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Surgery: Current Research | ISSN: 2161-1076 | Volume 8
August 31-September 01, 2018 | Toronto, Canada
Plastic & Cosmetic Surgery
International Conference on
Dermatopathology & Skin Care
International Conference & Expo on
&
High intensity targeted fractional CO
2
laser ablation of acne scars
Kalsoom Jawaid
Punjab Medical College Faisalabad, Pakistan
Introduction:
Treatment of acne scars in the pigmented skin has always been challenging, for which many of the procedures
have been tried, among them, the most advanced technique now is the fractional CO2 laser. Its results have been varied
with different technical expertise and are complicated by post-inflammatory hyperpigmentation. We have tried high fluence
targeted ablation of individual acne scars of all types.
Objective:
To obtain maximum possible effacement of all types of acne scars in the pigmented skin with 2 step approach i.e high
intensity fractional CO
2
laser ablation specifically targeted to the individual acne scars followed by low intensity resurfacing of
the whole of the involved area for blending purposes.
Materials and Methods:
20 patients with inactive acne and mixed types of scars underwent 3 sessions of fractional CO
2
phothermolysis at 6 weeks intervals. The severity of the scarring was graded from 0 to 10 by an independent dermatologist on
the visual analog scale. A Korean high power 30W fractional CO
2
laser was used. After topical anesthesia with EMLA under
occlusion for 30 minutes, fractional CO
2
laser therapy (150-200 mg/cm
2
, 20-30% coverage, 3-5 passes) precisely targeted to
the individual acne scars to get clinical end-point of about 90% scar effacement followed by low intensity (30-50 MJ/cm
2
,
25% coverage, single pass) resurfacing of the whole of the involved area to blend the scars’ edges with the surrounding skin.
Post-operative antiviral prophylaxis was given and polyfax skin ointment was advised until the crusting clears. Daily bedtime
application of Hydroquinone 2% plus Glycolic acid 1% combination was started on the 10th day after the procedure for
prevention of post-inflammatory hyperpigmentation.
Results:
Objective mean improvement of 55% (range 40 to 70%) was seen on visual analog in all patients 3 months after the last
session. Serosanguinous exudation, crusting, and erythema followed by transient hyperpigmentation were the most common
but predictable side effects noted.
Conclusion:
High energy, multiple passes, deep ablation of individual deep acne scars to get immediate maximum scar
effacement combined with superficial, low intensity, resurfacing of the whole of the anatomical zone is good option to balance
the efficacy and safety of fractional CO
2
laser resurfacing in pigmented skin. It leads to significant improvement even in ice
pick and boxcar scars but associated with frequent, but transient, postprocedural hyperpigmentation, which can be managed
to much extent with topical depigmenting agents.
dr.klsmjwd@gmail.comKalsoom Jawaid, Surgery Curr Res 2018, Volume 8
DOI: 10.4172/2161-1076-C4-044