Dr Sindy Hu et al. had evaluated the effectiveness and safety of ablative fractional 2,940nm Er-YAG laser with coagulation mode for the treatment of atrophic facial acne scars in Taiwanese skin. By the setting of 100 to 150μm, 5 to 20mm2 scanning pattern with a 430μm spot size and 11% coverage density, they performed two passes of the laser on the cheeks and nose and one pass on the forehead.

 

They also used level 2 to 3 coagulation mode on the cheeks and level 1 on the forehead and mandible to create an extra thermal effect. They found almost three-quarters of the patients had good to excellent improvement.

 

In another similar study, Dr Sindy Hu et al. also evaluate the effectiveness and safety of a non-ablative 1,550nm Er-Glass fiber laser in the atrophic facial acne scars in one treatment session. By using Fraxel SR750 (Reliant) at a setting of 15-20mJ/MTZ (682-754mm depth, 146-160mm width/spot) with a density of 1,000-2,000MTZ/cm2 and total average energy 1.55kJ, or Fraxel SR1500 at a setting of 30-40mJ/MTZ (980-1,120mm depth, 180 -190mm width/spot) with a density of 392-520MTZ/cm2 and total average energy 1.9kJ, they proved 60% of the patients had good to excellent results after 1 month.

 

Figure: Before and after treatment of non-ablative 1,550 nm Er-Glass fiber fractional laser (Sellas 3D) 4 sessions for depressed acne scar. (Courtesy of Dr. Jeng-Hsien Lin)

 

Both ablative and non-ablative fractional lasers have similar good results, but patients still wish to achieve a smoother skin surface with less downtime. Therefore, more and more dermatologists try to use both ablative and non-ablative fractional laser combined to achieve an even better results. They also tried various combination therapies described above. It is still very difficult to judge which combination methods fit best to different patients with various skin conditions.

 

HELIOSⅡ/LOTUSⅡ/HYPERION – Manufacturer: LASEROPTEK(www.laseroptek.com)

 

Other than fractional lasers, radiofrequency (RF) is another energy based procedure used to treat depressed acne scar. However, because most of the treatment benefits from RF are focused on the tightening effect, it is not as popular as fractional lasers.

 

Because each patient is different, from their skin type, to their lifestyle, to their tolerance for downtime, we can expect hybrid fractional lasers (HFLs) or various combination therapies will be more and more popular because they offer a more customized treatment with maximum results and low downtime, achieving ablative-like results and allowing patients non-ablative-like downtime.

 

-To be continued