Effectiveness of subcision using carboxytherapy plus fractional carbon dioxide laser resurfacing in the treatment of atrophic acne scars: comparative split face study.

Introduction: Fractional carbon dioxide laser resurfacing is the gold standard treatment for atrophic acne scars but when combined with subcision to the depressed scars it provides rapid improvement. Carboxytherapy is considered a tool for subcision via injecting the gas under pressure plus its well-known effect in rejuvenating scars. Aim: Main objective of the work is to evaluate the effectiveness of combined subcision using carboxytherapy plus fractional carbon dioxide laser resurfacing in the treatment of atrophic acne scars. Patients and method: Twenty patients with atrophic acne scars undergone three sessions of fractional carbon dioxide laser resurfacing for both sides of the face and subcision by CO2 gas for the right side scars only. Standardized photographs were taken before and three months after the last session and evaluated by two independent blinded dermatologists for the degree of improvement. Result: The right side of the face improved better than the left side and showed excellent improvement in 10% of cases that was statistically significant ( p value=.003). Conclusion: Subcision via carboxytherapy accelerate the improvement of atrophic acne scars when combined with fractional carbon dioxide laser resurfacing.