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Single-session combination therapy successfully treats rolling acne scars

Researchers found that a combination of a superficial chemical peel, subcision and fractional CO₂ laser resurfacing after tumescent anesthesia is a safe and effective treatment for rolling acne scars, according to a study data published in Dermatologic Surgery.

Mark B. Taylor, MD, of Gateway Aesthetic Institute and Laser Center in Salt Lake City, and colleagues combined a trichloracetic acid 20% chemical peel and extensive subcision, using a novel instrument designed by Taylor, with fractional CO₂ laser (Fraxel Re:Pair; Solta) to treat the rolling acne scars of 114 patients (75 women) with Fitzpatrick skin Types I-V.

“Single-treatment modalities for rolling acne scars can often have less than ideal results,” the investigators wrote. “Combining known procedures in the treatment of rolling acne scars appears to be beneficial in achieving excellent improvement in a single treatment.”

Patients were followed for 1 to 2 months after therapy, and seven observers reviewed 158 photos of the patients and graded on a scale of 1 to 4 for improvement. The results showed a mean improvement of 2.9 after treatment, and complications were considered “rare” and successfully treated.

Taylor and colleagues reported that the chemical peel was necessary; without it, a sharp demarcation between the laser-treated skin and the nontreated skin can occur. They also said patients should be advised about the “dramatic tumescent face” after the procedure and to expect “potential dramatic bleeding” after the fractional CO₂ laser treatment.

“Patients rarely achieve a 100% improvement, so additional treatments with nonablative lasers, micro-needling, fillers, fractional radiofrequency, and other modalities may still be undertaken if the patient so desires,” the researchers wrote. “However, more than 90% of the patients in this study were satisfied after the single combined procedure and did not express an interest in further procedures.” – by Talitha Bennett

Disclosure: Taylor reports designing the novel subcision instrument used in this study. The other researchers report no relevant financial disclosures.