Abstract:

Wu Hongjin, Zhou Bingrong, Xie Shufen, Zhang Jia′an, Li Jin, Liu Juan, Yi Fei, Wang Shen, Zhang Lichao, Luo Dan. Department of Dermatology and Venereology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China Corresponding authors: Luo Dan, Email: daniluo2005@163.com; Zhou Bingrong, Email: bingrong.2002@163.com 【Abstract】 Objective To evaluate the efficacy and safety of focal fractional laser treatment （FFLT） for atrophic acne scars. Methods A randomized, self-controlled study was performed. A total of 20 patients with atrophic facial acne scars were enrolled into this study. Treatments were randomly administered in a split-face manner. Half of each subject′s face received FFLT （FFLT side）, and the other half underwent full-face fractional CO2 laser resurfacing （control side）, for one session. All the patients were followed up for 3 months after the treatment. Evaluation was based on the ECCA grading scale （échelle d′évaluation clinique des cicatrices d′acné） and patient satisfaction score. A VISIA skin detector was used to take photographs and evaluate skin texture. Moreover, physical parameters of the skin, including erythema index, melanin index and transepidermal water loss （TEWL）, were measured. Adverse effects were recorded and evaluated. Statistical analysis was carried out by paired t test, Wilcoxon paired rank test, Fisher′s exact test and repeated-measure analysis of variance. Results The ECCA score decreased from 51.24 ± 17.61 at the baseline to 34.46 ± 14.99 at 3 months after the treatment at the FFLT side （t = 7.886, P < 0.05）, and from 50.96 ± 18.96 to 38.29 ± 14.86 at the control side （t = 6.123, P < 0.05）, and was significantly lower in the FFLT side than in the control side （t = 4.462, P < 0.05） at 3 months after the treatment. The improvement rate was significantly higher in the FFLT side than in the control side （32.75% vs. 24.86%, P = 0.016 by Fisher′s exact test） at 3 months after the treatment. Decreased pain and edema scores were observed at the FFLT side compared with the control side at 1 hour after the treatment （both P < 0.05）, but no significant difference was noted in the duration of erythema or crusting between the two sides （both P > 0.05）. Compared with those before the treatment, skin texture scores decreased in both sides （both P < 0.05）, and were significantly lower in the FFLT side than in the control side at 3 months after the treatment （P < 0.05）. The erythema index was significantly lower in the FFLT side than in the control side in both scarred areas and non-scarred areas on day 1 after the treatment （both P < 0.05）. Both melanin index and TEWL at the FFLT side were significantly increased in scarred areas, but decreased in non-scarred areas compared with those at the control side within 3 days after the treatment （all P < 0.05）. Similarly, the water content of the stratum corneum at the FFLT side was significantly lower in scarred areas, but higher in non-scarred areas compared with that at the control side between day 1 and 7 after the treatment （both P < 0.05）. No significant difference was observed in the erythema index, TEWL or water content of the stratum corneum between the FFLT side and control side at scarred areas or non-scarred areas （all P > 0.05） from 2 weeks to 3 months after the treatment （all P > 0.05）. Conclusion FFLT can improve therapeutic outcomes in atrophic acne scars with reduced adverse reactions.