Fractional ablative carbon dioxide laser in the treatment of atrophic acne scarring in Asian patients: A pilot study

INTRODUCTION: Ablative carbon dioxide resurfacing is the gold standard for treating atrophic acne scarring but is associated with prolonged recovery and many side effects. To address these limitations, newer modalities employing the principle of fractional photothermolysis have emerged. METHODS: We undertook a prospective study whereby five Asian patients of skin phototype IV with moderate to severe atrophic acne scarring received two sessions of a fractional carbon dioxide laser 6-8 weeks apart. Treatment parameters were: fluence, 28 J/cm(2); pulse width, 2.5 ms; spot size, 300 microm; penetration depth, up to 500 microm; degree of skin coverage, 20%; single pass. Photographic evaluation was done on the level of improvement according to a quartile grading scale: <or=25% (mild), 26-50% (moderate), 51-75% (marked), >75% (excellent). RESULTS: At 2 months post-treatment, all five subjects showed some clinical improvement (four: mild improvement; one: moderate improvement). The treatment was well tolerated. All patients had erythema, which lasted for a mean of 6 days. No other complications were observed. CONCLUSION: Our study has shown that in Asians the fractional ablative carbon dioxide laser produces mild to moderate improvement in acne scarring with the advantage of a quick recovery period with minimal adverse effects.