Efficacy and Safety of Fractional CO2 Laser for Atrophic Acne Scars and Related Clinical Factors in Buri Ram Hospital: A Split-Face Comparative Study
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Abstract
ABSTRACT: Background: Fractional CO2 laser is currently a widely used treatment for atrophic acne scars because of its favorable efficacy and minimal adverse effects. However, therapeutic outcomes may vary depending on individual clinical factors, and data from Health Region 9 remain limited.
Objective: This study was performed to evaluate the efficacy, safety, and clinical factors associated with treatment outcomes of fractional CO2 laser for atrophic acne scars in patients at Buri Ram Hospital.
Methods: A total of 14 participants diagnosed with atrophic acne scars were enrolled in this split-face comparative study. Fractional CO2 laser was administered using standard-energy settings on one side of the face and high-energy settings on the opposite side. All participants underwent three treatment sessions at intervals of 4–6 weeks. Efficacy and safety were interpreted in accordance with the ECCA grading scale, clinical photographs, and adverse event assessments. Clinical factors associated with treatment outcomes were also analyzed.
Results: A total of 14 participants with atrophic acne scars were enrolled, with no significant baseline difference in mean ECCA scores between facial sides. The high-energy side showed significantly greater and faster improvement than the control side (61.8 ± 21.8 vs. 79.3 ± 28.5; paired t-test mean difference = -17.50, 95% CI: -26.68 to -8.32; p = 0.001). Additionally, the mixed-effects model showed that the high-energy side achieved a significantly faster reduction in ECCA scores, particularly after the 3rd session (interaction coefficient = -18.93; p = 0.001), with rolling scars demonstrated the highest therapeutic response. No severe complications were observed, and no other clinical variables significantly correlated with clinical efficacy.
Conclusions: Our study demonstrated that high-energy fractional CO2 laser treatment was significantly more effective for the treatment of atrophic acne scars, with a favorable safety profile and no serious adverse events.
Keywords: Atrophic acne scars, Efficacy and safety, Fractional CO2 laser, ECCA grading scale.
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