Correction of atrophic post-acne scars with ablative erbium laser, taking into account the predominant type of scar

Abstract

Background. The choice of an effective method of laser correction of atrophic post-acne scars, suitable for a particular type of scar, remains a difficult task, despite the variety of interventions.

Aim. To study the effectiveness of a combination of planar and fractional laser ablation in patients with atrophic post-acne scars, taking into account the predominant type of scar.

Material and methods. An open clinical intervention study included 60 patients with II–IV scar severity grade, 36 females and 24 males, with a mean age of 28.87±4.81 years. The predominance of V-shaped scars was observed in 11 (18.3%) patients, U-shaped — in 29 (48.3%), M-shaped — in 12 (20.0%), macular — in 8 (13.3%) patients. An erbium laser with a wavelength of 2940 nm was used to resurface the edge of the scars, followed by fractional ablation of the affected area. The change in the severity and quantitative index of the severity of post-acne scars after treatment, as well as the results on the international scale of aesthetic improvement, were evaluated. The safety of the method was assessed during a clinical examination on the 7th day after each procedure and 3 months after the last one, any adverse events and complications were recorded. The significance of differences was calculated using the Wilcoxon, Mann–Whitney, Kruskal–Wallis and the χ2 tests. Differences were considered statistically significant at p <0.05.

Results. Reduction of scar severity was registered, the quantitative index after treatment decreased from 11.4±3.25 to 6.2±3.1 points (p=0.000, Wilcoxon criterion). Regression of quantitative indices was established in patients with U-shaped and macular scars compared with patients with a predominance of M- and V-shaped scars (p ≤0.05, Mann–Whitney test). The average effectiveness of treatment on a scale of aesthetic improvement was 2.42±0.72 points, in 33 (55.0%) people the result corresponded to a significant improvement, in 19 (31.7%) — moderately pronounced improvement, a noticeable improvement in appearance compared to baseline was noted in 8 (13.3%) patients (χ2=23.55, p <0.000). Complications of procedures were not registered.

Conclusion. Correction of atrophic scars with an erbium laser, which combines planar and fractional ablation, is effective and safe for various types of atrophic scars; the optimal result is achieved in patients with U-shaped and macular scars.

Keywords

post-acne scars / scars resurfacing / fractional ablation / erbium laser

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