• Logo
  • SBMUJournals

Ablative Fractional 10 600 nm Carbon Dioxide Laser Versus Non-ablative Fractional 1540 nm Erbium-Glass Laser in Egyptian Post-acne Scar patients

Mohamed Elsaie, Shady M. Ibrahim, Wael Saudi


Introduction: Non-ablative fractional erbium-doped glass 1540 nm and fractional ablative 10600 nm carbon dioxide lasers are regarded as effective modalities for treating acne atrophic scars. In this study, we aimed to compare the effectiveness of fractional CO2 laser and fractional non-ablative 1540 nm erbium doped glass laser in treating post acne atrophic scars in Egyptian patients.
Methods: Fifty-eight patients complaining of moderate and severe acne atrophic scars were randomly divided into 2 groups of 29 patients each. Both groups were subjected to 4 treatment sessions with 3 weeks interval and were followed up for 3 months. In group A, enrolled patients received CO2 laser, while in group B, patients were treated with 1540 nm erbium glass fractional laser.
Results: Clinical assessment revealed that the mean grades of progress and improvement were higher with fractional 10600 nm CO2 laser but with non-significant difference between both treatments (P = 0.1). The overall patients’ satisfaction with both lasers were not significantly different (P = 0.44).
Conclusion: Both fractional ablative CO2 and fractional non-ablative erbium glass lasers are good modalities for treating acne scars with a high efficacy and safety profile and good patient satisfaction. The fractional ablative laser showed higher efficacy while non-ablative laser offered less pain and shorter downtime.


Acne scars; Ablative laser; Fractional laser.


Asilian A, Salimi E, Faghihi G, Dehghani F, Tajmirriahi N, Hosseini SM. Comparison of Q-Switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar. J Res Med Sci. 2011;16(9):1189-1195.

Hirsch RJ. The future of acne treatment with lasers. Cosmet Dermatol. 2002;15:73-74.

Tanzi EL, Alster TS. Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatol Surg. 2004;30(2 Pt 1):152-157.

Tierney EP, Kouba DJ, Hanke CW. Review of fractional photothermolysis: treatment indications and efficacy. Dermatol Surg. 2009;35(10):1445-1461. doi:10.1111/j.1524- 4725.2009.01258.x

Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-438. doi:10.1002/ lsm.20048

Chan NPY, Ho SGY, Yeung CK, Shek SYN, Chan HH. The use of non-ablative fractional resurfacing in Asian acne scar patients. Lasers Surg Med. 2010;42(10):870-875. doi:10.1002/lsm.20976

Cho SB, Lee SJ, Cho S, et al. Non-ablative 1550-nm erbium-glass and ablative 10 600-nm carbon dioxide fractional lasers for acne scars: a randomized split-face study with blinded response evaluation. J Eur Acad Dermatol Venereol. 2010;24(8):921-925. doi:10.1111/j.1468-3083.2009.03551.x

Walgrave SE, Ortiz AE, MacFalls HT, et al. Evaluation of a novel fractional resurfacing device for treatment of acne scarring. Lasers Surg Med. 2009;41(2):122-127. doi:10.1002/lsm.20725

Sherling M, Friedman PM, Adrian R, et al. Consensus recommendations on the use of an erbium-doped 1,550- nm fractionated laser and its applications in dermatologic laser surgery. Dermatol Surg. 2010;36(4):461-469. doi:10.1111/j.1524-4725.2010.01483.x

Rongsaard N, Rummaneethorn P. Comparison of a fractional bipolar radiofrequency device and a fractional erbium-doped glass 1,550-nm device for the treatment of atrophic acne scars: a randomized split-face clinical study. Dermatol Surg. 2014;40(1):14-21. doi:10.1111/dsu.12372

Lee HS, Lee JH, Ahn GY, et al. Fractional photothermolysis for the treatment of acne scars: a report of 27 Korean patients. J Dermatolog Treat. 2008;19(1):45-49. doi:10.1080/09546630701691244

Bedi VP, Chan KF, Sink RK, et al. The effects of pulse energy variations on the dimensions of microscopic thermal treatment zones in nonablative fractional resurfacing. Lasers Surg Med. 2007;39(2):145-155. doi:10.1002/ lsm.20406

Sardana K, Garg V, Arora P, Khurana N. Histological validity and clinical evidence for use of fractional lasers for acne scars. J Cutan Aesthet Surg. 2012;5(2):75-90. doi:10.4103/0974-2077.99431

Hedelund L, Haak CS, Togsverd-Bo K, Bogh MK, Bjerring P, Haedersdal M. Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation. Lasers Surg Med. 2012;44(6):447-452. doi:10.1002/lsm.22048

Cho S, Jung JY, Shin JU, Lee JH. Non-ablative 1550 nm erbium-glass and ablative 10,600 nm carbon dioxide fractional lasers for various types of scars in Asian people: evaluation of 100 patients. Photomed Laser Surg. 2014;32(1):42-46. doi:10.1089/pho.2013.3608