Combination radiofrequency microneedling and carbon dioxide laser for acne scarring: A systematic review and retrospective case series across two centers
Rishi Mandavia, Massimiliano Cariati, Sepideh Shahidi, Cheka Spencer, Michael Somenek, Tatiana Lapa
Abstract
Abstract Introduction Combination radiofrequency (RF) microneedling with fractional ablative carbon dioxide (CO 2 ) laser is a new approach for acne scar treatment. Aims: (1) to systematically review the literature on the safety and effectiveness of this treatment for acne scarring; (2) to assess safety and effectiveness in a 2‐center case series. Methods Systematic review : Articles that assessed the safety and effectiveness of combination RF microneedling and fractional CO 2 laser for acne scarring were included and quality assessed using the Downs and Black checklist. Case series : Patient records were reviewed from 2 clinics, one in London, UK, and the other in Washington D.C., United States, to identify patients who underwent a single treatment with RF microneedling and fractional CO 2 laser for acne scarring. Outcome assessment was via the Scar Global Assessment (SGA) scale. Results Systematic review : Three articles were included and reported improvements in acne scar severity. Adverse effects included erythema, edema, pain, vesicle formation, erosion, petechiae, desquamation, post‐inflammatory hyperpigmentation (PIH), and acne flare. Quality scores ranged from 14 to 15 (maximum of 21). Case series : Twenty‐six patients were included. Mean SGA Score was 3.0 at baseline and 1.3 at follow‐up. All patients had an improved SGA score. Adverse effects included erythema, pain, edema, skin crusting, PIH, and acne flare. All patients resumed normal activities within 7 days of treatment. Conclusion Combination RF microneedling and fractional CO 2 laser appears a safe and effective treatment for patients with acne scarring. A single treatment can result in noticeable improvements in acne scar severity with a short recovery time.