Efficacy of Er:YAG laser vs. Bipolar RF Plus Infrared in the Treatment of Acne Scars

Erbium YAG (Er:YAG) lasers lead to increased expression of collagen. and may be more effective in treating acne scars than combination bi-polar radiofrequency with infrared diode laser (BRDL), according to a new study published in Lasers in Surgery and Medicine (April 2017).

Authors Seonguk Min, MD, PhD, et al, performed a split-face study that included 24 subjects. Each patients received two treatments spaced four weeks apart. One half for the face was treated with a fractional Er:YAG laser and the other with BRDL. The patients were assessed at baseline, 1, 3 and 7 days after each treatment, and four weeks after the final treatment session. The researchers also took skin biopsy specimens at baseline, 1, 3, 7 and 28 days after one session of treatment to investigate the molecular profile of acute skin changes.

The Investigator's Global Assessment (IGA) showed a 2.1 (50%) improvement in scars treated with the fractional Er:YAG laser and 1.2 (25%) improvement on the BRDL-treated side. The Er:YAG laser induced later and higher peak expression of TGFβs and collagenases, whereas BRDL induced earlier and lower expression of TGFβ and collagenases. Immunohistochemistry revealed higher expression of TIMP, which may be associated with the expression of upregulation of collagen fibers, after Er:YAG treatment compared with BRDL.

The authors posited that the superior efficacy of the fractional Er:YAG laser in the treatment of acne scars may be associated with higher expression of collagen, associated with differential expression of TGFβs, collagenases, PPARγ and TIMP.