Fractional photothermolysis for the treatment of acne scars: a report of 27 Korean patients.

OBJECTIVES Atrophic post-acne scarring remains a therapeutically challenging condition despite various currently available technologies. Fractional photothermolysis (FP) is a novel concept of cutaneous resurfacing which induces non-contiguous microscopic thermal injury. The aim of this study is to evaluate the safety and efficacy of FP in the treatment of acne scars in Asian patients. METHODS A total of 27 Korean patients (Fitzpatrick skin types IV or V) with moderate to severe facial acne scars received three to five sessions of FP treatment (Fraxel Laser; Reliant Technologies, CA, USA), each spaced 3-4 weeks apart. Standardized digital photographs were obtained before each treatment and 3 months after the final treatment. In addition, the patients' perceived degrees of improvement were assessed 3 months after the final treatment using a five-point grading scale. RESULTS FP led to marked improvement in the appearance of acne scars at 3 months post-treatment. Patients' self-assessed degrees of improvement were as follows: excellent improvement in eight patients (30%), significant improvement in 16 patients (59%), and moderate improvement in three patients (11%). Adverse events were limited to transient pain, erythema and edema. CONCLUSIONS The 1550-nm erbium-doped FP is associated with significant patient-reported improvement in the appearance of acne scars, with minimal downtime.

[1]  Y. Suga,et al.  Clinical trial of a laser device called fractional photothermolysis system for acne scars , 2006, The Journal of dermatology.

[2]  G. Goodman Management of post-acne scarring. What are the options for treatment? , 2000, American journal of clinical dermatology.

[3]  Facd,et al.  Postacne Scarring: A Review of its Pathophysiology and Treatment , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[4]  S Jowett,et al.  Skin disease and handicap: an analysis of the impact of skin conditions. , 1985, Social science & medicine.

[5]  G. Lipper,et al.  Nonablative Acne Scar Reduction after a Series of Treatments with a Short‐Pulsed 1,064‐nm Neodymium:YAG Laser , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[6]  P. Friedman,et al.  Treatment of atrophic facial acne scars with the 1064-nm Q-switched Nd:YAG laser: six-month follow-up study. , 2004, Archives of dermatology.

[7]  H. Chan,et al.  Prospective direct comparison study of fractional resurfacing using different fluences and densities for skin rejuvenation in Asians , 2007, Lasers in surgery and medicine.

[8]  W. Cunliffe,et al.  A clinical evaluation of acne scarring and its incidence , 1994, Clinical and experimental dermatology.

[9]  H. Chan,et al.  Use of 1,320 nm Nd:YAG laser for wrinkle reduction and the treatment of atrophic acne scarring in Asians , 2004, Lasers in surgery and medicine.

[10]  E. Tanzi,et al.  Comparison of a 1450‐nm Diode Laser and a 1320‐nm Nd:YAG Laser in the Treatment of Atrophic Facial Scars: A Prospective Clinical and Histologic Study , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[11]  E. Tanzi,et al.  The Use of Fractional Laser Photothermolysis for the Treatment of Atrophic Scars , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[12]  P. Friedman,et al.  Fractional photothermolysis for the treatment of surgical scars: A case report , 2006, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[13]  G. Fulchiero,et al.  Subcision and 1320‐nm Nd: YAG Nonablative Laser Resurfacing for the Treatment of Acne Scars A Simultaneous Split‐Face Single Patient Trial , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[14]  G. Haroske,et al.  Tumor Necrosis Factor-α Inhibitor-Induced Psoriasis or Psoriasiform Exanthemata , 2008 .

[15]  J. Dover,et al.  Acne scarring: a classification system and review of treatment options. , 2001, Journal of the American Academy of Dermatology.

[16]  R. Anderson,et al.  Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury , 2004, Lasers in surgery and medicine.

[17]  G. Goodman,et al.  Postacne scarring – a quantitative global scarring grading system , 2006, Journal of cosmetic dermatology.

[18]  P. Friedman,et al.  Fractional Resurfacing for the Treatment of Hypopigmented Scars: A Pilot Study , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[19]  K. Arndt,et al.  Patient Satisfaction and Reported Long‐Term Therapeutic Efficacy Associated with 1,320 nm Nd: YAG Laser Treatment of Acne Scarring and Photoaging , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[20]  S. Chua,et al.  Nonablative 1450‐nm Diode Laser in the Treatment of Facial Atrophic Acne Scars in Type IV to V Asian Skin: A Prospective Clinical Study , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[21]  A. Layton Optimal Management of Acne to Prevent Scarring and Psychological Sequelae , 2001, American journal of clinical dermatology.

[22]  T. Alster,et al.  Laser Scar Revision: A Review , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[23]  R. Halder,et al.  Photoaging and nonablative photorejuvenation in ethnic skin. , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[24]  S. Shek,et al.  The prevalence and risk factors of post‐inflammatory hyperpigmentation after fractional resurfacing in Asians , 2007, Lasers in surgery and medicine.

[25]  Y. Kye,et al.  Resurfacing of Pitted Facial Acne Scars with a Long‐Pulsed Er:YAG Laser , 2001, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[26]  W. Cunliffe,et al.  Inflammation in acne scarring: a comparison of the responses in lesions from patients prone and not prone to scar , 2004, The British journal of dermatology.

[27]  H. Laubach,et al.  Skin responses to fractional photothermolysis , 2006, Lasers in surgery and medicine.

[28]  D. Goldberg,et al.  Atrophic and a Mixed Pattern of Acne Scars Improved With a 1320‐nm Nd: YAG Laser , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[29]  N. Sadick,et al.  A Preliminary Study of Utilization of the 1320‐nm Nd:YAG Laser for the Treatment of Acne Scarring , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[30]  G. Goodman Management of Post-Acne Scarring , 2000 .

[31]  R. Jordan,et al.  Laser resurfacing of the skin for the improvement of facial acne scarring: a systematic review of the evidence , 2000, The British journal of dermatology.

[32]  R. Weiss,et al.  Improvement of atrophic acne scars with a 1,320 nm Nd:YAG laser: retrospective study. , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[33]  Dong Hun Lee,et al.  Fractional Photothermolysis for the Treatment of Striae Distensae in Asian Skin , 2008, American journal of clinical dermatology.