Sang-Hyuk Woo1, Jae-Hong Park, Young-Chul Kye. 1. Department of Dermatology, Korea University Anam Hospital, #126-1, 5-Ka, Anam-dong, Sungbuk-ku, Seoul 136-705, Korea.
Abstract
BACKGROUND: Laser skin resurfacing has become a popular therapeutic modality for the correction of acne scars, but it is not always effective in all types of acne scars. OBJECTIVE: To evaluate the clinical effects of resurfacing with the short-pulsed Er:YAG laser, the variable-pulsed Er:YAG laser, and the dual-mode Er:YAG laser for each type of facial acne scars. METHODS: One hundred fifty-eight patients with facial acne scars were included in this study. Eighty three patients (18 deep boxcar scars, 8 ice-pick scars, 11 rolling scars, and 46 shallow boxcars) were treated with the 350-micros short-pulsed Er:YAG laser at the setting of 12.5 to 15%/cm(2). Thirty-five patients (8 deep boxcar scars, 4 ice-pick scars, 12 rolling scars, and 11 shallow boxcars) were treated with the variable-pulsed Er:YAG laser at the setting of 7.0 to 7.5%/cm(2) and 7-ms pulse duration. Forty patients (8 deep boxcar scars, 4 ice-pick scars, 17 rolling scars, and 11 shallow boxcars) were treated with the dual-mode Er:YAG laser with 350-micro ablation mode at 17.5%/cm(2) and 8-ms coagulation mode at 3.15%/cm(2). Facial photographs were obtained at baseline and at 2- to 4-week intervals postoperatively. Acne scars were classified into four types, and clinical improvements of facial acne scars were evaluated. RESULTS: Resurfacing with the short-pulsed Er:YAG laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and poor to fair for rolling scars. Resurfacing with the variable-pulsed laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and good for rolling scars. Resurfacing with the dual-mode laser shows good to excellent results for ice-pick, shallow, and rolling scars and produced good results on deep boxcar scars. CONCLUSION: Shallow boxcar and ice-pick scars can be treated successfully using any types of Er:YAG laser. In cases of rolling and deep boxcar scars, however, Er:YAG laser with a long-pulse duration for a thermal effect is needed for successful treatment.
BACKGROUND: Laser skin resurfacing has become a popular therapeutic modality for the correction of acne scars, but it is not always effective in all types of acne scars. OBJECTIVE: To evaluate the clinical effects of resurfacing with the short-pulsed Er:YAG laser, the variable-pulsed Er:YAG laser, and the dual-mode Er:YAG laser for each type of facial acne scars. METHODS: One hundred fifty-eight patients with facial acne scars were included in this study. Eighty three patients (18 deep boxcar scars, 8 ice-pick scars, 11 rolling scars, and 46 shallow boxcars) were treated with the 350-micros short-pulsed Er:YAG laser at the setting of 12.5 to 15%/cm(2). Thirty-five patients (8 deep boxcar scars, 4 ice-pick scars, 12 rolling scars, and 11 shallow boxcars) were treated with the variable-pulsed Er:YAG laser at the setting of 7.0 to 7.5%/cm(2) and 7-ms pulse duration. Forty patients (8 deep boxcar scars, 4 ice-pick scars, 17 rolling scars, and 11 shallow boxcars) were treated with the dual-mode Er:YAG laser with 350-micro ablation mode at 17.5%/cm(2) and 8-ms coagulation mode at 3.15%/cm(2). Facial photographs were obtained at baseline and at 2- to 4-week intervals postoperatively. Acne scars were classified into four types, and clinical improvements of facial acne scars were evaluated. RESULTS: Resurfacing with the short-pulsed Er:YAG laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and poor to fair for rolling scars. Resurfacing with the variable-pulsed laser shows good to excellent results for ice-pick and shallow boxcar scars, fair to good for deep boxcar scars, and good for rolling scars. Resurfacing with the dual-mode laser shows good to excellent results for ice-pick, shallow, and rolling scars and produced good results on deep boxcar scars. CONCLUSION: Shallow boxcar and ice-pick scars can be treated successfully using any types of Er:YAG laser. In cases of rolling and deep boxcar scars, however, Er:YAG laser with a long-pulse duration for a thermal effect is needed for successful treatment.