Prognostic Factors Associated with Clinical Improvement Following Energy-Based Device Treatment in Thai Patients with Atrophic Acne Scars: A Retrospective Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Acne scarring is a prevalent complication of acne vulgaris, often resulting in significant psychosocial distress. While energy-based devices (EBDs), including fractional laser (FL) and fractional radiofrequency (FRF), are increasingly used for atrophic acne scars, limited data exist on prognostic factors predicting treatment outcomes, particularly in Asian populations. The study aims to identify clinical predictors of graded clinical improvement in patients with atrophic acne scars treated with FL and FRF. This retrospective cohort study was conducted at a university hospital in Bangkok, Thailand, from 2012 to 2023. Clinical improvement was assessed using standardized photographic evaluations and categorized into four levels: < 25%, 25–50%, 51–75%, and > 75% improvement. Univariable and multivariable ordinal logistic regression models were used to determine prognostic factors. Sensitivity analyses were performed to confirm the robustness of the findings. A total of 397 patients were included, of whom 254 received FL and 143 received FRF treatments. Older age (per 5-year increase) (mOR: 1.24; 95% CI: 1.07–1.43), male sex (mOR: 1.29; 95% CI: 1.06–1.57), shorter scar duration (per 5 years) (mOR: 0.73; 95% CI: 0.56–0.97), lower Fitzpatrick skin phototypes, and completion of at least three treatment sessions (mOR: 1.33; 95% CI: 1.16–1.53) were independently associated with greater clinical improvement. Sensitivity analyses confirmed the robustness of these associations. Key clinical factors, including patient age, sex, scar duration, skin phototype, and completion of at least three treatment sessions, significantly influence treatment outcomes with EBDs. These findings support the development of personalized treatment strategies to optimize outcomes, particularly in patients with severe scarring. TCTR20240512006. Acne scars are a common and distressing problem that can affect a person’s confidence and quality of life. New treatments using energy-based devices, such as fractional lasers and radiofrequency devices, are becoming popular because they are less invasive and can improve the appearance of acne scars. However, it is still unclear which patients benefit the most from these treatments. In this study, we looked at the medical records of 397 patients with acne scars who received treatment with either fractional lasers or radiofrequency devices at a hospital in Thailand. We wanted to determine which factors were linked to better treatment results. We found that patients who were older, male, had newer (younger) scars, had lighter skin color, and had completed at least three treatment sessions were more likely to see better improvement. In people with severe acne scars, completing at least three sessions was especially important to get good results. These findings can help doctors predict which patients will benefit the most from treatment and guide patients in making informed decisions about their care. Future research should explore more treatment combinations and include patient feedback to better understand the results of these treatments.
Source: Dermatology and Therapy
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $7,400
OpenAlex ID: W4412376436