Ablative Fractional CO2 Laser Treatment With and Without Oral Isotretinoin: A Study on Side Effects and Acne Scars Improvement in Southeast Asians.

OBJECTIVES

There have been concerns regarding combining procedural treatments for acne scars concurrently with isotretinoin (ISO) treatment due to risks of delayed healing and adverse events. However, recent studies showed favorable outcomes of several procedures without serious side effects, though evidence in Southeast Asians is lacking. This study aims to demonstrate the safety and efficacy of fractional ablative carbon dioxide laser (AFCL) for acne scars in concurrence with ISO treatment in the population with Fitzpatrick skin type (FST) 3 or higher.

MATERIAL AND

METHODS

This prospective study enrolled Thai participants with acne scars of 2 or more based on the Qualitative Global Scarring Grading Score (QGSGS). Twenty-five participants were currently on ISO 30-70 mg/week. Investigators provided whole-face AFCL three times along with assessments of adverse events, edema, crusting, and erythema at baseline, Months 1 and 3. At Months 1, 3, and 6, post-inflammatory hyperpigmentation (PIH) and acne scars were examined by clinical and quantitative evaluations.

RESULTS

Of the 50 participants, 45 completed the study, with most classified as FST 4 and 5. The post-laser edema and erythema showed no significant difference in the severity between both groups. However, participants in the non-ISO group experienced significantly more severe crusting following treatment (p-value = 0.006). The incidence of PIH was 23.81% (ISO) versus 42.23% (non-ISO) (p-value = 0.024). Depression volume and the QGSGS showed significant reduction compared to the baseline; however, there was no significant difference between groups.

CONCLUSIONS

Thus, AFCL is a safe and effective treatment for acne scar patients with FST of 3 or higher in Southeast Asians currently undergoing oral ISO.