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Management of Acne Scarring, Part I

A Comparative Review of Laser Surgical Approaches

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Abstract

Acne scarring is the result of a deviation in the orderly pattern of healing and can have profound psychosocial implications for patients. While the most effective means of addressing acne scarring is to prevent its formation through good acne control, there are a number of therapeutic interventions that improve the appearance of acne scars. Many of these procedural modalities have flaws and are limited by operator skill and experience. Laser scar revision, on the other hand, is a precise, well tolerated procedure with clinically demonstrable efficacy and minimal adverse effects that may be used alone or in combination with other scar treatments. The last 20 years has seen a dramatic evolution in laser treatment of acne scars, spanning ablative and nonablative technologies, to the current popularity of fractional laser scar revision. Determining which laser system to use depends upon the type and severity of acne scarring, the amount of recovery a patient can tolerate, and the ultimate goals and expectations of each patient. The importance of proper acne scar classification, laser scar revision techniques, and the evidence that addresses each laser system is reviewed in this article.

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References

  1. AHRQ. Management of acne: summary. Evidence report/technology assessment — number 17. AHRQ publication no. 01-E018, March 2001 [online]. Rockville (MD): Agency for Healthcare Research and Quality, 2001. Available from URL: http://archive.ahrq.gov/clinic/epcsums/acnesum.htm [Accessed 2012 May 8]

    Google Scholar 

  2. Layton AM, Henderson CA, Cunliffe WJ. A clinical evaluation of acne scarring and its incidence. Clin Exp Dermatol 1994; 19: 303–8

    Article  PubMed  CAS  Google Scholar 

  3. Cunliffe WJ, Gould DJ. Prevalence of facial acne vulgaris in late adolescence and in adults. BM J 1979; 1(6171): 1109–10

    Article  CAS  Google Scholar 

  4. Johnson MT, Roberts J. Skin conditions and related need for medical care among persons 1/2-74 years, United States, 1971–1974 [series 11, no. 212]. Washington, DC: US Department of Health, Education and Welfare, Vital and Health Statistics, 1978 Nov

    Google Scholar 

  5. Goulden V, Stables Gl, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol 1999; 41: 577–80

    PubMed  CAS  Google Scholar 

  6. Rivera AE. Acne scarring: a review and current treatment modalities. J Am Acad Dermatol 2008; 59: 659–76

    Article  PubMed  Google Scholar 

  7. Kranning KK, Odland GF. Prevalence, morbidity and cost of dermatological diseases. J Invest Dermatol 1979; 73 Suppl.: 395–401

    Google Scholar 

  8. Thomas DR. Psychosocial effects of acne. J Cutan Med Surg 2004; 8 Suppl. 4: 3–5

    PubMed  Google Scholar 

  9. Cunliffe WJ. Unemployment and acne. Br J Dermatol 1986; 115: 386

    Article  PubMed  CAS  Google Scholar 

  10. Rumsey N, Clarke A, White P. Exploring the psychosocial concerns of outpatients with disfiguring conditions. J Wound Care 2003; 12: 247–52

    PubMed  CAS  Google Scholar 

  11. Goodman G. Acne and acne scarring: the case for active and early intervention. Aust Fam Physician 2006; 35(7): 503–4

    PubMed  Google Scholar 

  12. Jeremy AHT, Holland DB, Roberts SG, et al. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol 2003; 121: 20–7

    Article  PubMed  CAS  Google Scholar 

  13. Taylor M, Gonzalez M, Porter R. Pathways to inflammation: acne pathophysiology. Eur J Dermatol 2011; 21(3): 323–33

    PubMed  CAS  Google Scholar 

  14. Urioste SS, Arndt KA, Dover JS. Keloids and hypertrophic scars: review and treatment strategies. Semin Cutan Med Surg 1999; 18: 159–71

    Article  PubMed  CAS  Google Scholar 

  15. Fabbrocini G, D’Arco AV, De Vita V, et al. Acne scars: pathogenesis, classification and treatment. Derm Res Pract 2010; 893080: 1–13

    Article  Google Scholar 

  16. Holland DB, Jeremy AHT, Roberts SG, et al. Inflammation in acne scarring: a comparison of the responses in lesions from patients prone and not prone to scar. Br J Dermatol 2004; 150(1): 72–81

    Article  PubMed  CAS  Google Scholar 

  17. Monaco JL, Lawrence WT. Acute wound healing: an overview. Clin Plast Surg 2003; 30: 1–12

    Article  PubMed  Google Scholar 

  18. Alster TS, Tanzi EL. Hypertrophic scars and keloids: etiology and management. Am J Clin Dermatol 2003; 4: 235–43

    Article  PubMed  Google Scholar 

  19. Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 2001; 45: 109–17

    Article  PubMed  CAS  Google Scholar 

  20. Brown BC, McKenna SP, Siddhi K, et al. The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 2008; 61: 1049–58

    Article  PubMed  CAS  Google Scholar 

  21. Alster TS, Railan D. Laser scar revision. In: Goldman MP, editor. Cosmetic and cutaneous laser surgery. London: Mosby Elsevier, 2006: 271–6

    Google Scholar 

  22. Alster TS, Greenberg HL. Laser treatment of scars and striae. In: Kauvar AN, Hruza G, editors. Principles and practices in cutaneous laser surgery. New York: Taylor & Francis, 2005: 619–35

    Google Scholar 

  23. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983; 22: 524–7

    Article  Google Scholar 

  24. Alster TS, Kurban AK, Grove GL, et al. Alteration of argon laser-induced scars by the pulsed dye laser. Lasers Surg Med 1993; 13: 368–73

    Article  PubMed  CAS  Google Scholar 

  25. Benedetto AV, Griffin TD, Benedetto EA et al. Dermabrasion: therapy and prophylaxis of the photoaged face. J Am Acad Dermatol 1992; 27: 439–47

    Article  PubMed  CAS  Google Scholar 

  26. Brody HJ. Variations and comparisons in medium depth chemical peeling. J Dermatol Surg Oncol 1989; 15: 953–63

    PubMed  CAS  Google Scholar 

  27. Apfelberg DB, Maser MR, Lash H, et al. Preliminary results of argon and carbon dioxide laser treatment of keloid scars. Lasers Surg Med 1984; 4:283–90

    Article  PubMed  CAS  Google Scholar 

  28. Alster TS, McMeekin TO. Improvement of facial acne scars by the 585-nm flashlamp-pumped pulsed dye laser. J Am Acad Dermatol 1996; 35: 79–81

    Article  PubMed  CAS  Google Scholar 

  29. Kuo YR, Jeng SF, Wang FS, et al. Flashlamp pulsed dye laser (PDL) suppression of keloid proliferation through down-regulation of TGF-beta1 expression and extracellular matrix expression. Lasers Surg Med 2004; 34: 104–8

    Article  PubMed  Google Scholar 

  30. Reiken SR, Wolfort SF, Berthiamume F, et al. Control of hypertrophic scar growth using selective photothermolysis. Lasers Surg Med 1997; 21:7–12

    Article  PubMed  CAS  Google Scholar 

  31. Alster TS, Williams CM. Improvement of keloid sternotomy scars by the 585nm pulsed dye laser: a controlled study. Lancet 1995; 345: 1198–200

    Article  PubMed  CAS  Google Scholar 

  32. Alster TS, Nanni CA. Pulsed dye laser treatment of hypertrophic burn scars. Plast Reconstr Surg 1998; 102: 2190–5

    Article  PubMed  CAS  Google Scholar 

  33. Patel N, Clement M. Selective nonablative treatment of acne scarring with 585-nm flashlamp pulsed dye laser. Dermatol Surg 2002; 28: 942–5

    Article  PubMed  Google Scholar 

  34. Reish RG, Eriksson E. Scars: a review of emerging and currently available therapies. Plast Reconstr Surg 2008; 122: 1068–78

    Article  PubMed  CAS  Google Scholar 

  35. Alster TS, Zaulyanov-Scanlon L. Laser scar revision: a review. Dermatol Surg 2007; 33: 131–40

    Article  PubMed  CAS  Google Scholar 

  36. Alster TS. Laser treatment of scars and striae. In: Alster TS. Manual of cutaneous laser techniques. Philadelphia (PA): Lippincott-Raven; 2000: 89–107

    Google Scholar 

  37. Alster TS. Laser scar revision: comparison of pulsed dye laser with and without intralesional corticosteroids. Dermatol Surg 2002; 29: 25–9

    Article  Google Scholar 

  38. Manuskiatti W, Fitzpatrick RE. Treatment response of keloidal and hypertrophic sternotomy scars: comparison among intralesional corticosteroid, 5-fluorouracil, and 585-nm flashlamp-pumped pulsed-dye laser treatments. Arch Dermatol 2002; 138: 1149–55

    Article  PubMed  CAS  Google Scholar 

  39. Hermanns JF, Petit L, Hermanns LT, et al. Analytic quantification of phototype-related regional skin complexion. Skin Res Technol 2001; 7: 168–71

    Article  PubMed  CAS  Google Scholar 

  40. Alster TS. Cutaneous resurfacing with CO2 and erbium: YAG lasers: pre-operative, intraoperative and postoperative considerations. Plast Reconstr Surg 1999; 103: 619–32

    Article  PubMed  CAS  Google Scholar 

  41. Tanzi EL, Alster TS. Treatment of atrophic facial acne scars with a dual-mode erbium: YAG laser. Dermatol Surg 2002; 28: 551–5

    Article  PubMed  Google Scholar 

  42. Tanzi EL, Alster TS. Side effects and complications of variable-pulsed erbium: YAG laser skin resurfacing: extended experience with 50 patients. Plast Reconstr Surg 2003; 111: 1524–9

    Article  PubMed  Google Scholar 

  43. Fitzpatrick RE, Smith SR, Sriprachya-anunt S. Depth of vaporization and the effect of pulse stacking with a high-energy, pulsed CO2 laser. J Am Acad Dermatol 1999; 40: 615–22

    Article  PubMed  CAS  Google Scholar 

  44. Fitzpatrick RE, Rostan EF, Marchell N. Collagen tightening induced by carbon dioxide laser versus erbium: YAG laser. Lasers Surg Med 2000; 27: 395–403

    Article  PubMed  CAS  Google Scholar 

  45. Alster TS, Bellew SG. Improvement of dermatochalasis and periorbital rhytides with a high-energy pulsed CO2 laser. Dermatol Surg 2004; 30: 483–7

    Article  PubMed  Google Scholar 

  46. Alster TS, West TB. Resurfacing of atrophic facial acne scars with a high-energy, pulsed carbon dioxide laser. Dermatol Surg 1996; 22: 151–5

    Article  PubMed  CAS  Google Scholar 

  47. Apfelberg DB. A critical appraisal if high-energy pulsed carbon dioxide laser resurfacing for acne scars. Ann Plast Surg 1997; 38: 95–100

    Article  PubMed  CAS  Google Scholar 

  48. Bernstein LJ, Kauvar ANB, Grossman MC, et al. Scar resurfacing with high-energy, short-pulsed and flashscanning carbon dioxide lasers. Dermatol Surg 1998; 24: 101–7

    PubMed  CAS  Google Scholar 

  49. Walia S, Alster TS. Prolonged clinical and histologic effects from CO2 laser resurfacing of atrophic acne scars. Dermatol Surg 1999; 25: 926–30

    Article  PubMed  CAS  Google Scholar 

  50. Alster TS. Clinical and histologic evaluation of six erbium: YAG lasers for cutaneous resurfacing. Lasers Surg Med 1999; 24: 87–92

    Article  PubMed  CAS  Google Scholar 

  51. Alster TS, Lupton JR. An overview of cutaneous laser resurfacing. Clin Plast Surg 2001; 28: 37–52

    PubMed  CAS  Google Scholar 

  52. Tanzi El, Alster TS. Single-pass CO2 versus multiple-pass Er: YAG laser skin resurfacing: a comparison of postoperative wound healing and side-effect rates. Dermatol Surg 2003; 29: 80–4

    Article  PubMed  Google Scholar 

  53. Jeong JT, Kye TC. Resurfacing of pitted facial acne scars with a long-pulsed Er: YAG laser. Dermatol Surg 2001; 27: 107–10

    Article  PubMed  CAS  Google Scholar 

  54. Woo SH, Park JH, Kye YC. Resurfacing of different types of facial acne scar with short-pulsed, variable-pulsed, and dual-mode Er: YAG laser. Dermatol Surg 2004; 30: 488–93

    Article  PubMed  Google Scholar 

  55. Horton S, Alster TS. Preoperative and postoperative considerations for cutaneous laser resurfacing. Cutis 1999; 64: 399–406

    PubMed  CAS  Google Scholar 

  56. Alster TS, Lupton JR. Prevention and treatment of side effects and complications of cutaneous laser resurfacing. Plast Reconstr Surg 2002; 109: 308–16

    Article  PubMed  Google Scholar 

  57. Katz BE, MacFarlane DF. Atypical facial scarring after isotretinoin therapy in a patient with a previous dermabrasion. J Am Acad Dermatol 1994; 30: 852–3

    Article  PubMed  CAS  Google Scholar 

  58. Nanni CA, Alster TS. Complications of CO2 laser resurfacing: an evaluation of 500 patients. Dermatol Surg 1998; 24: 315–20

    Article  PubMed  CAS  Google Scholar 

  59. Walia S, Alster TS. Cutaneous CO2 laser resurfacing infection rate with and without prophylactic antibiotics. Dermatol Surg 1999; 25: 857–61

    Article  PubMed  CAS  Google Scholar 

  60. Alster TS, Nanni CA. Famciclovir prophylaxis of herpes simplex virus reactivation after cutaneous laser resurfacing. Dermatol Surg 1997; 25: 242–6

    Article  Google Scholar 

  61. Beeson WH, Rachel JD. Valacyclovir prophylaxis for herpes simplex virus infection or infection recurrence following laser skin resurfacing. Dermatol Surg 2002; 28: 331–6

    Article  PubMed  Google Scholar 

  62. Fisher AA. Lasers and allergic contact dermatitis to topical antibiotics, with particular reference to bacitracin. Cutis 1996; 58: 252–4

    PubMed  CAS  Google Scholar 

  63. Alster TS, Khoury R. Treatment of laser complications. Facial Plast Surg 2009; 25: 316–23

    Article  PubMed  CAS  Google Scholar 

  64. Alster TS, Tanzi EL. Laser skin resurfacing: ablative and nonablative. In: Robinson J, Sengelman R, Siegel DM, et al., editors. Surgery of the skin. Philadelphia (PA): Elsevier, 2005; 611–24

    Google Scholar 

  65. Friedman PM, Skover GR, Payonik G, et al. 3D in-vivo optical skin imaging for topographical quantitative assessment of non-ablative laser technology. Dermatol Surg 2002; 28: 199–204

    Article  PubMed  Google Scholar 

  66. Alster TS, Lupton JR. Are all infrared lasers equally effective in skin rejuvenation. Sem Cutan Med Surg 2002; 21: 274–9

    Article  Google Scholar 

  67. Rogachefsky AS, Hussain M, Goldberg DJ. Atrophic and a mixed pattern of acne scars improved with a 1320-nm Nd: YAG laser. Dermatol Surg 2003; 29: 904–8

    Article  PubMed  Google Scholar 

  68. Bellew SG, Le C, Weiss MA, et al. Improvement of atrophic acne scars with a 1,320 nm Nd: YAG laser: retrospective study. Dermatol Surg 2005; 31:1218–22

    Article  PubMed  CAS  Google Scholar 

  69. Bhatia AC, Dover JS, Arndt KA, et al. Patient satisfaction and reported long-term therapeutic efficacy associated with 1,320 nm Nd: YAG laser treatment of acne scarring and photoaging. Dermatol Surg 2006; 32: 346–52

    Article  PubMed  CAS  Google Scholar 

  70. Chua SH, Ang P, Khoo LSW, et al. Nonablative 1450-nm diode laser in the treatment of facial atrophic acne scars in type IV to V Asian skin: a prospective clinical study. Dermatol Surg 2004; 30: 1287–91

    Article  PubMed  Google Scholar 

  71. Tanzi EL, Alster TS. Comparison of a 1450-nm diode laser and a 1320-nm Nd: YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatol Surg 2004; 30: 152–7

    Article  PubMed  Google Scholar 

  72. Keller R, Belda Junior W, Valente NY, et al. Nonablative 1,064-nm Nd: YAG laser for treating atrophic facial acne scars: histologic and clinical analysis. Dermatol Surg 2007; 33: 1470–6

    PubMed  CAS  Google Scholar 

  73. Lee DH, Choi YS, Min SU, et al. Comparison of a 585-nm pulsed dye laser and a 1064-nm Nd: YAG laser for the treatment of acne scars: a randomized split-face clinical study. J Am Acad Dermatol 2009; 60: 801–7

    Article  PubMed  Google Scholar 

  74. Min SU, Choi YS, Lee DH, et al. Comparison of a long-pulse Nd: YAG laser and a combined 585/1,064-nm laser for the treatment of acne scars: a randomized split-face clinical study. Dermatol Sur 2009; 35: 1720–7

    Article  CAS  Google Scholar 

  75. Sobanko JF, Alster TS. Laser skin resurfacing of rhytides and scars. In: Spiegel J, editor. Office based techniques in plastic surgery. New York (NY): Springer, 2012

    Google Scholar 

  76. MacGregor JL, Alster TS. Fractional laser skin resurfacing: Ablative and nonablative. In: Nouri K, editor. Dermatologic surgery: step by step. Oxford: Wiley-Blackwell, 2012

    Google Scholar 

  77. Manstein D, Herron GS, Sink RK et al. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004; 34: 426–38

    Article  PubMed  Google Scholar 

  78. Laubach HJ, Tannous Z, Anderson RR, et al. Skin responses to fractional photothermolysis. Lasers Surg Med 2006; 38: 142–9

    Article  PubMed  Google Scholar 

  79. Walgrave S, Zelickson B, Childs J, et al. Pilot investigation of the correlation between histological and clinical effects of infrared fractional resurfacing lasers. Dermatol Surg 2008; 34: 1443–53

    Article  PubMed  CAS  Google Scholar 

  80. Sherling M, Friedman PM, Adrian R, et al. Consensus recommendations on the use of an erbium-doped 1,550 nm fractionated laser and its applications in dermatologic laser surgery. Dermatol Surg 2010; 36: 461–9

    Article  PubMed  CAS  Google Scholar 

  81. Geronemus R. Fractional photothermolysis: current and future applications. Lasers Surg Med 2006; 38: 169–76

    Article  PubMed  Google Scholar 

  82. Alster TS, Tanzi EL, Lazarus E. The use of fractional laser photothermolysis for the treatment of atrophic scars. Dermatol Surg 2007; 33: 295–9

    Article  PubMed  CAS  Google Scholar 

  83. Taub AF. Fractionated delivery systems for difficult to treat clinical applications: acne scarring, melasma, atrophic scarring, striae distensae, and deep rhytides. J Drugs Dermatol 2007; 6: 1120–8

    PubMed  Google Scholar 

  84. Tanzi EL, Wanitphakdeedecha R, Alster TS. Fraxel laser indications and long-term follow-up. Aesth Surg J 2008; 28: 61–4

    Article  Google Scholar 

  85. Chrastil B, Glaich AS, Goldberg LH, et al. Second-generation 1,550-nm fractional photothermolysis for the treatment of acne scars. Dermatol Surg 2008; 34: 1327–32

    Article  PubMed  CAS  Google Scholar 

  86. Hu S, Chen MC, Lee MC, et al. Fractional resurfacing for the treatment of atrophic facial acne scars in Asian skin. Dermatol Surg 2009; 35: 826–32

    Article  PubMed  CAS  Google Scholar 

  87. Cho SB, Le JH, Choi MJ, et al. Efficacy of the fractional photothermolysis system with dynamic operating mode on acne scars and enlarged pores. Dermatol Surg 2009; 35: 108–14

    Article  PubMed  CAS  Google Scholar 

  88. Hedelund L, Moreau KER, Beyer D, et al. Fractional nonablative 1,540 nm laser resurfacing of atrophic acne scars. A randomized controlled trial with blinded response evaluation. Lasers Med Sci 2010; 25: 749–54

    Article  PubMed  Google Scholar 

  89. Manstein D, Zurakowski D, Thongsima S, et al. The effects of multiple passes on the epidermal thermal damage pattern in nonablative fractional resurfacing. Lasers Surg Med 2009; 41: 149–53

    Article  PubMed  Google Scholar 

  90. Thongsima S, Zurakowski D, Manstein D. Histological comparison of two different fractional photothermolysis devices operating at 1,550 nm. Lasers Surg Med 2010; 42: 32–7

    Article  PubMed  Google Scholar 

  91. Chan NPY, Ho SGY, Yeung CK, et al. The use of non-ablative fractional resurfacing in Asian acne scar patients. Lasers Surg Med 2010; 42: 710–5

    PubMed  Google Scholar 

  92. Hantash BM, Bedi VP, Kapadia B, et al. In vivo histological evaluation of a novel ablative fractional resurfacing device. Lasers Surg Med 2007; 39: 96–107

    Article  PubMed  Google Scholar 

  93. Saluja R, Khoury J, Detwiler SP, et al. Histologic and clinical response to varying density settings with a fractionally scanned carbon dioxide laser. J Drugs Dermatol 2009; 8: 17–20

    PubMed  Google Scholar 

  94. Prignano F, Campolmi P, Bonan P, et al. Fractional CO2 laser: a novel therapeutic device upon photomodulaiton of tissue remodeling and cytokine pathway of tissue repair. Dermatol Ther 2009; 22: S8–15

    Article  PubMed  Google Scholar 

  95. Waibel J, Beer K, Narurkar V, et al. Preliminary observations on fractional ablative resurfacing devices: clinical impressions. J Drugs Dermatol 2009; 8:481–5

    PubMed  Google Scholar 

  96. Chapas AM, Brightman L, Sukal S, et al. Successful treatment of acneiform scarring with CO2 ablative fractional resurfacing. Lasers Surg Med 2008; 40:381–6

    Article  PubMed  Google Scholar 

  97. Cho SB, Lee SJ, Kang JM, et al. The efficacy and safety of 10,600-nm carbon dioxide fractional laser for acne scars in Asian patients. Dermatol Surg 2009; 35: 1955–61

    Article  PubMed  CAS  Google Scholar 

  98. Walgrave SE, Ortiz AE, MacFalls HT, et al. Evaluation of a novel fractional resurfacing device for the treatment of acne scarring. Lasers Surg Med 2009; 41: 122–7

    Article  PubMed  Google Scholar 

  99. Gotkin RH, Sarnoff DS, Cannarozzo G, et al. Ablative skin resurfacing with a novel microablative CO2 laser. J Drugs Dermatol 1009; 8: 138–44

    Google Scholar 

  100. Ortiz AE, Tremaine AM, Zachary CB. Long-term efficacy of a fractional resurfacing device. Lasers Surg Med 2010; 42: 168–70

    Article  PubMed  Google Scholar 

  101. Manuskiatti W, Triwongwaranat D, Varothai S, et al. Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians. J Am Acad Dermatol 2010; 63: 274–83

    Article  PubMed  Google Scholar 

  102. Kim S, Cho KH. Clinical trial of dual treatment with an ablative fractional laser and a nonablative laser for the treatment of acne scars in Asian patients. Dermatol Surg 2009; 35: 1089–98

    Article  PubMed  CAS  Google Scholar 

  103. Cho SB, Lee SJ, Oh SH, et al. Non-ablative 1550nm erbium-glass and ablative 10,600nm carbon dioxide fractional lasers for acne scars: a randomized split-face study with blinded response evaluation. JEADV 2010; 24: 921–5

    PubMed  CAS  Google Scholar 

  104. Sobanko JF, Alster TS. Laser treatment for improvement and minimization of facial scars. Facial Plast Surg Clin N Am 2011; 19: 527–42

    Article  Google Scholar 

  105. Wang Y, Kwang Tay Y, Kwok C. Fractional ablative carbon dioxide laser in the treatment of atrophic acne scarring in Asian patients: a pilot study. J Cosmet Laser Ther 2010; 12: 61–4

    Article  PubMed  Google Scholar 

  106. Graber EM, Tanzi EL, Alster TS. Side effects and complications of fractional laser photothermolysis: experience with 961 treatments. Dermatol Surg 2008; 34: 301–7

    Article  PubMed  CAS  Google Scholar 

  107. Metelitsa AI, Alster TS. Fractionated laser skin resurfacing treatment complications: a review. Dermatol Surg 2010; 36: 299–306

    Article  PubMed  CAS  Google Scholar 

  108. Alster TS, Wanitphakdeedecha R. Improvement of post-fractional laser erythema with light-emitting diode photomodulation. Dermatol Surg 2009; 35: 813–5

    Article  PubMed  CAS  Google Scholar 

  109. Mahmoud BH, Srivastava D, Janiga JJ, et al. Safety and efficacy of erbium-doped yttrium aluminum garnet fractionated laser for treatment of acne scars in type IV to VI skin. Dermatol Surg 2010; 36: 602–9

    Article  PubMed  CAS  Google Scholar 

  110. Avram MM, Tope WD, Yu T, et al. Hypertrophic scarring of the neck following ablative fractional carbon dioxide laser resurfacing. Lasers Surg Med 2009; 41: 185–8

    Article  PubMed  Google Scholar 

  111. Fife DJ, Fitzpatrick RE, Zachary CB. Complications of fractional CO2 laser resurfacing: four cases. Lasers Surg Med 2009; 41: 179–84

    Article  PubMed  Google Scholar 

  112. Mamelak AJ, Goldberg LH, Marquez D, et al. Eruptive keratoacanthomas on the legs after fractional photothermolysis: report of two cases. Dermatol Surg 2009; 35: 513–8

    Article  PubMed  CAS  Google Scholar 

  113. Foster KW, Fincher EF, Moy RL. Heat-induced ‘recall’ of treatment zone erythema following fractional resurfacing with a combination laser (1320 nm/1440 nm). Arch Dermatol 2008; 144: 1398–9

    Article  PubMed  Google Scholar 

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No sources of funding were used to prepare this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Joseph F. Sobanko

  2. Washington Institute of Dermatologic Laser Surgery, 1430 K Street, NW Suite 200, Washington, DC, 20005, USA

    Tina S. Alster

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Correspondence to Tina S. Alster.

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Sobanko, J.F., Alster, T.S. Management of Acne Scarring, Part I. Am J Clin Dermatol 13, 319–330 (2012). https://doi.org/10.2165/11598910-000000000-00000

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