Comparison of the efficacy of fractional CO2 laser with microneedling in management of patients with atrophic acne scars: a single-blind clinical trial

Background and Aim: Atrophic scars constitute a common complication of acne and various methods have been proposed for their treatment. This study aims at comparing the efficacy of fractional CO2 laser with microneedling in the management of atrophic acne scars. Methods: Patients with atrophic acne scars presenting to dermatology clinic of Hamadan’s Sina hospital between March 2016 and March 2018 were included in the study. Every 3 weeks, each patient received fractional CO2 laser on one side of the face and microneedling on the other side, for a total of 4 sessions. Patient’s satisfaction and the severity of scars (based on Goodman and Baron’s scar scale) were assessed 1, 2 and 6 months thereafter. Results: Overall, 24 participants were included. Prior to intervention, no significant difference was observed between groups in terms of mean scar score (P=0.726). At 1, 2 and 6month follow-up visits, the scar score of the side treated with laser was significantly lower than the microneedling side (P for 1, 2 and 6month follow-up visits: 0.033, 0.008 and 0.014). No significant difference was observed between groups in terms of patient’s satisfaction (P for 1, 2 and 6 month follow-up visits: 0.589, 0.469 and 0.840). The most prevalent side effect was erythema in 3 patients treated with laser. Due to low prevalence, statistical analysis of side effects between groups was impossible. Conclusion: Compared to microneedling, fractional CO2 laser was more effective in reducing the scar score of patients. The prevalence of side effects in both treatments were low.