Evaluation of Efficiency of CO2Fractionated Technique versus Automated Microneedling Technique in Defective Facial Scars Improvement (Clinical Comparative Study in Terms of Pain and Pigmentation)

Abstract

Background: Scars are a common phenomenon as they develop after skin injury in patients of all ages. Although most scars do not pose a health risk, they can be highly disfiguring, resulting in decreased quality of life. For nearly 15 years, the carbon dioxide laser has been the gold standard for skin injuries treatment . Skin microneedling or fractional microneedle therapy is a recent approach uses for scars treatment and skin rejuvenation or to enhance transdermal delivery of topical medications.

Aim of the study: the aim of this work is to assess the efficiency and safety of fractional CO2 Laser for the treatment of surgical and post-traumatic scars in comparison with automated microneedling in term of pain and pigmentation. 

Materials and methods: The study evaluated 28 scars  from 11 patients aged between 18 and 49. One-half of the scars (chosen at random) were treated using Automated Microneedling technology and the other half were treated with fractional CO2Laser. In each case, three treatment sessions were given at 21-days intervals, in addition to a final 6-month evaluation session. Using the Patient and Observer Scar Assessment scale V2.0 (POSAS), each scar has been evaluated from the patient’ scale in terms of pain, itchiness, skin color, hardness, thickness, shape and the overall state of the abnormal facial scar. The same abnormal facial scars have  been evaluated by three different observers in terms of vascularity, pigmentation, thickness, pliability, surface area and the overall state of scars using the POSAS Observer’ scale at four distinct stages. Clinical evaluation of the results was performed.

Results: Concerning the use of fractional CO2 Laser, the findings of this study reveal statistical differences at significance level of 5% between each session. This indicates a reduction in the scale values of the studied variables. In addition, the mean clinical improvement was similar between the two techniques, and there was no statistical differences at significance level of 5%.

Conclusion: we concluded that fractional CO2Laser is safe and efficient and leads to a similar results in the improvement of the characteristics of the scars including pain and pigmentation after comparison with automated microneedling.