| Objective:Comparing the different curative and adverse effects between two methods of domestic fractional C02 laser that called "Deep analog mode" combined with "improved Active mode"and "simple Deep analog mode" in curing atrophic acne scar to find out the better treatment method and parameter settings for atrophic acne scar.Methods:42 patients’ clinical data were collected whom diagnosed of atrophic acne scar and with symmetrical scars on both sides of the face from January 20,2017 to November 31,2017.There were 25 males and 17 females with the average age of 24.69±5.69 years old whose two sides of the face were randomly divided into experimental and control group.Experimental group,In the first step,using domestic fractional C02 laser to treat atrophic acne scar area only on the method called "Deep analog mode"(low energy density,low coverage,small spot),energy:80-99mJ,spacing:0.9-1.2cm).In the second step,treating the atrophic acne scars and the entire surrounding area on the method called "improved Active mode"(low energy density,low coverage,small spot),energy:40-60mJ,and the distance was 1.0-1.3cm.Control group,the treatment method and parameter settings were the same as the first step in experimental group.Every patient completed 2 times of treatments.The treatment interval was 2 months.The patients were suggested follow-up 2 months after each treatment.The patients were photographed and scored for ECCA,atrophy,smoothness,efficiency,adverse reaction and patient’s satisfaction.Results:1.When 42 patients diagnosed of atrophic acne scar completed 2 times treatments by domestic fractional CO2 laser,the ECCA weighted scores both of the experimental group and the control group gradually decreased with the increase in the frequency of treatment,and that of the experimental group improved significantly compared with the control group ’ s,and the difference was statistically significant(P<0.05).2.The ECCA weighted scores for different times of the treatment demonstrated the ECCA values in the experimental group decreased significantly after the first time of treatment,whereas the control group decreased significantly after the second time of treatment.And that of the experimental group improved significantly compared with the control group,and the difference was statistically significant(P<0.05).3.The decline of the ECCA weighted scores was the most significant in the truck type in both of experimental group and control group,and the difference was statistically significant between the two groups(P<0.05),and followed by the ice cone type,and rolling type abysmally.While,there was no significant difference between the rolling type and the ice cone type(P>0.05).4.All of the truck type,ice cone type and rolling type in the atrophy acne scars,the decline of the ECCA weighted scores of experimental group were obviously lower than those of the control group,and the difference was not statistically significant between the two groups(P>0.05).5.Skin lesions situation of depression,smoothness scores and total scores:the two groups are gradually reduced with the increase in the times of treatment,and the experimental group improvement is better than those of the control group in the skin lesions situation of depression and smoothness scores,and the experimental group healing faster than the control group,and the difference was statistically significant between the two groups(P<0.05).6.The effectiveness of treatment:the total effective rate of the experimental group and that of the control group was 100%.Markedly effective in 3 cases(7.1%)vs 1 case(2.3%),and effective in 28 cases(66.7%)vs 18 cases(42.9%),and general in 11 cases(26.2%)vs 23 cases(54.8%),and invalid 0 case(0.0%)vs 0 case(0.0%)between the experimental and control group.There was a significant difference between the experimental and the control group in the treatment(z=-3.742,P<0.05).7.Self-satisfaction degree,very satisfied in 4 cases(9.5%)vs 1 case(2.4%),and satisfied in 29 cases(69.0%)vs 25 cases(59.5%),and generally satisfied in 9 cases(21.4)%)vs 16 cases(38.1%),and unsatisfied in 0 case(0.0%)vs 0 case(0.0%)between the experimental and the control group.There was a statistically significant difference in self-satisfaction between the experimental group and the control group(z=-3.162,P<0.05),indicating that the experimental group’s self-satisfaction degree is better than that of the control group.8.The erythema,edema,paining,pruritus,and scars would recover 7-12 days after the treatment both of the experimental and control group.Only two patients had terminated the treatment because of facial pigmentation spots on both sides of the face,while pigmentation spots resolved significantly 4 months later,and no significant adverse reactions were observed on the remaining patients.Conclusions:1.The method of "Deep analog mode" combined with "improved Active mode" is more effective and faster than "simple Deep analog mode" in treating atrophic acne scars by domestic fractional CO2 lasers.2.The method of "Deep analog mode" combined with "improved Active mode" is better than the "simple Deep analog mode" in treatment of improving skin texture,tone and minimizing pores,and also got higher patient satisfaction by domestic fractional CO2 lasers.3.Both methods of domestic fractional C02 lasers got the same outcome that the best curative effect on the trucks type,followed by the ice cone type and rolling type.4.In the dark-skinned population,the method of "Deep analog mode" combined with "improved Active mode" in domestic fractional CO2 lasers may be more prone to pigmentation than that of the method of "simple Deep analog mode",so need to warning patients to protect themselves from sunshine. |
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