Safety and Efficacy of 1550nm Fractional Laser Treatment for Acne Scars in Fitzpatrick Type IV-VI Skin

Background: Ablative resurfacing lasers are effective for treatment of acne scars, but they have a high risk of complications. Fractional lasers have less severe side effects but more moderate efficacy than ablative devices. Studies were performed in individuals with Fitzpatrick skin type I to VI.

Objective: To determine the efficacy and safety of an erbium 1,550-nm fractional laser in the treatment of facial acne scars in Fitzpatrick skin types IV to VI.

Methods: We conducted a prospective, single-blind, randomized trial in patients with acne scars (n=15), skin type IV to VI, with a 1,550-nm erbium fractionated laser. Patients were divided into two groups; one was treated with 10 mJ and the other with 40 mJ. Five monthly laser sessions were performed. A patient questionnaire was distributed.

Inclusion criteria

• Male or female voluntary patients between the ages of 18 and 59 with Fitzpatrick skin type IV-VI as verified by one of the investigators
• Patients with clinical diagnosis of ice pick, rolling, or boxcar type ane scarring
• Patients able to follow instructions
• If patient has a history of cold sores (herpes labialis) they must be willing to take prophylactic valtrex
• Written informed consent from the patients (Appendix II)

Exclusion criteria

• Children (less than 18 years old)
• Pregnant or lactating women
• Personal history of keloids or hypertrophic scarring
• Active acne requiring topical or oral therapy
• Accutane or other oral retinoid in past year
• Patients with a known allergy to lidocaine
• Allergy to valacyclovir in a patient that needs prophylaxis
• Patients with an unstable or non controlled underlying medical problem
• Patients who are not able to follow instructions
• Patients who have participated in a study within the 3 months prior to study entry
• Patients who refuse to give written informed consent
• Patients with a history of a pigmentary abnormality