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Journal of the American Academy of Dermatology
Volume 63, n° 2
pages 274-283 (août 2010)
Doi : 10.1016/j.jaad.2009.08.051
Dermatologic Surgery

Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians

Woraphong Manuskiatti, MD , Daranporn Triwongwaranat, MD, Supenya Varothai, MD, Sasima Eimpunth, MD, Rungsima Wanitphakdeedecha, MD
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 

Reprint requests: Woraphong Manuskiatti, MD, Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok 10700, Thailand.

Treatment of atrophic scars with a fractional laser resurfacing technique has demonstrated favorable outcomes, although data on the efficacy and adverse effects of this procedure in persons with dark-skinned phototypes are limited.


This study was conducted to evaluate the efficacy and safety of carbon-dioxide ablative fractional resurfacing on atrophic acne scars in Asian individuals.


Thirteen subjects (8 female and 5 male, aged 25-52 years) with skin phototype IV and atrophic acne scars were treated with 3 sessions of carbon-dioxide ablative fractional resurfacing laser on an average of 7-week interval. Objective (ultraviolet A-light video camera) and subjective (clinical evaluation by two blinded dermatologists) assessments were obtained at baseline and at 1, 3, and 6 months after the final treatment.


At the 6-month follow-up, 85% of the subjects were rated as having at least 25% to 50% improvement of scars. Improvement significantly progressed from the 1-month follow-up to the 6-month follow-up (P  = .002). At 1 month after 3 treatments, surface smoothness (P  = .03) and scar volume (P  < .001) significantly improved, compared with baseline measurements. Of the subjects, 62% rated themselves as having at least 50% improvement in their scars. Mild postinflammatory hyperpigmentation was the most common adverse effect observed in 92% of the subjects or 51% of treatment sessions, and was completely resolved in an average of 5 weeks.


The small sample size was a study limitation.


Carbon-dioxide ablative fractional resurfacing appears to be effective and well tolerated for the treatment of atrophic acne scars in Asians.

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Key words : ablative fractional resurfacing, Asians, atrophic acne scars, carbon dioxide, fractional photothermolysis

Abbreviations used : AFR, ALR, CO2 , FP, MTZ, NAFR, PIH

 Supported by a research grant from Ellipse A/S, Hørsholm, Denmark.
 Conflicts of interest: None declared.

© 2009  American Academy of Dermatology, Inc.@@#104156@@