The Efficacy and Safety of Epidermal Growth Factor Combined with Fractional Carbon Dioxide Laser for Acne Scar Treatment: A Split-Face Trial

Abstract

Background: Epidermal growth factor (EGF) stimulates collagen production and supports the wound healing process. However, there are no studies on fractional carbon dioxide (CO₂) laser combined with EGF for acne scar treatment.

Objective: We sought to evaluate the efficacy and safety of fractional CO₂ laser combined with topical EGF versus fractional CO₂ laser alone in the treatment of acne scars.

Methods: Twenty-three patients with atrophic acne scars underwent three monthly sessions of randomized split-face application of fractional CO₂ laser combined with topical EGF or placebo twice daily for seven days following each laser session. Scar improvement was evaluated at one month and three months posttreatment by two blinded dermatologists and the Antera 3D^® skin analysis system. Wound healing response and adverse events were also evaluated.

Results: Twenty-one patients completed the trial. According to dermatologist grading and skin analysis system, EGF showed significant superiority at three months posttreatment compared to placebo. The wound healing response did not differ between the groups. Surprisingly, the melanin index on the EGF side showed a significant decrease at three months posttreatment, compared to placebo. There was no allergic reaction to the topical EGF.

Conclusion: Treatment with topical EGF after ablative fractional CO₂ laser improves the clinical appearance of atrophic acne scars, and EGF may help decrease skin pigmentation after laser treatment. The use of topical EGF is safe when applied to post-laser ablation.

Keywords: Epidermal growth factor; acne scar; fractional carbon dioxide laser.

FIGURE 1.

Clinical photographs of 29-year-old male; Figures 1A–1C show the side treated with the epidermal growth factor, and Figures 1D–1F show the placebo-treated side. (A) and (D) are baseline. (B) and (E) are at one month posttreatment. (C) and (F) are at three months posttreatment.