Treatment Of Atrophic Facial Scars Research Articles

What Role for Carboxytherapy in the Treatment of Acne Scars?

Introduction: Acne is an extremely prevalent condition. The healing of active acne lesions may result in the development of scars. Atrophic scars are the main scars caused by acne and result from the degradation of collagen fibers. Carboxytherapy is a minimally invasive method that involves the application of carbon dioxide subcutaneously through small infiltrations in the skin, which improves scar tissue by increasing collagen's deposition and reorganization. The aim of this study is to review the role of carboxytherapy in the treatment of atrophic facial scars, alone or in combination with other techniques.
 Methods: A literature search was conducted on several databases using MeSH terms “carboxytherapy”, “carbon dioxide/therapy” and “wounds” for guidelines, systematic reviews, randomized controlled trials, and observational studies, published over the last 20 years in Portuguese, English or Spanish languages.
 Results: A total of 129 articles were retrieved, of which four experimental studies and one case series were selected. Comparing the techniques of microneedling and carboxytherapy, both were considered non-invasive treatment modalities with equal effectiveness, tolerability and safety, resulting in similar histopathological changes. On the other hand, despite the improvement of acne scars in both treatment modalities, the results were significantly better in favor of carbon dioxide fractional laser, despite having more side effects than carboxytherapy. When these techniques are combined and carboxytherapy is used as a subcision method, there is a more marked and rapid improvement in the appearance of acne scars.
 Discussion: Carboxytherapy is a promising modality in the treatment of atrophic acne scars, alone or in combination with other techniques.

A novel technique for treating atrophic facial scars in Asians using ultra‐pulse CO2 laser

Fractional lasers have become increasingly popular for treating atrophic scars, but their effectiveness is limited for deeper scars. We developed a novel technique (manual fractional thermal contraction technology, MFTCT) using an ultra-pulse CO2 laser and evaluated its efficacy and safety for treating atrophic facial scars. A total of 44 patients with atrophic facial scars were treated with MFTCT every 8weeks for 1-4 times. Overall scar improvement was assessed by photographs taken at baseline and 3months after the last treatment according to the 4-point global assessment scale (GAS) and ECCA grading scale. Improvements in color, distortion, and texture were assessed by the modified Manchester Scar Scale and scored individually from 1 to 4. Pain degrees and adverse reactions during and after treatment were recorded. A total of 44 patients completed the treatment and follow-ups; of them, 89% reported at least 50% overall improvement after the last treatment. The mean ECCA scores fell from 67.50±23.98 to 45.68±18.57 (a 32% improvement), and the change was significant (P=.000). The average score for overall improvement was 3.48. The average scores for color, distortion, and texture were 3.07±0.62, 3.27±0.50, and 3.52±0.51, respectively. Mean pain degree score was 4.27±1.04, and mean erythema duration was 28.43±6.58days. Some patients developed pigmentation for a few months that resolved with topical treatment. Manual fractional thermal contraction technology has definite clinical efficacy in the treatment of atrophic facial scars with fewer adverse reactions and is worth using in the clinical setting.

Treatment of atrophic facial scars of acne vulgaris by Q-Switched Nd:YAG (Neodymium: Yttrium-Aluminum-Garnet) laser 1064 nm wavelength

Background. Q-Switched Nd:YAG laser (1064 nm) is a new modality that was reported to be effective in treatment of acne scars. Objective. To evaluate the effectiveness and the safety of this laser in treatment of acne scars. Patients and methods. This case series, descriptive and comparative study was conducted in Al-Najaf Teaching Hospital of Kufa Medical College, Iraq from October 2010 to October 2011. A total of 16 patients having mild to moderate facial acne scars were enrolled; 10 of them completed the study. All patients had Fitzpatrick skin type III. They were divided into two groups A and B and were treated with two different energy fluences: 5 J/cm2 for group (A) and 15 J/cm2 for group (B). Five treatment sessions with 2-week intervals were done for all patients and were followed up for 6 months. The improvement was evaluated by objective and subjective methods. Results. Changes in acne scores in both groups were statistically insignificant after 6 months follow-up. Only two patients were satisfied with the improvement after treatment– one patient from each group. No serious side effects were reported. Conclusion. Q-Switched Nd:YAG laser (1064 nm) can be used in treating atrophic facial scars of acne vulgaris.

Facial Acne Scarring

Facial Acne Scarring

Treatment of atrophic facial scars with combined use of high-energy pulsed CO2 laser and Er:YAG laser: a practical guide of the laser techniques for the Er:YAG laser.

Although CO2 laser resurfacing provides substantial clinical improvement for atrophic facial scars, the CO2 laser often results in excessive thermal damage to the skin. It increases complications postoperatively. The Er:YAG laser ablates thinner layers of tissue than the CO2 laser with minimal thermal damage to the surrounding skin. To determine the efficacy of combined treatment of atrophic facial scars with high-energy pulsed CO2 laser and Er:YAG laser. One hundred fifty-eight patients were treated with a combination of high-energy pulsed CO2 laser and Er:YAG laser for atrophic facial scars. All patients were evaluated after 3 months of treatment. The scars improved 80-89% in 65 patients, 70-79% in 56 patients, more than 90% in 32 patients, 60-69% in 2 patients, and less than 60% in 3 patients after laser treatment. Treatment of atrophic facial scars with combined use of high-energy pulsed CO2 laser and Er:YAG laser is a very effective and useful method.