摘要

Objectives: To compare the efficacy, patient satisfaction, and safety of fractional CO₂ laser + PRP versus microneedling + PRP in the treatment of atrophic acne scars. Learning outcomes for attendees include: • Gaining evidence-based insight into the comparative effectiveness of two widely used combination therapies. • Understanding patient-centered outcomes, including quality of life and satisfaction. • Recognizing safety profiles and practical considerations for selecting appropriate scar management protocols. Introduction: Atrophic acne scars significantly impair patients’ quality of life. Fractional CO₂ laser and microneedling are established treatment modalities, while platelet-rich plasma (PRP) has emerged as an adjunct to enhance collagen remodeling and scar healing. Limited evidence directly compares the synergistic efficacy of these combination therapies. Materials / method: A split-face comparative trial was conducted at Chughtai Medical Centre, Lahore, Pakistan, over 18 months. Fifty-eight patients (28 male, 30 female; mean age 27 ± 8 years) with atrophic acne scars were enrolled. Each patient received fractional CO₂ + PRP on one facial half and microneedling + PRP on the contralateral half across multiple sessions. Outcomes were assessed using Goodman & Baron’s qualitative scar grading, photographic analysis, patient-reported satisfaction, and Dermatology Life Quality Index (DLQI). Results: In the fractional CO₂ + PRP group, 52 patients (89.7%) achieved >50% scar reduction, compared with 19 patients (32.8%) in the microneedling + PRP group (p < 0.05). Patient satisfaction and quality-of-life improvement were significantly higher in the fractional CO₂ + PRP arm. Adverse effects were mild and transient in both groups, with post-inflammatory hyperpigmentation reported more frequently after CO₂ laser. Conclusion: Fractional CO₂ + PRP demonstrated superior efficacy and patient satisfaction compared with microneedling + PRP for atrophic acne scars, with acceptable safety. This combination may represent a preferred therapeutic approach in aesthetic dermatology. Larger multicenter trials with extended follow-up are warranted.