Comparison of Q-Switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar*

BACKGROUND Acne scarring is treatable by a variety of modalities. Ablative carbon dioxide laser (ACL), while effective, is associated with undesirable side effect profiles. Newer modalities using the principles of fractional photothermolysis (FP) produce modest results than traditional carbon dioxide (CO(2)) lasers but with fewer side effects. A novel ablative CO(2) laser device use a technique called ablative fractional resurfacing (AFR), combines CO(2) ablation with a FP system. This study was conducted to compare the efficacy of Q-switched 1064-nm Nd: YAG laser and that of fractional CO(2) laser in the treatment of patients with moderate to severe acne scarring. METHODS Sixty four subjects with moderate to severe facial acne scars were divided randomly into two groups. Group A received Q-Switched 1064-nm Nd: YAG laser and group B received fractional CO(2) laser. Two groups underwent four session treatment with laser at one month intervals. Results were evaluated by patients based on subjective satisfaction and physicians' assessment and photo evaluation by two blinded dermatologists. Assessments were obtained at baseline and at three and six months after final treatment. RESULTS Post-treatment side effects were mild and transient in both groups. According to subjective satisfaction (p = 0.01) and physicians' assessment (p < 0.001), fractional CO(2) laser was significantly more effective than Q- Switched 1064- nm Nd: YAG laser. CONCLUSIONS Fractional CO2 laser has the most significant effect on the improvement of atrophic facial acne scars, compared with Q-Switched 1064-nm Nd: YAG laser.