Laser treatment for acne scars

Jordan R, Cummins CCL, Burls A, Seukeran DDC

Published Online:

July 8, 2009

Acne (acne vulgaris) is caused by a combination of excess skin oil, bacteria and other tissue leading to blockage of the pores. Inflamed spots usually appear on the face, chest, shoulders or upper arms. Permanent physical scarring may result. Treatment of scars includes using steroids, chemical and mechanical resurfacing techniques (such as dermabrasion), or surgery to fill the scarred area with fat, skin or collagen. Laser resurfacing has the potential to be more precise than other techniques in the treatment of some facial scars, but is expensive and may have adverse effects. The review found no trials of laser resurfacing. There is not enough evidence to show whether laser resurfacing is worthwhile for acne scars.

Abstract (click to read)

Background:

Most people have acne at some stage during their life, with about one per cent being left with permanent acne scars. Recent laser techniques are thought to be more effective than chemical peels and dermabrasion.

Objectives:

To assess the effects of laser resurfacing for treating facial acne scars.

Search strategy:

We searched MEDLINE (1966 to April 1999), EMBASE (1980 to April 1999), Science Citation Index (1981 to April 1999), the Cochrane Controlled Trials Register (April 1999), DARE (April 1999), INAHTA (April 1999), NHS HTA Internet site (April 1999). Dermatological Surgery (1995 to March 1999) and the British Journal of Dermatology (1995 to September 1999) were handsearched. We searched the reference lists of relevant articles and contacted experts and commercial laser manufacturers.

Selection criteria:

Randomised controlled trials which compare different laser resurfacing techniques for treating patients with facial acne scars, or compare laser resurfacing with other resurfacing techniques or no treatment.

Data collection and analysis:

Two reviewers independently selected studies, assessed the quality of studies and extracted data.

Main results:

No randomised controlled trials where laser treatment was compared to either placebo or a different type of laser were found. Most of the 27 studies uncovered were poor quality case series with small numbers of acne-scarred patients.

Authors' conclusions:

The lack of good quality evidence does not enable any conclusions to be drawn about the effectiveness of lasers for treating atrophic or ice-pick acne scars. Well designed randomised controlled comparisons of carbon dioxide versus Erbium:YAG laser are urgently needed.

This record should be cited as:

Jordan R, Cummins CCL, Burls A, Seukeran DDC. Laser resurfacing for facial acne scars. Cochrane Database of Systematic Reviews 2001, Issue 1. Art. No.: CD001866. DOI: 10.1002/14651858.CD001866

Assessed as up to date:

March 14, 2000

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Primary Review Group:

Skin Group

Health topics:

Skin > Acne

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