Efficacy and Tolerability of a Hybrid Fractional Laser for the Treatment of Acne Scars in Patients With Skin of Color

Change in acne scarring severity from baseline to nine months will be assessed using the Global Scale for Acne Scar Severity (SCAR-S) scale. The SCAR-S is a validated scale used to assess the severity of acne scarring using a 6-point scale ranging from 0 ("Clear, no visible scars from acne") to 5 ("Very Severe; entire area with prominent atrophic or hypertrophic scars") such that higher scores are indicative of more severe scarring. Two independent blinded dermatologists will rate before and after treatment images using the SCAR-S scale. Results will be summarized by study arm using descriptive statistics.

Change in aesthetic success from baseline will be evaluated using the Clinician's Global Assessment of Improvement Scale (CGAIS). The CGAIS evaluates overall efficacy and cosmetic outcomes of the treatment. The CGAIS is based upon a 7-point scale ranging from -3 ("Greatly worsened") to +3 ("Greatly improved"), with 0 ("No change") as the midpoint. Two independent unbiased blinded dermatologists will conduct live/photographic assessments to evaluate patients at baseline, Month 2, Month 3, Month 4, Month 6, and Month 9. Results will be summarized by study arm using descriptive statistics.

Overall patient satisfaction will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients to select the option that better represents the change in how their skin looks using a 7-point scale ranging from -3 ("Greatly decreased") to +3 ("Greatly increased"), with 0 ("No change") as the midpoint. Scores will be summarized by study arm using descriptive statistics.

Patient assessment of acne scarring will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients to select the option that better represents the change in acne scarring in the area treated using a 7-point scale ranging from -3 ("Greatly decreased") to +3 ("Greatly increased"), with 0 ("No change") as the midpoint. Scores will be summarized by study arm using descriptive statistics.

Patient assessment of skin texture will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients to select the option that better represents the change in their skin texture using a 7-point scale ranging from -3 ("Greatly improved") to +3 ("Greatly worsened"), with 0 ("No change") as the midpoint. Scores will be summarized by study arm using descriptive statistics.

Patient assessment of skin pigmentation will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients to select the option that better represents the change in their skin pigmentation using a 7-point scale ranging from -3 ("Greatly improved") to +3 ("Greatly worsened"), with 0 ("No change") as the midpoint. Scores will be summarized by study arm using descriptive statistics.

Patient assessment of general skin changes will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients "beyond texture, pigmentation, and overall acne scarring, did you notice any other changes in the area that was treated." Patients will select either "Yes" or "No." Binary responses will be summarized by study arm.

Patients who confirmed that they did notice changes in the "Patient Assessment of General Skin Changes - Binary" query on the PSQ will be asked to specify what those changes were from a menu of options. These options are "Pores are smaller," "Skin is less oily," "Skin is smoother," "Skin feels better," "Skin looks more radiant," "Face feels more youthful," and "Other." Patients will have the option of selecting more than one response. Responses will be categorically summarized by study arm.

Patient satisfaction with treatment will be assessed throughout the study using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. This question asks patients how they would characterize their satisfaction with the treatment using the following suite of options: "Very dissatisfied," "Dissatisfied," "Slightly dissatisfied," "Neither Satisfied or Dissatisfied," "Slightly satisfied," "Satisfied," or "Very Satisfied." Ordinal responses will be summarized by study arm using descriptive statistics.

Patients will be asked whether they would recommend the treatment to friends and family members using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Binary ("Yes" or "No") responses of recommendations to family/friends will be summarized by study arm.

Patients will be asked whether they are following skin care accommodations for laser treatment using an item from the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Binary ("Yes" or "No") responses of adherence to skin care accommodations for laser treatment will be summarized by study arm.

Patients will be asked whether they are using daily mineral sunscreen of SPF30 or greater on the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Binary ("Yes" or "No") responses of usage will be summarized by study arm.

Patients will be asked whether they are avoiding the sun on the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Binary ("Yes" or "No") responses of sun avoidance will be summarized by study arm.

One of the safety variables will be treatment-related side effects. Patients will be asked whether they are experienced any of the following side effects following laser treatment: "Erythema," "Prolonged erythema," "Acne flare up," "Hypopigmentation," and "Hyperpigmentation." on the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Patients can select any/all treatment-related side effects which they experienced. Responses will be categorically summarized by study arm.

One of the safety variables will be pain discomfort. Patients will be asked to quantify the degree of pain discomfort experienced following treatment using a pain scale item provided on the Patient Satisfaction Questionnaire (PSQ) completed during each visit. Patients will rate their pain discomfort on an 11-point Likert scale ranging from 0 ("No Pain") to 10 ("Worst Possible Pain"), such that higher scores are indicative of increased pain discomfort. Results will be summarized by study arm using descriptive statistics.

Dermatology quality of life will be assessed using the Dermatology Life Quality Index (DLQI). The DLQI is a standardized 10-item dermatology scale which determines how much impact a skin condition has had on life quality. Patients are asked to consider how much their skin problem has affected their life over the prior week when responding to each question. Questions are subjectively answered by patients using the following choices: "Very much" (= 3 points), "A lot" (= 2 points), "A little" (= 1 point), and "Not at all" or "Not relevant" (= 0 points). Scores are summarized for an overall possible range of 0-30, such that higher scores are indicative of greater dermatology-related life quality impairment. Results will be summarized by study arm using descriptive statistics.