Comparative appraisal with meta-analysis of erbium vs. CO2 lasers for atrophic acne scars
Corresponding Author
Husein Husein-ElAhmed
Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
Correspondence to
Husein Husein-ElAhmed, MD, PhD
Department of Dermatology and Venereology
Hospital de Baza
Carr. de Murcia, S/N
18800 Baza, Granada, Spain
E-mail: [email protected]
Search for more papers by this authorMartin Steinhoff
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
Weill Cornell Medicine-Qatar, College of Medicine, Doha, Qatar
Qatar University, Medical School, Doha, Qatar
Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
Search for more papers by this authorCorresponding Author
Husein Husein-ElAhmed
Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
Correspondence to
Husein Husein-ElAhmed, MD, PhD
Department of Dermatology and Venereology
Hospital de Baza
Carr. de Murcia, S/N
18800 Baza, Granada, Spain
E-mail: [email protected]
Search for more papers by this authorMartin Steinhoff
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
Weill Cornell Medicine-Qatar, College of Medicine, Doha, Qatar
Qatar University, Medical School, Doha, Qatar
Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
Search for more papers by this authorSummary
Recent advances in laser technology allowed the development of systems that improve texture, appearance and pliability of skin in acne scars (AS). Currently, comprehensive comparative studies on the efficacy of the most commonly used fractional systems in AS are lacking. Thus, the aim of this work was to appraise and compare the clinical response to erbium versus CO2 lasers in AS in the form of a meta-analysis. The databases MEDLINE, EMBASE, Cochrane library were searched. Main clinical outcomes were investigator-reported scar improvement and participant-reported scar improvement. Five studies were included in this meta-analysis. Scar improvement was similar for both types of laser in terms of investigator-reported scar improvement (RR: 0.60 95 % CI: 0.35–1.02) and participant-reported scar improvement (RR: 0.99 95 % CI: 0.79–1.25). A sensitivity analysis that excluded studies with high risk of bias found the CO2 lasers to be superior to the erbium lasers (RR: 0.47 95 % CI: 0.24–0.93): However, the subgroup analysis showed the CO2 laser not to be significantly different from either the non-ablative erbium (RR: 0.65 95 % CI: 0.34–1.24) or the ablative erbium laser (RR: 0.60 95 % CI: 0.35–1.02). The CO2 laser produced a slightly greater clinical response compared to the erbium lasers based on the physician’s assessment. Overall, the two devices do not differ largely in terms of efficacy but may be complementary, with each resurfacing laser better suited for different clinical tasks.
Conflict of interest
None.
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