Evaluation of a novel fractional resurfacing device for treatment of acne scarring

Background and Objective: Pulsed carbon dioxide (CO ₂) laser devices are considered highly effective treatment options for skin resurfacing. However, the high risk for significant treatment complications following CO ₂ resurfacing has warranted the development of new treatment modalities. The concept of fractional photothermol-ysis was developed to address the shortcomings of ablative and non-ablative device modalities. This report evaluates a fractional approach to CO ₂ laser resurfacing for the treatment of moderate to severe acne scarring. The primary endpoint of the study was the overall improvement in the appearance of acne scarring. Study Design/Materials and Methods: Thirty subjects, with moderate to severe acne scarring, underwent up to three treatments with an FDA IDE and IRB approved 10,600 nm fractional CO ₂ laser system. All subjects were Fitzpatrick skin types I-V and 18-75 years of age. Treatment parameters ranged from 20 to 100 mJ with total densities of 600-1,600 MTZ/cm ². Improvement of acne scarring was evaluated at 1 and 3 months post-treatment. Results: Twenty-three out of25 subjects sustained clinical improvement in the appearance of acne scarring at the 3-month follow-up visits according to study investigator quartile improvement scoring. Subjects also had improvement in their overall appearance, including pigmentation and rhytides. Serosanguinous oozing resolved within 24-48 hours following treatment. All subjects had transient erythema, which resolved in the majority of subjects within 1-3 months. Post-operative downtime was significantly decreased compared to traditional ablative resurfacing. No serious complications were reported. Conclusion: Fractional deep dermal ablation improves moderate to severe acne scarring. The added benefit is a considerable reduction both in downtime and risk of complications when compared to traditional CO ₂ ablative resurfacing techniques.