Subcision With CO₂ Laser or PRP vs Subcision Alone in Atrophic Acne Scars

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Acne vulgaris is an inflammatory disease of pilosebaceous unit ,leading to different types of scars including atrophic, hypertrophic and keloidal. Atrophic scars are the most common type ,affecting about 75-90% of acne scar cases and can be ice pick, rolling or boxcar in morphology . Theses scars may cause significant impact such as depression, anxiety , and reduced quality of life. multiple treatment modalities exist, including lasers ,chemical peels, dermabrasion, microneedling, subcision and platelet rich plasma. Subcision is a well established technique that improves rolling and boxcar scars by releasing fibrotic strands. Fractional co2 laser induces dermal remodeling and collagen neogenesis, while PRP enhances wound healing and collagen induction through growth factors. Combinig subcision with either co2 laser or PRP may enhance treatment efficacy compared to subcision alone. rational : Subcision alone may provide limited improvement in some patients. Fractional CO₂ laser and PRP are promising adjunctive modalities that could enhance collagen remodeling and improve cosmetic outcomes. Evaluating their combined effect versus subcision alone will help determine the most effective and safe approach for managing atrophic post-acne scars. aim of work:To compare the efficacy and safety of combined subcision with either fractional CO₂ laser or platelet-rich plasma versus subcision alone in the treatment of facial atrophic post-acne scars.

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