Resurfacing of facial acne scars with pulsed carbon dioxide laser: a case series of 10 patients


  • Anil P. Gosavi Department of Dermatology, Venereology and Leprosy, B. J. G. Medical College, Pune,
  • Ravindranath B. Chavan Department of Dermatology, Venereology and Leprosy, B. J. G. Medical College, Pune,
  • Darshana R. Kundale Department of Dermatology, Venereology and Leprosy, B. J. G. Medical College, Pune,
  • Neelam Bhatt Department of Dermatology, Venereology and Leprosy, B. J. G. Medical College, Pune,



Acne vulgaris, Atrophic acne scars, Carbon dioxide laser


Acne vulgaris is a common skin disorder affecting 80% of people between 11-30 years of age with many experiencing some degree of scarring. Pulsed wave carbon dioxide (CO2) laser resurfacing is a recent addition in armamentarium of treatment options for acne scars. This study focuses on one of the most common type of acne complication - atrophic scars treated with pulsed wave carbon dioxide laser. To evaluate efficacy of pulsed carbon dioxide laser for treatment of mild to moderate atrophic facial acne scars. 10 subjects (6 male and 4 females, aged 22-35 years) with skin type III-V and atrophic acne scars were treated with 4 sessions of carbon dioxide non-ablative laser resurfacing on 6 weeks interval. 7 out of 10 subjects in our study perceived an excellent to good improvement with 2 patients showing fair improvement and 1 patient with no improvement. Adverse effects were limited to prolonged erythema (two patients), and post-inflammatory hyperpigmentation (three patient). Excellent to good clinical improvement observed in 70% of patients with acne scars. This underscore pulsed carbon dioxide laser’s effectiveness in the treatment of mild to moderate atrophic acne scars.


Tasoula E, Gregoriou S, Chalikias J, Lazarou D, Danopoulou I, Katsambas A, et al. The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece: Results of a population survey. An Bras Dermatol. 2012;87(6):862-9.

Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Brit J Dermatol. 1998;139(5):846-50.

Yazici K, Baz K, Yazici AE, Köktürk A, Tot S, Demirseren D, et al. Disease-specific quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol. 2004;18(4):435-9.

Vallerand IA, Lewinson RT, Parsons LM, Lowerison MW, Frolkis AD, Kaplan GG, et al. Risk of depression among patients with acne in the U.K.: a population-based cohort study. Brit J Dermatol. 2018;178(3):194-5.

Magin P, Adams J, Heading G, Pond D, Smith W. Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: Results of a qualitative study. Scand J Caring Sci. 2008;22(3):430-6.

Misery L, Wolkenstein P, Amici JM, Maghia R, Brenaut E, Cazeau C, et al. Consequences of acne on stress, fatigue, sleep disorders and sexual activity: A population-based study. Acta Derm-Venereol. 2015;95(4):485-8.

Murray CD, Rhodes K. ‘Nobody likes damaged goods’: The experience of adult visible acne. Brit J Health Psych. 2005;10(2):183-202.

Papadopoulos L, Walker C, Aitken D, Bor R. The relationship between body location and psychological morbidity in individuals with acne vulgaris. Psychol Health Med. 2000;5(4):431-8.

Goodman G. Dermabrasion using tumescent anesthesia. J Dermatol Surg Onco. 1994;20:802-7.

Solotoff S. Treatment for pitted acne scarring: postauricular punch grafts followed by dermabrasion. J Dermatol Surg Oncol. 1986;12:10.

Johnson W. Treatment of pitted scars: punch transplant technique. J Dermatol Surg Oncol. 1986;12:260-5.

Baker TJ, Gordon HL. Chemical face peeling and dermabrasion. Surg Clin North Am. 1971;5:387-401.

Lober CW. Chemexfoliation: indications and cautions. J Am Acad Dermatol. 1987;17:109-12.

Garrett AB, Dufresne RG, Ratz JL, Berlin AJ. Carbon dioxide laser treatment of pitted acne scarring. J Dermatol Surg Oncol. 1990;16:737-40.

Fitzpatrick RE. Use of the ultrapulse CO2 laser for dermatology including facial resurfacing. Lasers Surg Med. 1995;57:50.

Weinstein C, Alster TS. Skin resurfacing with high-energy, pulsed carbon dioxide lasers. In: Alster TS, Apfelberg DB, eds. Cosmetic Laser Surgery. New York: John Wiley Sons, Inc.; 1996:9-27.

Jih MH, Asadi K. Laser treatment of Acne Vulgaris. Semin Plast Surg. 2007;21(3):167-74.

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.

Tarijian AL, Goldberg DJ. Fractional ablative laser skin resurfacing: a review. J Cosmet Laser Ther. 2011;13:262-4.

Rahman Z, MacFalls H, Jiang K, et al. Fractional deep dermal ablation induces tissue tightening. Lasers Surg Med. 2009;41:78-86.

Prignano F, Campolmi P, Bonan P, et al. Fractional CO2 laser: a novel therapeutic device upon photo biomodulation of tissue remodelling ad cytokine pathway of tissue repair. Dermatol Ther. 2009;22(1):8-15.