Fractional CO2 laser alone versus combined with topical timolol or insulin for acne Scar treatment: a randomized controlled clinical trial

Abstract

Introduction: Acne vulgaris is a common disease involving adolescents predominantly, which can lead to scar formation. This study aimed to compare the efficacy of fractional CO2 laser therapy, alone or combined with topical Timolol or insulin, for acne scar treatment, which has not been yet rigorously investigated.

Method: In this Randomized Controlled Trial (RCT) conducted in 2024, we enrolled 30 subjects and randomly assigned them to groups A and B. Both groups received bilateral fractional CO2 laser therapy; one group received unilateral topical 0.5% Timolol Maleate, while the other received unilateral topical regular insulin. Scar severity was assessed using the Scale for Acne Scar Severity (SCAR-S), Acne Scar Assessment Scale (ASAS), and Goodman and Baron Quantitative Global Scarring Grading System (GBAQGS) before and after the therapy. Additionally, patients' quality of life was evaluated using the Dermatologic Life Quality Index (DLQI) questionnaire at the designated time points. Statistical analyses were conducted using the IBM ™ SPSS Statistics application (version 26.0).

Results: The subjects consisted of 20 females and 10 males of Persian ethnicity, with a mean age of 32.20 years. Despite significant improvements in acne scar severity, and quality of life observed following fractional CO2 laser therapy alone and in combination with topical Timolol or insulin application, no significant differences existed between these treatment approaches. No adverse effect was seen during the study.

Conclusion: Fractional CO2 laser alone or its combination with topical Timolol or insulin mitigated acne scar severity and enhanced patients' quality of life, despite the absence of significant differences.

Keywords: Acne vulgaris; Fractional CO2 laser; Regular insulin; Scar; Timolol.