Resurfacing of pitted facial scars with a pulsed Er:YAG laser

BACKGROUND. Laser resurfacing has beneficial effects for the treatment of several skin conditions. Recently, the pulsed Er:YAG laser has been shown to be a highly effective treatment for several kinds of pitted facial scars. OBJECTIVE. The purpose of this study was to assess the efficacy and safety of pulsed Er:YAG laser skin resurfacing for pitted facial scars. METHODS. Four patients with small pox scars, five patients with chicken pox scars, and 21 patients with acne scars were included in this study. All patients were skin type III and IV. All patients were instructed to use tretinoin cream 0.05% nightly for 2-4 weeks prior to the laser treatment. The pulsed Er:YAG laser with 2-mm handpiece at the setting of 500 mJ/pulse, 3.5-4.5 W was used. Two weeks after laser treatment, topical application of hydroquinone 4%, tretinoin 0.05%, and hydrocortisone 1% cream was recommended for 2-4 weeks. Facial photographs were obtained at baseline and 2-week intervals postoperatively with a 35-mm single lense reflex camera equipped with a lense mounted ring flash. The results of treatment were evaluated for the changes of skin texture and color at 2 weeks, 1 month, and 3 months. Three patients with acne scars agreed to skin biopsy. RESULTS. Three months after laser treatment, all patients with small pox and chicken pox scars were improved about 55%, and patients with acne scars were improved about 40% on average. CONCLUSION. Pulsed Er:YAG laser skin resurfacing is an effective and safe treatment for pitted facial scars.