Fractional ablative CO2 laser and oral isotretinoin—A prospective randomized controlled split‐face trial comparing concurrent versus delayed laser treatment for acne scars

Abstract

AbstractBackgroundTherapeutic dogma has been to treat acne scars with ablative fractional laser no less than 6 months after isotretinoin (ITN) cessation.ObjectiveTo evaluate the safety and efficacy of fractional ablative CO2 laser (FACL) in patients treated concurrently with ITN.MethodsWe conducted a prospective split‐face randomized control trial in patients treated with FACL concurrently with ITN versus patients treated with FACL 6 months post‐ITN treatment. Patients received 3 monthly sessions of FACL with concurrent ITN treatment on half of the face; the other side of the face received the same FACL treatment regimen 6 months post‐ITN cessation. Patients were followed for adverse effects up to 6 months post‐FACL treatment. Final cosmesis was scored using the Quantitative Global Acne Scarring Grading System (GASGS) by three independent dermatologists.ResultsThe GASGS of the concurrent ITN‐FACL treated side of the face was significantly lower than the side treated with delayed laser therapy (4.7 ± 2.5 vs. 7.7 ± 2.9, respectively, p < 0.001).LimitationsThe laser's settings were standardized, and not adjusted per patient skin type.ConclusionPer our prospective trial, concurrent treatment of FACL ‐ITN is superior to delayed FACL treatment 6 months post‐ITN cessation.Fractional ablative laser treatment is effective in improving acne scars, which persist despite isotretinoin therapy.