Abstract：
BACKGROUND: Differences in clinical efficacy based on the fluence of fractional picosecond laser treatment for acne scars are unknown.
OBJECTIVE: To compare the efficacy and safety of low-fluence versus high-fluence fractional picosecond Nd:YAG 1064-nm laser treatment in acne scar patients.
METHODS: In this 12-week, investigator-blinded, randomized, split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high-fluence laser treatment (1.0 J/cm2 ) on one side of their face and low-fluence (0.3 J/cm2 ) on the other side every 4 weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4 weeks. The histological analysis compared the acne scars obtained before and 4 weeks after treatment.
RESULTS: At their last visit, 88.00% and 92.00% of the subjects achieved >30% reduction in scar counts on the low- and high-fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4 weeks after the last treatment. Although the high-fluence side showed a greater reduction in scar counts (-66.73%) than the low-fluence side (-62.13%), the two sides had no significant difference in the grading scores. The high-fluence side showed significantly more severe pain and higher side-effect scores immediately and 4 weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low-fluence side.
CONCLUSIONS: The low-fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high-fluence setting.
OBJECTIVE: To compare the efficacy and safety of low-fluence versus high-fluence fractional picosecond Nd:YAG 1064-nm laser treatment in acne scar patients.
METHODS: In this 12-week, investigator-blinded, randomized, split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high-fluence laser treatment (1.0 J/cm2 ) on one side of their face and low-fluence (0.3 J/cm2 ) on the other side every 4 weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4 weeks. The histological analysis compared the acne scars obtained before and 4 weeks after treatment.
RESULTS: At their last visit, 88.00% and 92.00% of the subjects achieved >30% reduction in scar counts on the low- and high-fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4 weeks after the last treatment. Although the high-fluence side showed a greater reduction in scar counts (-66.73%) than the low-fluence side (-62.13%), the two sides had no significant difference in the grading scores. The high-fluence side showed significantly more severe pain and higher side-effect scores immediately and 4 weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low-fluence side.
CONCLUSIONS: The low-fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high-fluence setting.
摘要：
背景：基于皮秒级激光治疗痤疮疤痕的影响因素的临床疗效差异尚不清楚。
目的：比较低通量和高通量分数皮秒Nd:YAG1064-nm激光治疗痤疮瘢痕患者的疗效和安全性。
方法：在这12周内，调查员失明，随机化，分面研究，25例中度至重度痤疮疤痕的患者每4周在面部一侧接受三次高注量激光治疗（1.0J/cm2），在另一侧接受低注量（0.3J/cm2）。使用痤疮疤痕计数对患者进行评估，疤痕全球评估（SGA），每4周进行一次ECCA瘢痕分级。组织学分析比较了治疗前和治疗后4周获得的痤疮疤痕。
结果：在他们最后一次访问时，88.00％和92.00％的受试者在低通量和高通量侧的疤痕计数减少>30％，分别,双方没有明显差异。在两边，伤疤很重要,SGA,末次治疗后4周ECCA评分明显改善。尽管高注量侧显示出比低注量侧（-62.13％）更大的疤痕计数减少（-66.73％），双方的评分无显著差异。高通量侧在治疗后立即和4周表现出明显更严重的疼痛和更高的副作用评分。组织学分析显示胶原蛋白显著增加，弹性蛋白,低通量侧治疗后波形蛋白表达。
结论：与高通量设置相比，低通量设置在治疗痤疮疤痕方面表现出可比的疗效和优异的安全性。
目的：比较低通量和高通量分数皮秒Nd:YAG1064-nm激光治疗痤疮瘢痕患者的疗效和安全性。
方法：在这12周内，调查员失明，随机化，分面研究，25例中度至重度痤疮疤痕的患者每4周在面部一侧接受三次高注量激光治疗（1.0J/cm2），在另一侧接受低注量（0.3J/cm2）。使用痤疮疤痕计数对患者进行评估，疤痕全球评估（SGA），每4周进行一次ECCA瘢痕分级。组织学分析比较了治疗前和治疗后4周获得的痤疮疤痕。
结果：在他们最后一次访问时，88.00％和92.00％的受试者在低通量和高通量侧的疤痕计数减少>30％，分别,双方没有明显差异。在两边，伤疤很重要,SGA,末次治疗后4周ECCA评分明显改善。尽管高注量侧显示出比低注量侧（-62.13％）更大的疤痕计数减少（-66.73％），双方的评分无显著差异。高通量侧在治疗后立即和4周表现出明显更严重的疼痛和更高的副作用评分。组织学分析显示胶原蛋白显著增加，弹性蛋白,低通量侧治疗后波形蛋白表达。
结论：与高通量设置相比，低通量设置在治疗痤疮疤痕方面表现出可比的疗效和优异的安全性。
