Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lackin...Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lacking.This study aimed to determine the effectiveness and safety of a sequential combination therapy with MNRF followed by FCO_(2) laser compared with each therapy administered alone for the treatment of atrophic acne scars.Methods:An open randomized trial was conducted on 45 patients with atrophic acne scars at Al-Salam Teaching Hospital,Mosul,Iraq,from January 2022 to July 2023.The patients were randomized into 3 groups,with 15 patients in each group:FCO_(2) group(6 sessions of FCO_(2) laser treatment),MNRF group(6 sessions of MNRF treatment),and combined group(3 sessions of MNRF treatment followed by 3 sessions of FCO_(2) laser treatment).The Goodman and Baron Global Quantitative Acne Scar Grading System(GBGQASGS)was used to assess the treatment effectiveness.Adverse effects of treatment were monitored.The pre-treatment and post-treatment GBGQASGS scores and the percentage reductions in the GBGQASGS scores in the 3 groups were assessed by analysis of variance.The effect size of each treatment regimen was assessed using the Cohen d effect size.Results:The 45 patients enrolled comprised 20(44.4%)men and 25(55.6%)women,with a mean age of 25.10±2.80 years and a GBGQASGS score of 28.93±6.19.All 3 types of treatment significantly reduced the GBGQASGS scores after 6 sessions(all P<0.05)as following:FCO_(2) group,from 28.66±5.71 to 11.66±2.71(59.3%reduction;Cohen d=3.80);MNRF group,from 27.26±6.93 to 11.66±3.09(57.2%reduction;Cohen d=2.90);Combined group,from 30.87±5.73 to 9.01±2.03(70.8%reduction;Cohen d=5.08).There was no difference in the GBGQASGS score of post-treatment among 3 groups(P=0.300),however,the combined group exhibited a significant reduction in the GBGQASGS score from pre-treatment to post-treatment(P<0.001).Post-inflammatory hyperpigmentation was reported in FCO_(2) and MNRF groups,tram-track scarring was found in FCO_(2) group,while no serious adverse effects were reported in the combined group.Conclusion:Sequential combination therapy with MNRF followed by FCO_(2) laser was as effective as each monotherapy for the treatment of atrophic acne scars with fewer adverse effects.The results may provide evidence for treatment choice.展开更多
文摘Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lacking.This study aimed to determine the effectiveness and safety of a sequential combination therapy with MNRF followed by FCO_(2) laser compared with each therapy administered alone for the treatment of atrophic acne scars.Methods:An open randomized trial was conducted on 45 patients with atrophic acne scars at Al-Salam Teaching Hospital,Mosul,Iraq,from January 2022 to July 2023.The patients were randomized into 3 groups,with 15 patients in each group:FCO_(2) group(6 sessions of FCO_(2) laser treatment),MNRF group(6 sessions of MNRF treatment),and combined group(3 sessions of MNRF treatment followed by 3 sessions of FCO_(2) laser treatment).The Goodman and Baron Global Quantitative Acne Scar Grading System(GBGQASGS)was used to assess the treatment effectiveness.Adverse effects of treatment were monitored.The pre-treatment and post-treatment GBGQASGS scores and the percentage reductions in the GBGQASGS scores in the 3 groups were assessed by analysis of variance.The effect size of each treatment regimen was assessed using the Cohen d effect size.Results:The 45 patients enrolled comprised 20(44.4%)men and 25(55.6%)women,with a mean age of 25.10±2.80 years and a GBGQASGS score of 28.93±6.19.All 3 types of treatment significantly reduced the GBGQASGS scores after 6 sessions(all P<0.05)as following:FCO_(2) group,from 28.66±5.71 to 11.66±2.71(59.3%reduction;Cohen d=3.80);MNRF group,from 27.26±6.93 to 11.66±3.09(57.2%reduction;Cohen d=2.90);Combined group,from 30.87±5.73 to 9.01±2.03(70.8%reduction;Cohen d=5.08).There was no difference in the GBGQASGS score of post-treatment among 3 groups(P=0.300),however,the combined group exhibited a significant reduction in the GBGQASGS score from pre-treatment to post-treatment(P<0.001).Post-inflammatory hyperpigmentation was reported in FCO_(2) and MNRF groups,tram-track scarring was found in FCO_(2) group,while no serious adverse effects were reported in the combined group.Conclusion:Sequential combination therapy with MNRF followed by FCO_(2) laser was as effective as each monotherapy for the treatment of atrophic acne scars with fewer adverse effects.The results may provide evidence for treatment choice.
