Applied Lasers in Acne Scar Treatment: A Brief Review
DOI:
https://doi.org/10.12970/2310-998X.2019.07.05Keywords:
Acne, Scar, Laser therapy.Abstract
Introduction: Scar of Acne is a prevalent condition that may lead negative impact on the patients’ quality of life and is frequently might be worsened by aging. A number of options are available for the treatment of acne scarring, including retinoid, microdermabrasion, dermal fillers, and surgical techniques such as subcision. The aim of this study is to review the different laser modalities that have been applied in clinical studies for treatment of acne scars, and summarize current clinical approaches.
Methods: A Medline search spanning was performed on acne scarring. Search terms included "atrophic acne scars," "ablative'', "non-ablative," "fractional," "non-fractional," "neodymium," "alexandrite," "pulsed dye" lasers, and results are summarized.
Results: Various types of lasers have been evaluated for the treatment of atrophic acne scars. While they are efficacious overall, they differ in terms of side effects and clinical outcomes, depending on patients’ skin and acne scar type. A new emerging trend is to combine lasers with other energy-based devices and/or topical.
Conclusions: Evaluation of the literature examining acne scar treatment with lasers revealed that clinical outcomes are dependent on various patient factors, including atrophic acne scar subtype, patient skin type, treatment modality, and side-effect profile.
References
Sadick NS, Cardona A. Laser treatment for facial acne scars: A review. Journal of Cosmetic and Laser Therapy 1476-4172 (Print) 1476-4180.
Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol 1999; 41(4): 577-80. https://doi.org/10.1016/S0190-9622(99)70300-2
Oberemok SS, Shalita AR. Acne vulgaris, I: pathogenesis, and diagnosis. Cutis 2002; 70: 101-105.
Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol 1994; 19 (4): 303-08. https://doi.org/10.1111/j.1365-2230.1994.tb01200.x
Babilas P, Schreml S, Eames T, Hohenleutner U, Landthaler M, Hohenleutner S. Experience with non-ablative fractional photothermolysis with a dual-mode laser device (1,440/1,320 nm): no considerable clinical effect on hypertrophic/acne scars and facial wrinkles. Lasers Med Sci 2011; 26(4): 473-79. https://doi.org/10.1007/s10103-011-0893-2
Akaishi S, Koike S, Dohi T, Kobe K, Hyakusoku H, Ogawa R. Nd: YAG laser treatment of keloids and hypertrophic scars. Eplasty 2012; 12: e1.
Fabbrocini G, Annunziata MC, D’Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract 2010; 2010: 893080. https://doi.org/10.1155/2010/893080
Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 2001; 45(1): 109017. https://doi.org/10.1067/mjd.2001.113451
Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 2001; 45(1): 109-17. https://doi.org/10.1067/mjd.2001.113451
Magnani LR, Schweiger ES. Fractional CO2 lasers for the treatment of atrophic acne scars: a review of the literature. J Cosmet Laser Ther 2014; 16(2): 48-56. https://doi.org/10.3109/14764172.2013.854639
Faghihi G, Nouraei S, Asilian A, Keyvan S, Abtahi-naeini B, Rakhshanpour M, Nilforoushzadeh AM, Hosseini SM. Efficacy of punch elevation combined with fractional carbon dioxide laser resurfacing in facial atrophic acne scarring: a randomized split-face clinical study. Indian J Dermatol 2015; 60(5): 473-78. https://doi.org/10.4103/0019-5154.159616
Cohen BE, Brauer JA, Geronemus RG. Acne scarring: a review of available therapeutic lasers. Lasers Surg Med 2016; 48(2): 95-115. https://doi.org/10.1002/lsm.22410
Rivera AE. Acne scarring: a review and current treatment modalities. J Am Acad Dermatol 2008; 59(4): 659-76. https://doi.org/10.1016/j.jaad.2008.05.029
Wolfram D, Tzankov A, Pulzl P, Piza-Katzer H. Hypertrophic scars and keloids–a review of their pathophysiology, risk factors, and therapeutic management. Dermatol Surg 2009; 35(2): 171-81. https://doi.org/10.1111/j.1524-4725.2008.34406.x
Majid I, Imran S. Fractional CO2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars. J Cutan Aesthet Surg 2014; 7(2): 87-92. https://doi.org/10.4103/0974-2077.138326
Min SU, Choi YS, Lee DH, Yoon MY, Suh DH. Comparison of a long-pulse Nd: YAG laser and a combined 585/1064-nm laser for the treatment of acne scars: a randomized split-face clinical study. Dermatol Surg 2009; 35(11): 1720-27. https://doi.org/10.1111/j.1524-4725.2009.01086.x
Manuskiatti W, Iamphonrat T, Wanitphakdeedecha R, Eimpunth S. Comparison of fractional erbium-doped yttrium aluminum garnet and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians. Dermatol Surg 2013; 39(1 Pt 1): 111-20. https://doi.org/10.1111/dsu.12030
Maluki AH, Mohammad FH. Treatment of atrophic facial scars of acne vulgaris by Q-switched Nd: YAG (Neodymium: yttriumAluminum-Garnet) laser 1064 nm wavelength. J Cosmet Laser Ther 2012; 14(5): 224-33. https://doi.org/10.3109/14764172.2012.723807
Orringer JS, Kang S, Johnson TM, Karimipour DJ, Hamilton T, Hammerberg C, Voorhees JJ, Fisher GJ. Connective tissue remodeling induced by carbon dioxide laser resurfacing of photodamaged human skin. Arch Dermatol 2004; 140(11): 1326-32. https://doi.org/10.1001/archderm.140.11.1326
Walsh JT Jr., Deutsch TF. Pulsed CO2 laser tissue ablation: measurement of the ablation rate. Lasers Surg Med 1988; 8(3): 264-75. https://doi.org/10.1002/lsm.1900080308
Alexiades-Armenakas MR, Dover JS, Arndt KA. The spectrum of laser skin resurfacing: non-ablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol 2008; 58(5): 719-37; quiz 738-740. https://doi.org/10.1016/j.jaad.2008.01.003
Zhou BR, Zhang T, Bin Jameel AA, Xu Y, Xu, Y, Guo SL, Wang Y, Permatasari F, Luo D. The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation. J Cosmet Laser Ther 2016; 18(3): 138-48. https://doi.org/10.3109/14764172.2015.1114638
Alajlan AM, Alsuwaidan SN. Acne scars in ethnic skin treated with both non-ablative fractional 1,550 nm and ablative fractional CO2 lasers: comparative retrospective analysis with recommended guidelines. Lasers Surg Med 2011; 43(8): 787-91. https://doi.org/10.1002/lsm.21092
Patidar MV, Deshmukh AR, Khedkar MY. Efficacy of Intense Pulsed Light Therapy in the Treatment of Facial Acne Vulgaris: Comparison of Two Different Fluences. Indian J Dermatol 2016; 61(5): 545-549. https://doi.org/10.4103/0019-5154.190115
Lee DH, Choi YS, Min SU, Yoon MY, Suh DH. Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd: YAG laser for the treatment of acne scars: A randomized split-face clinical study. J Am Acad Dermatol 2009; 60(5): 801-07. https://doi.org/10.1016/j.jaad.2008.11.883
Tanzi EL, Alster TS. 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. Dermatol Surg 2004; 30(2 Pt 1): 152-57. https://doi.org/10.1111/j.1524-4725.2004.30078.x
Oram Y, Akkaya AD. Refractory postinflammatory hyperpigmentation treated fractional CO2 laser. J Clin Aesthet Dermatol 2014; 7(3): 42-44.
Nirmal B, Pai SB, Sripathi H, Rao R, Prabhu S, Kudur MH, Nayak SUK. Efficacy and safety of erbium-doped yttrium aluminium garnet fractional resurfacing laser for treatment of facial acne scars. Indian J Dermatol Venereol Leprol 2013; 79(2): 193-98. https://doi.org/10.4103/0378-6323.107635
Lee HS, Lee JH, Ahn GY, Lee DH, Shin JW, Kim DH, Chung JH. Fractional photothermolysis for the treatment of acne scars: a report of 27 Korean patients. J Dermatolog Treat. 2008; 19(1): 45-49. https://doi.org/10.1080/09546630701691244
Taylor MB, Zaleski-Larsen L, McGraw TA. Single session treatment of rolling acne scars using tumescent anesthesia, 20% trichloracetic acid extensive subcision, and fractional CO2 laser. Dermatol Surg 2017; 43(Suppl 1): S70-S74. https://doi.org/10.1097/DSS.0000000000000895
Asilian A, Salimi E, Faghihi G, Dehghani F, Tajmirriahi N, Hosseini SM. Comparison of Q-switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar. J Res Med Sci 2011; 16(9): 1189-95
Kang WH, Kim YJ, Pyo WS, Park SJ, Kim JH. Atrophic acne scar treatment using triple combination therapy: dot peeling, subcision and fractional laser. J Cosmet Laser Ther 2009; 11(4): 212-15. https://doi.org/10.3109/14764170903134326
Pei S, Inamadar AC, Adya KA, Tsoukas MM. Light-based therapies in acne treatment. Indian Dermatol Online J 2015; 6(3): 145-157. https://doi.org/10.4103/2229-5178.156379
Shirkavand A, Babadi M, Najafzadeh E, Laser applications in medical sciences. Laser in Medicine 2018; 15(3).
Jih MH, Kimyai-Asadi A. Laser Treatment of Acne Vulgaris. Seminars in Plastic Surgery 21(3): 167-74. https://doi.org/10.1055/s-2007-991185
Linkner RV, Jimon S, Haddican M, Singer G, Shim-Chang H. Evaluating the Efficacy of Photodynamic Therapy with 20% Aminolevulinic Acid and Microdermabrasion as a Combination Treatment Regimen for Acne Scarring A Split-face, Randomized, Double-blind Pilot Study. Clinical Aesthetic 2014; 7(5).
Chen X, Song H, Chen S, Zhang J, Niu G, Liu X. Clinical efficacy of 5-aminolevulinic acid photodynamic therapy in the treatment of moderate to severe facial acne vulgaris. Experimental and Therapeutic Medicine 2015; 10: 1194-1198. https://doi.org/10.3892/etm.2015.2638