Evaluating the Picosecond 755-nm Alexandrite Laser With Diffractive Lens Array and Radiofrequency Microneedling for the Treatment of Atrophic Acne Scarring

BACKGROUND Acne scarring can impact patients negatively psychosocially. Picosecond lasers and radiofrequency microneedling may be used to improve this condition. OBJECTIVE To evaluate the efficacy and safety of combination treatment with a picosecond 755-nm Alexandrite laser (PSAL; Picosure Pro; Cynosure, Westford, MA) with diffractive lens array and a radiofrequency microneedling device (RFM; Potenza; Cynosure) for treating facial atrophic acne scars. METHODS This was a prospective, single-center, evaluator-blinded, split-face, randomized clinical trial. Twenty subjects with moderate to severe atrophic facial acne scarring were randomized to have one facial half treatment with PSAL followed by full-face treatment with RFM. Subjects received 4 treatments at 4-week intervals. RESULTS The blinded Investigator's échelle d'évaluation clinique des cicatrices d'acné (ECCA) acne grading, Physician Global Aesthetic Improvement Scale (PGAIS), and Subject Global Aesthetic Improvement Scale (SGAIS) did not show a significant difference between the facial half treated with RFM only and the half treated with RFM and PSAL at interval time points. However, there was significant improvement in ECCA, PGAIS, and SGAIS for both groups over study duration. CONCLUSION Both RFM and PSAL appear safe and may be effective for acne scarring treatment, but larger trials are required to confirm superiority or synergy.