PDO screw threads versus fractional CO2 laser, after subcision, for atrophic acne scar remodelling: a randomized group-based comparative study

Abstract

Atrophic acne scars present a significant therapeutic challenge. While subcision with various adjunctive treatments, including fractional CO₂ lasers and polydioxanone (PDO) threads, has been employed for scar remodeling, comparative evidence on their efficacy remains limited. This study aims to compare the clinical efficacy and patient satisfaction between subcision with fractional CO₂ laser and subcision with PDO screw threads in managing atrophic acne scars. A randomized, controlled study was conducted on 40 patients with atrophic acne scars. Patients were assigned to two groups: Group A underwent subcision with PDO screw threads insertion, and Group B underwent subcision followed by fractional CO₂ laser resurfacing. Outcomes were assessed using the Goodman and Baron grading system, Antera 3D imaging, and patient satisfaction. Significant scar improvement was observed in both groups, with Group B demonstrating greater reduction in scar severity and depth (p = 0.022). While Group A showed faster recovery and lower downtime, Group B yielded higher patient satisfaction scores. Subcision combined with fractional CO₂ laser resulted in superior long-term scar improvement, although PDO threads provided quicker recovery. The choice of treatment may depend on patient preferences and scar characteristics.