Journal of Cutaneous and Aesthetic Surgery
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Year : 2019  |  Volume : 12  |  Issue : 2  |  Page : 85-94

Fractional carbon dioxide laser: Optimizing treatment outcomes for pigmented atrophic acne scars in skin of color

1 Renewderm–Skin Hair Lasers Aesthetics Centre, Mumbai, Maharashtra, India
2 Consultant dermatologist, Janta hospital, Surat, Gujarat, India

Correspondence Address:
Shehnaz Z Arsiwala
Renewderm Skin Hair Lasers Aesthetics Centre, Nesbit Road, Mazgaon, Mumbai 400010, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCAS.JCAS_171_18

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Dark skin type has high propensity to acne scarring and is often complicated by persistent erythema or pigmentation at the base. Fractional lasers are available for the longest period and are able to improve most atrophic acne scars. Often pigmented scar bases and dark skin types limit the use of aggressive laser parameters. Long pulse mode is preferred over short pulse to prevent epidermal damage; low fluence is chosen versus high fluence and low density versus high density. Repeated treatments are needed to minimize complications and optimize results; all these must be achieved through a controlled stage of inflammation. Interventional priming with chemical peels and laser toning before ablative fractional carbon dioxide laser helps to reduce photodamage, recent tan, and pigment at scar base, thus minimizing the risk of post-inflammatory hyperpigmentation. Multiple recent literature evidence validates the combinations to optimize outcomes in atrophic acne scars as discussed in this review article.

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