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This study aims to compare the efficacy and safety of combined subcision with either fractional CO<jats:sub>2<\/jats:sub> laser or cross-linked hyaluronic acid filler (HA) versus subcision alone in the treatment of facial atrophic post-acne scars. Forty patients with atrophic post-acne scars were subjected to subcision on both sides of the face, then were randomly divided into three groups. Group I (20 patients): subcision combined with cross-linked HA filler injection at one side of the face; group II (20 patients): subcision followed by fractional CO<jats:sub>2<\/jats:sub> at the other side of the face; and group III (20 patients): with subcision only as a control group. Treatment sessions were every month until clinical improvement or for maximum three sessions. The treatment\u2019s efficacy was assessed by Goodman and Baron\u2019s qualitative and quantitative grading systems. The two blinded investigator scores showed significant improvement in both the filler side versus subcision (<jats:italic>p<\/jats:italic> value\u2009=\u20090.015), and the fractional laser side versus subcision (<jats:italic>p<\/jats:italic> value\u2009&lt;\u20090.001), with no statistically significant difference between both sides (<jats:italic>p<\/jats:italic> value\u2009=\u20090.171). Qualitative grading by Goodman and Baron scores showed that the percentage of patients with excellent improvement was higher in group 1 and group 2 than in group 3 with <jats:italic>p<\/jats:italic> value\u2009=\u20090.031; also the mean percentage of reduction in quantitative grading was higher in group 1 and group 2 than in group 3 with <jats:italic>p<\/jats:italic> value\u2009&lt;\u20090.00. Either combined subcision with fractional CO<jats:sub>2<\/jats:sub> laser or with cross-linked HA filler achieved superior improvement in facial atrophic post acne scars treatment with no serious side effects in this study. However, subcision only by blunt canula also had modest improvement.<\/jats:p>","DOI":"10.1007\/s10103-022-03677-y","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T03:06:34Z","timestamp":1671851194000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A combined subcision approach with either fractional CO2 laser (10,600\u00a0nm) or cross-linked hyaluronic acid versus subcision alone in atrophic post-acne scar treatment"],"prefix":"10.1007","volume":"38","author":[{"given":"Alaa Abdelaziz","family":"Abdelwahab","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada Abdel badea","family":"Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2575-8566","authenticated-orcid":false,"given":"Mervat","family":"Hamdino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"3677_CR1","doi-asserted-by":"publisher","first-page":"153","DOI":"10.4103\/0974-2077.167272","volume":"8","author":"SY Chuah","year":"2015","unstructured":"Chuah SY, Goh CL (2015) The impact of post-acne scars on the quality of life among young adults in Singapore. 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The study was following the Helsinki declaration.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"All study participants provided written informed consent to the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"20"}}