While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between.Aim:The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars.Materials and Methods:Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ‘excellent’ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ‘good’ and ‘poor’ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted.Results:Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3%) while 15 (25%) and 19 patients (31.7%) demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks.Conclusions:Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal adverse effects.

Evaluation of microneedling fractional radiofrequency device for treatment of acne scars.

Background:Various treatment modalities including non-invasive methods such as chemical peels, topical retinoids, microdermabrasion, minimally invasive techniques such as microneedling, fractional lasers, microneedling radiofrequency devices and invasive procedures such as acne scar surgeries and ablative lasers are used for acne scars, each with its own unique advantages and disadvantages. This study is a retrospective assessment of efficacy and safety of microneedling fractional radiofrequency in the treatment of acne scars.Methods:Thirty one patients of skin types III-V with moderate and severe facial acne scarring received four sequential fractional radiofrequency treatments over a period of 6 months with an interval of 6 weeks between each session. Goodman & Baron's acne scar grading system was used for assessment by a side by side comparison of preoperative and post- operative photographs taken at their first visit and at the end of 3 months after the last session.Results:Estimation of improvement with Goodman and Baron's Global Acne Scarring System showed that by qualitative assessment of 31 patients with grade 3 and grade 4 acne scars, 80.64% showed improvement by 2 grades and 19.35% showed improvement by 1 grade. Quantitative assessment showed that 58% of the patients had moderate, 29% had minimal, 9% had good and 3% showed very good improvement. Adverse effects were limited to transient pain, erythema, edema and hyperpigmentation.Conclusion:Microneedling fractional radiofrequency is efficacious for the treatment of moderate and severe acne scars.

Effect of 2790 nm YSGG fractional laser on facial atrophic acne scars

Objective To evaluate the effect of resurfacing facial atrophic acne scars with 2790 nm YSGG fractional laser.Methods 38 patients with facial atrophic acne scars were treated with the 2790 nm YSGG fractional laser.All patients were randomly divided into two groups:group A using the combination with ablative and non-ablative mode of treatment; group B only using the non-ablative mode throughout the entire face,four treatment sessions for each patient,6 weeks interval.Comparative photographs were taken by using VISIA.Specific complexion analysis was used to identify and quantify depressed scars and texture,and patient satisfaction was graded with a 4-point scale.Results All of facial atrophic acne scars obtained different degree of improvement were treated by 4 times.In groups A and B,cure rate achieved 56.0 ％ and 30.8 ％,respectively.All the 38 patients had a chieved efficacy (81.6 ％),and they were satisfied with the results (84.2 ％).No severe side effect was observed.Conclusions 2790 nm YSGG laser is easy to manipulate and is more exactly than other lasers.It is especially effective in enhancing the clinical outcomes of scar revision with less complications and pigmentation,and thereby 2790 nm YSGG fractional laser can provide the patients with superficial scar in face as an additional therapeutic option. Key words: Atrophic acne scars; Fractional photothermolysis