title: Fractional Erbium-Doped Yttrium Aluminum Garnet Laser Versus Microneedling in Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study.
abstract: BACKGROUND
  Ablative fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser and microneedling have been popularized in recent years and their effectiveness and side effects individually reported. No previous study, however, has directly compared the efficacy and safety between the 2 different treatments.
  
  
  OBJECTIVE
  To compare the efficacy and safety of the ablative fractional Er:YAG laser and microneedling for the treatment of atrophic acne scars.
  
  
  METHODS
  Thirty patients with atrophic acne scars were randomly treated in a split-face manner with a fractional Er:YAG laser on one side and microneedling on the other side. All patients received 5 treatments with a 1-month interval. Objective and subjective assessments were obtained at baseline and at 3 months after the final treatment.
  
  
  RESULTS
  At the 3-month follow-up, both treatment modalities induced noticeable clinical and histological improvement, with significantly better results in fractional Er:YAG laser versus microneedling (70% vs 30%), respectively (p < .001). Fractional Er:YAG laser sides had significantly lower pain scores. Total downtime was significantly shorter in microneedling sides.
  
  
  CONCLUSIONS
  Both treatment modalities are effective and safe in the treatment of atrophic acne scars, with significantly higher scar response to the fractional Er:YAG laser treatment.
authors.affiliation: *National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt; †Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mai Abdel Raouf
authors.initials: MA
authors.lastname: Osman
authors.forename: Hisham Ali
authors.initials: HA
authors.lastname: Shokeir
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Fawzy
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000328:Adult; D001284:Atrophy / Q000628:therapy; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D003357:Cosmetic Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D053844:Lasers, Solid-State; D008297:Male; D009339:Needles; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult