Acne scars treatment witnesses’ multiple approaches; however, some are expensive, ineffective and may cause complications. The present study evaluated the efficacy and safety of ultra-pulsed CO₂ fractional laser combined with 30% supramolecular salicylic acid in treating acne scars in a prospective split-face control study. 

It enrolled 20 patients with symmetrical facial acne scars. It treated one side of the face with 30% supramolecular salicylic acid and two sides with an ultra-pulsed CO₂ fractional laser. It evaluated the clinical efficacy using the Echelle d′Evaluation Clinique des Cicatrices d′Acne (ECCA) scale before and 3 months after treatment. It directed patients for self-evaluation using a quartile scale. The study recorded pain scores after each treatment using a visual analog scale. It also recorded side effects and other adverse reactions on the face. 

The study observed:

• Treatment completion and follow-up by all the patients.
• Statistical difference in ECCA scores of bilateral facial acne scars after three treatments.
• Lower ECCA scores on the combined side after three treatments than those on the laser side.
• Larger patient satisfaction quartile scale on the combined side than that on the laser side alone. 

This study shows that ultra-pulsed CO₂ fractional laser combined with 30% supramolecular salicylic acid gives better efficacy in treating acne scars than laser alone. It was backed by the patient self-assessment of combined treatment which showed a greater degree of improvement in acne scars and did not increase patient pain scores and related adverse reactions.

Source: Zhang YJ, Chen YM, Shao XY, et al. Combination treatment with 30% salicylic acid and fractional CO₂ laser for acne scars: a 20-week prospective, randomized, split-face study. Dermatol Ther. 2022;35(9):e15693.