Impact of 30% supramolecular salicylic acid combined with ultra-pulse carbon dioxide fractional laser therapy on facial atrophic acne scars

To assess the impact of 30% supramolecular salicylic acid (SSA) combined with ultra-pulse carbon dioxide (CO2) fractional laser therapy on facial atrophic acne scars. This retrospective study included patients with atrophic acne scars treated from June 2020 to June 2022. The patients were divided into the combination group (SSA combined with ultra-pulse CO2 fractional laser therapy) and the laser group (ultra-pulse CO2 fractional laser therapy alone). Four treatment sessions were conducted for each group. Follow-up visits were performed every 2 months after each treatment and included assessments of the Échelle d'Évaluation clinique des cicatrices d'acné (ECCA) score, effective rate, and visual analogue scale score. The combination and laser groups comprised 72 and 61 patients, respectively. There were no significant differences in sex, age, or baseline ECCA score between the two groups. The effective rate (95.8% vs. 67.2%, P < 0.001) was higher and the pain scores (during and after the intervention) were lower in the combination group than in the laser group (P < 0.001). The severity of erythema, edema, and crusting was milder in the combination group (P < 0.001). The proportion of highly satisfied patients was higher (73.6% vs. 31.2%, P < 0.001) and the Dermatology Life Quality Index showed greater improvement (0.15 ± 0.40 vs. 1.39 ± 1.53, P < 0.001) in the combination group than in the laser group. The combination of ultra-pulse CO2 fractional laser therapy and 30% supramolecular SSA had improved efficacy in treating facial atrophic acne scars without increasing pain or inducing adverse reactions.