Lasers for the treatment of erythema, dyspigmentation, and decreased elasticity in macular acne scars: a systematic review

Abstract

Scarring is one of the most esthetically challenging and psychologically burdening aspects following inflammatory acne. While "macular" disease is the scar subtype with the least complicated outcome, its phase can be regarded as the most defining in the ultimate scar appearance. Moreover, with lasers recently gaining much popularity in the scientific community for managing several dermatologic conditions, we aimed to evaluate whether they would lead to significant benefits. For this systematic review, four databases consisting of PubMed, Scopus, Embase, and Web of Science were searched using a comprehensive string, with the data from the relevant yet eligible identified records qualitatively synthesized. After investigating the data obtained from the nine included studies, we found the utilized lasers, namely neodymium-doped yttrium aluminum garnet, fractional carbon dioxide, pulsed dye, erbium:glass, pro-yellow, and high-power optically pumped semiconductor, to be highly effective in managing the erythematous or dyspigmented appearance with the reduced elasticity also significantly improving. Moreover, the adverse events were both bearable and minimal, and transient. However, the degree of improvement each type of scar demonstrated following laser therapy varied based on the laser used. Neodymium-doped yttrium aluminum garnet, fractional carbon dioxide, and pulsed dye are the most commonly investigated lasers for managing macular acne scars, demonstrating eye-catching capabilities in managing either erythema or dyspigmentation. However, we still recommend that further comparative interventional studies be carried out, while the intended outcomes also assessed with objective measures for further clarification.

Keywords: Dyspigmentation; Fractional CO2; Fractional erbium:glass; Lasers; Macular acne scars; Nd:YAG; Pulsed dye; Pure yellow.