Abstract
Background: Acne vulgaris is a very common skin disorder that affects virtually all individuals at least once during life. Acne scarring can have a great impact on the psychosocial life for the young adults. Er:YAG lasers has been used in the treatment of acne scarring. The results, however, produced open wounds with significant downtime. In contrast, nonablative remodeling lasers, (1064-nm Nd:YAG lasers) can reduce acne scarring without significant downtime, but at lower efficacies. Recently, resurfacing with fractional microscopic delivery of high energies to targeted depths in the dermis has made possible significant clinical improvements often approaching that of ablative lasers without any reports of permanent hypo pigmentation or scarring. So the aim of this study was to determine the best modality in treatment of acne scars.
Patients and methods: 26 patients with mild to moderate facial acne scarring were included in this study, they were divided into 3 groups using traditional ablative Er:YAG laser, Nd:YAG laser and fractional Er:YAG laser respectively. Histopathological specimen were taken for objective  assessment,  and  subjectively  by  patient  satisfaction,  doctor  satisfaction.
Results: Showed that the use of fractional Er:YAG laser had the greatest clinical improvements in scar treatment, with mild erythema without any downtime. With edema not lasting for more than  1  day.  No  crusting,  scabbing  formation,  or  infection  was  seen  in  this  group.
Conclusion: Er:YAG laser fractional photocoagulation is a promising option for the treatment of atrophic post acne scars, avoiding the adverse effects of ablative laser procedures with improving the limited efficacy of the nonablative ones.