Comparison of Sequential CO2 Laser and Dermaroller versus CO2 Laser Alone in the Treatment of Acne Scarring

Background: Ablative CO2 laser resurfacing and dermaroller are proven effective modalities for the treatment of acne scarring. However, one out of two techniques is done exclusively in a patient. We have compared the sequential fractional CO2 laser and dermaroller in one group of patients, while the other group was subjected to exclusive fractional CO2 laser treatment. Materials and Methods: A total of 28 patients were recruited for the study. Fourteen patients (aged 21–35 years) with moderate-to-severe acne scars underwent one sitting of fractional CO2 laser, followed by dermaroller after 6 weeks to follow the same sequence making total of four sittings over 6 months, while other 14 patients (aged 21–36 years) underwent total of four fractional CO2 laser sittings within a gap of 6 weeks each. Outcomes were based on scar severity scores as described by Lipper and Perez and patients' subjective ratings. Results: Acne scarring improved significantly in all 28 patients. Mean scar severity scores decreased to 34.3% as compared to 80.7% before treatment, decreasing by a mean of 56.9% in Group A, while in Group B, the mean scar severity scores decreased to 40.5% as compared to 76.3%, decreasing by a mean of 46.9%. Mean patients' subjective score was recorded as 2, which represents a good improvement (25%–50%) in Group A, while it was recorded as 1, representing mild improvement (0%–25%) in Group B. Conclusions: Successfully combining fractional CO2 laser with dermaroller constitutes a safe and extremely effective treatment modality for acne scarring.