Abstract: 【Abstract】 Objective To observe the efficacy and adverse reactions of negative pressure suction combined with fractional laser and pinprick in the treatment of facial atrophic scars. Methods A total of 21 patients with acne atrophic scars were randomly assigned to receive fractional laser and pinprick treatment on one side of the face （control group）, while the other side of the face received fractional laser and pinprick treatment followed by negative pressure suction （experimental group）. The severity of acne scars was assessed using the échelle d′évaluation Clinique des Cicatrices d′Acné （ECCA） score, Investigator's Visual Assessment （IVA）, patient self-assessed overall aesthetic improvement （Global Aesthetic Improvement Scale, GAIS） score, Dermatology Life Quality Index （DLQI）, and satisfaction score at 1 and 3 months after the first treatment, and at 1, 3, 6, and 12 months after the second treatment. Adverse reactions and their duration were also recorded. Data were analyzed using SPSS 27.0 software, with between-group comparisons performed using the paired-sample rank sum test. Comparisons at each time point within groups were made using the Friedman two-way repeated measures analysis of variance （ANOVA）, with pairwise comparisons adjusted using the Bonferroni correction method. Results Six months after the second treatment, the ECCA score in the experimental group （47.50 ［35.00, 50.00］） was lower than that in the control group （50.00 ［45.00, 57.75］, Z = -2.00, P = 0.045）. The IVA score in the experimental group （3.00 ［2.00, 3.00］） was higher than that in the control group （2.00 ［2.00, 2.50］, Z = -2.35, P = 0.019）. Over time, both groups showed a decreasing trend in ECCA scores and an increasing trend in IVA scores. At the one-year follow-up, the experimental group had higher satisfaction and GAIS scores than the control group （both P < 0.05）. The DLQI score decreased from 6.0 （3.0, 8.5） before treatment to 1.0 （0.0, 1.5） after treatment （Z = -4.02, P < 0.001）. The short-term adverse reactions in both groups were primarily scabbing, erythema, and pain. There were no statistically significant differences between the groups in terms of the incidence and duration of adverse reactions. One participant experienced pigmentation on both the experimental and control sides. Conclusion The clinical efficacy of fractional laser combined with pinprick treatment followed by negative pressure suction for facial atrophic scars is significant, and it does not increase the adverse reactions post-treatment.

Key words: Cicatrix, Laser therapy, Negative-pressure wound therapy, Randomized controlled trial, Fractional laser, Acne scars, Atrophic scars