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.

Background: Fractional technology has changed the dermatologists view in how to treat acne scars in ethnic skin as a result of its favorable safety profile.

Objectives: To evaluate the safety and efficacy of non-ablative fractional (NAF) 1,550 nm and ablative fractional (AF) CO(2) Lasers in the treatment of acne scars in ethnic skin.

Methodology: In this retrospective analysis patients with acne scars who were treated with NAF 1,550 nm or AF CO(2) lasers from January 2008 until July 2009 were included. Evaluation was made through comparing pre- and post-photographs and physician global assessment. Patients' satisfaction rate was also recorded. Assessment of improvement was based on a quartile grading scale. Bleaching creams and oral antibiotics were routinely given after each session. Adverse effects were recorded. Follow up visits were scheduled at weeks 1 and 4 of each session and 12 weeks post-last session.

Results: A total of 82 patients were recruited in the study. Forty-five patients treated with NAF 1,550 nm laser and 37 patients with AF CO(2) laser. Skin phototype was mainly type IV (III-V). An overall patient satisfaction was 71% for NAF 1,550 nm laser group and 65% for AF CO(2) laser group. Thirty-five percent and 37% of patients attained more than 50% improvement with NAF 1,550 nm and AF CO(2) lasers, respectively. Patients treated with NAF 1,550 nm laser had less down time. Transient post-inflammatory hyperpigmentation (PIH) was noted in 17% of patients treated with NAF 1,550 nm laser compared to 14% with AF CO(2) .

Conclusion: Both NAF 1,550 nm and AF CO(2) lasers are effective in treating acne scars in ethnic skin with good patient satisfaction rate and high safety profile. PIH decreased with routine use of prophylactic bleaching creams. Fractional laser resurfacing open a wide horizon for treating acne scars in ethnic skin.