| Objective:To observe the clinical efficacy of erbium fractional laser combined with recombinant human collagen type Ⅲ in treatment of atrophic acne scar and the effect of reducing postoperative adverse reactions after laser surgery.Methods:60 patients treated in the dermatology clinic of Affiliated Hospital of Inner Mongolia Medical University from December 2020 to December 2021.They were collected and randomly divided into experimental group and control group,each group contains 30 patients..The experimental group was treated with 2940 nm Erbium fractional laser combined with recombinant human collagen type Ⅲ;the control group was treated with simple 2940 nm Erbium fractional laser,both groups were treated three times with 2 months’ intermediate interval.Finally,two dermatologists evaluated the clinical symptom improvement of atrophic acne scar based on ECCA weight score and grade 4 single-blind assessment results of both group;analysis of erythema,pores,spots,texture,brown spots and ultraviolet spots index by VISIA facial image analyzer;Multifunctional skin tester MPA9 for Transepidermal water loss(TEWL);Postoperative VAS pain assessment;follow-up and record scab shedding time to assess wound healing;And recorded adverse reactions during the course to assess safety.Results:All 60 patients had completed the three times treatments,assessments,and follow-up.In the experimental group,18 males(60%),12 females(40%),age 18-31 years,mean age 25.60 ± 2.86 years,course of disease: 1-12 years,mean 6.60 ± 2.99 years.In the control group,15 males(50%),15 females(50%),age 19-35 years,mean age 25.23 ± 3.98 years,course of disease:1-13 years,mean 6.17 ± 3.66 years.ECCA evaluation: the mean ECCA before experimental group was 161.33 ± 27.04,ECCA96.17 ± 33.31 before treatment ECCA was 153.67 ± 32.51,and ECCA 115.17 ± 35.82,the ECCA value was statistically significant(P <0.05).Level 4 single-blind assessment:9 patients,12 effective,6 patients,3 patients,total response rate of 90%,3 patients,12,8,total efficiency of 73.3%,higher than the control group(P <0.05).Observation indicators: erythema,spots,pores,spots,texture,brown spots,ultraviolet spots,spots and percutaneous water loss were significantly improved compared with the control group,and the difference was statistically significant(P <0.05).The mean time of scab shedding in the experimental group was 5.80 ± 1.24 days shorter than that of 6.67 ±1.40 days,which was significant(P <0.05).The mean VAS score of experimental group was 5.97 ± 1.45,and the mean VAS score of control group was 5.63 ± 1.16,which was not significant(P> 0.05).All patients developed edema,punctate bleeding,exudation and pain at the treatment site after 2940 nm erbium fractional laser treatment,which subsided within 24 to 48 hours,and the obvious erythema gradually subsided within 10 days.Follow-up found that one patient in the experimental group developed pigmentation after the end of the third treatment.No patients developed skin infection,scar hyperplasia,hypopigmentation,and persistent erythema during follow-up from the start of treatment and 2 months after the end of the course.Conclusion:Erbium fractional laser combined recombinant human collagen type Ⅲtreatment of atrophic acne scar curative effect,not only can effectively improve clinical symptoms,improve the total efficiency,and to reduce the laser postoperative erythema and pigmentation,repair skin barrier function,promote wound healing,improve pores and texture also,no serious adverse reactions,although lacking in reducing pain,but overall,It is a safe and effective combination treatment,and worthy to clinical application. |
