• Elliot T Weiss, Anne Chapas, Lori Brightman, Christopher Hunzeker, Elizabeth K Hale, Julie K Karen, Leonard Bernstein, and Roy G Geronemus.
• Laser & Skin Surgery Center of New York, 317 E 34th St, New York, NY 10016, USA. eweiss@laserskinsurgery.com
• Arch Dermatol. 2010 Feb 1;146(2):133-40.

ObjectiveTo assess the safety and efficacy of ablative fractional resurfacing (AFR) for nonacne atrophic scarring.DesignIn this before-and-after trial, each scar received 3 AFR treatments and 6 months of follow-up.SettingPrivate academic practice.PatientsFifteen women with Fitzpatrick skin types I to IV, aged 21 to 66 years, presented with 22 nonacne atrophic scars between June 1 and November 30, 2007. Three patients (3 scars) were excluded from the study after receiving 1 AFR treatment and not returning for follow-up visits. The remaining 12 patients (19 scars) completed all 3 treatments and 6 months of follow-up.InterventionsEach scar received 3 AFR treatments at 1- to 4-month intervals.Main Outcome MeasuresErythema, edema, petechiae, scarring, crusting, and dyschromia were graded after treatment and through 6 months of follow-up. Skin texture, pigmentation, atrophy, and overall appearance were evaluated after treatment and through 6 months of follow-up by the patient and a nonblinded investigator. A 3-dimensional optical profiling system generated high-resolution topographic representations of atrophic scars for objective measurement of changes in scar volume and depth.ResultsAdverse effects of treatment were mild to moderate, and no scarring or delayed-onset hypopigmentation was observed. At the 6-month follow-up visit, patient and investigator scores demonstrated improvements in skin texture for all scars (patient range, 1-4 [mean, 2.79]; investigator range, 2-4 [mean, 2.95]), pigmentation for all scars (patient range, 1-4 [mean, 2.32]; investigator range, 1-4 [mean, 2.21]), atrophy for all scars (patient range, 1-4 [mean, 2.26]; investigator range, 2-4 [mean, 2.95]), and overall scar appearance for all scars (patient range, 2-4 [mean, 2.89]; investigator range, 2-4 [mean, 3.05]). Image analysis revealed a 38.0% mean reduction of volume and 35.6% mean reduction of maximum scar depth.ConclusionThe AFR treatments represent a safe, effective treatment modality for improving atrophic scarring due to surgery or trauma.

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