Comparative evaluation of punch elevation combined with fractional CO2 laser resurfacing versus fractional CO2 laser alone in the treatment of atrophic acne scars

Seif–Allah Mohamed Refaat El-Fiky; Sahar El-Sayed Ahmed; Rania Mahmoud Elhusseiny; Mohamed Hussein AbouHadeed; Dalia Gamal Aly

doi:10.53730/ijhs.v5nS2.15297

Authors

Seif–Allah Mohamed Refaat El-Fiky Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Ain Shams University
Sahar El-Sayed Ahmed Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Ain Shams University
Rania Mahmoud Elhusseiny Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Ain Shams University
Mohamed Hussein AbouHadeed
mh2us@yahoo.com
Department of Dermatology and Venereology, National Research Centre, Giza, Egypt
Dalia Gamal Aly Department of Dermatology and Venereology, National Research Centre, Giza, Egypt

Keywords:

Scars, Punch elevation, Acne, Fractional CO2

Abstract

Background: Acne vulgaris is a chronic inflammatory skin condition that often results in atrophic scarring, impacting physical appearance and mental health. This study aims to evaluating the potential effect of combining punch elevation with fractional CO₂ laser resurfacing versus laser treatment alone for moderate to severe atrophic acne scars. Patients and Methods: A split-face comparative study involved 20 adults aged 18 to 55 with moderate to severe atrophic acne scars. One side received punch elevation followed by fractional CO₂ laser resurfacing, while the other side received fractional CO₂ laser treatment alone. Clinical assessments included Goodman and Baron’s grading scale and patient satisfaction ratings. Histopathological evaluations analyzed fibroblast activity, epidermal thickness, and collagen composition. Results: The combined treatment significantly improved scar severity, with a mean reduction of 44.40% compared to 18.89% for the laser-only group (p < 0.001). Histopathological analysis showed increases in fibroblast activity (5.87% to 19.14%, p < 0.003) and epidermal thickness (635.65 µm to 1497.35 µm, p < 0.001). Patient satisfaction was higher for the combined approach (6.80 ± 1.2) versus laser-only treatment (5.65 ± 1.3, p < 0.001). Conclusion: Combining punch elevation technique with fractional CO₂ laser resurfacing enhances treatment outcomes for atrophic acne scars,,,

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