Successful treatment of atrophic postoperative and traumatic scarring with carbon dioxide ablative fractional resurfacing: quantitative volumetric scar improvement.
OBJECTIVE
To assess the safety and efficacy of ablative fractional resurfacing (AFR) for nonacne atrophic scarring.


METHODS
In this before-and-after trial, each scar received 3 AFR treatments and 6 months of follow-up.


METHODS
Private academic practice.


METHODS
Fifteen women with Fitzpatrick skin types I to IV, aged 21 to 66 years, presented with 22 nonacne atrophic scars between June 1 and November 30, 2007. Three patients (3 scars) were excluded from the study after receiving 1 AFR treatment and not returning for follow-up visits. The remaining 12 patients (19 scars) completed all 3 treatments and 6 months of follow-up.


METHODS
Each scar received 3 AFR treatments at 1- to 4-month intervals.


METHODS
Erythema, edema, petechiae, scarring, crusting, and dyschromia were graded after treatment and through 6 months of follow-up. Skin texture, pigmentation, atrophy, and overall appearance were evaluated after treatment and through 6 months of follow-up by the patient and a nonblinded investigator. A 3-dimensional optical profiling system generated high-resolution topographic representations of atrophic scars for objective measurement of changes in scar volume and depth.


RESULTS
Adverse effects of treatment were mild to moderate, and no scarring or delayed-onset hypopigmentation was observed. At the 6-month follow-up visit, patient and investigator scores demonstrated improvements in skin texture for all scars (patient range, 1-4 [mean, 2.79]; investigator range, 2-4 [mean, 2.95]), pigmentation for all scars (patient range, 1-4 [mean, 2.32]; investigator range, 1-4 [mean, 2.21]), atrophy for all scars (patient range, 1-4 [mean, 2.26]; investigator range, 2-4 [mean, 2.95]), and overall scar appearance for all scars (patient range, 2-4 [mean, 2.89]; investigator range, 2-4 [mean, 3.05]). Image analysis revealed a 38.0% mean reduction of volume and 35.6% mean reduction of maximum scar depth.


CONCLUSIONS
The AFR treatments represent a safe, effective treatment modality for improving atrophic scarring due to surgery or trauma.
Laser & Skin Surgery Center of New York, 317 E 34th St, New York, NY 10016, USA. eweiss@laserskinsurgery.com
Elliot T
ET
Weiss
Anne
A
Chapas
Lori
L
Brightman
Christopher
C
Hunzeker
Elizabeth K
EK
Hale
Julie K
JK
Karen
Leonard
L
Bernstein
Roy G
RG
Geronemus
D000328:Adult; D000368:Aged; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult