Lower-fluence, higher-density versus higher-fluence, lower-density treatment with a 10,600-nm carbon dioxide fractional laser system: a split-face, evaluator-blinded study

Dermatol Surg. 2010 Dec;36(12):2022-9. doi: 10.1111/j.1524-4725.2010.01803.x. Epub 2010 Nov 11.


Background: Adequate laser settings in the treatment of scars using a carbon dioxide fractional laser system (CO(2) FS) have not been established.

Objective: To compare the efficacy and safety of low-fluence, high-density with high-fluence, low-density treatment with CO(2) FS on acne scars and enlarged pores.

Methods: Ten patients with mild to severe atrophic acne scars and enlarged pores were enrolled. Half of each subject's face was treated with a single session of CO(2) FS with a fluence of 70 mJ and a density of 150 spots/cm(2) ; the other half was treated with a fluence of 30 mJ and a density of 250 spots/cm(2) .

Results: Follow-up results 3 months after a single low-fluence, high-density treatment with CO(2) FS showed that four of 10 participants had clinical improvement of 51% to 75% from baseline. After the high-fluence, low-density CO(2) FS treatment, five of 10 patients demonstrated marked clinical improvements of more than 76%.

Conclusion: Higher-energy, lower-density laser settings seem to be more effective than lower-energy, higher-density settings for acne scars and enlarged pores, although our results do not constitute a conclusive comparison of the two different modes of CO(2) FS.

MeSH terms

  • Acne Vulgaris / radiotherapy*
  • Adult
  • Carbon Dioxide
  • Cicatrix / radiotherapy*
  • Face
  • Humans
  • Low-Level Light Therapy / instrumentation
  • Low-Level Light Therapy / methods*
  • Male
  • Prospective Studies
  • Statistics, Nonparametric
  • Treatment Outcome


  • Carbon Dioxide