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Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars.
Dermatol Surg 1999; 25(12):926-30DS

Abstract

BACKGROUND

The recent development of high-energy pulsed CO2 lasers that minimize thermal injury to uninvolved adjacent structures has revolutionized the manner in which atrophic facial scars are recontoured. Significant improvement of atrophic scars with laser resurfacing has clearly been demonstrated; however, the exact timing for assessment of skin for further treatment has varied due to the unknown amount of time needed after laser scar resurfacing to effect maximal collagen formation and remodeling.

OBJECTIVE

The aim of this study was to determine the immediate and long-term (12-18 months) histologic and clinical effects of atrophic acne scars after CO2 laser resurfacing in order to provide physician guidelines for postoperative clinical assessment for retreatment.

METHODS

Sixty patients (50 women, 10 men, mean age 38 years, skin types I-V) with moderate to severe atrophic facial scars were evaluated. Nineteen patients received regional cheek treatment and 41 patients received full-face resurfacing with a high-energy pulsed CO2 laser. Independent clinical assessments of treated scars were performed at 1, 6, 12, and 18 months and blinded histologic analyses were made of skin biopsies immediately prior to and after laser resurfacing, and at 1, 6, 12, and 18 months postoperatively in six patients.

RESULTS

Significant immediate and prolonged clinical improvement in skin tone, texture, and appearance of CO2 laser-irradiated scars was seen in all patients. Average clinical improvement scores were 2.22 (69%) at 1 month, 2.1 (67%) at 6 months, 2.37 (73%) at 12 months, and 2.5 (75%) at 18 months. Continued collagenesis and subsequent dermal remodeling were observed on histologic examination of biopsied tissue up to 18 months after surgery.

CONCLUSION

Continued clinical improvement was observed as long as 18 months after CO2 laser resurfacing of atrophic scars, with an 11% increase in improvement observed between 6 and 18 months postoperatively. We propose that a longer postoperative interval (12-18 months) prior to assessment for re-treatment be advocated in order to permit optimal tissue recovery and an opportunity for collagen remodeling.

Authors+Show Affiliations

Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10594623

Citation

Walia, S, and T S. Alster. "Prolonged Clinical and Histologic Effects From CO2 Laser Resurfacing of Atrophic Acne Scars." Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], vol. 25, no. 12, 1999, pp. 926-30.
Walia S, Alster TS. Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars. Dermatol Surg. 1999;25(12):926-30.
Walia, S., & Alster, T. S. (1999). Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 25(12), pp. 926-30.
Walia S, Alster TS. Prolonged Clinical and Histologic Effects From CO2 Laser Resurfacing of Atrophic Acne Scars. Dermatol Surg. 1999;25(12):926-30. PubMed PMID: 10594623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars. AU - Walia,S, AU - Alster,T S, PY - 1999/12/14/pubmed PY - 2000/9/2/medline PY - 1999/12/14/entrez SP - 926 EP - 30 JF - Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] JO - Dermatol Surg VL - 25 IS - 12 N2 - BACKGROUND: The recent development of high-energy pulsed CO2 lasers that minimize thermal injury to uninvolved adjacent structures has revolutionized the manner in which atrophic facial scars are recontoured. Significant improvement of atrophic scars with laser resurfacing has clearly been demonstrated; however, the exact timing for assessment of skin for further treatment has varied due to the unknown amount of time needed after laser scar resurfacing to effect maximal collagen formation and remodeling. OBJECTIVE: The aim of this study was to determine the immediate and long-term (12-18 months) histologic and clinical effects of atrophic acne scars after CO2 laser resurfacing in order to provide physician guidelines for postoperative clinical assessment for retreatment. METHODS: Sixty patients (50 women, 10 men, mean age 38 years, skin types I-V) with moderate to severe atrophic facial scars were evaluated. Nineteen patients received regional cheek treatment and 41 patients received full-face resurfacing with a high-energy pulsed CO2 laser. Independent clinical assessments of treated scars were performed at 1, 6, 12, and 18 months and blinded histologic analyses were made of skin biopsies immediately prior to and after laser resurfacing, and at 1, 6, 12, and 18 months postoperatively in six patients. RESULTS: Significant immediate and prolonged clinical improvement in skin tone, texture, and appearance of CO2 laser-irradiated scars was seen in all patients. Average clinical improvement scores were 2.22 (69%) at 1 month, 2.1 (67%) at 6 months, 2.37 (73%) at 12 months, and 2.5 (75%) at 18 months. Continued collagenesis and subsequent dermal remodeling were observed on histologic examination of biopsied tissue up to 18 months after surgery. CONCLUSION: Continued clinical improvement was observed as long as 18 months after CO2 laser resurfacing of atrophic scars, with an 11% increase in improvement observed between 6 and 18 months postoperatively. We propose that a longer postoperative interval (12-18 months) prior to assessment for re-treatment be advocated in order to permit optimal tissue recovery and an opportunity for collagen remodeling. SN - 1076-0512 UR - https://www.unboundmedicine.com/medline/citation/10594623/Prolonged_clinical_and_histologic_effects_from_CO2_laser_resurfacing_of_atrophic_acne_scars_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1076-0512&date=1999&volume=25&issue=12&spage=926 DB - PRIME DP - Unbound Medicine ER -