{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:25:57Z","timestamp":1785461157291,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Atrophic acne scars are a common dermatological concern, often requiring fractional carbon dioxide (CO<jats:sub>2<\/jats:sub>) laser resurfacing for effective treatment. However, in darker skin types (Fitzpatrick III\u2013V), the high risk of post\u2010inflammatory hyperpigmentation (PIH) remains a significant limitation, affecting treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study evaluates the efficacy of a novel pre\u2010 and post\u2010treatment peel in reducing PIH following fractional CO<jats:sub>2<\/jats:sub> laser resurfacing, particularly in higher Fitzpatrick skin types. The primary outcome was the incidence and severity of PIH, while secondary outcomes included healing time and changes in acne scar grading.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Twenty\u2010nine patients underwent fractional CO<jats:sub>2<\/jats:sub> laser resurfacing, with the study group (<jats:italic>n<\/jats:italic>\u2009=\u200915) receiving adjunctive peeling treatment before and after the procedure. PIH severity was assessed using the Post\u2010Inflammatory Hyperpigmentation Area and Severity Index (PIHASI) at Week 6. Healing time and changes in acne scar grading (Goodman and Baron scale) were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The peel\u2010treated group had a lower median PIHASI score (0.0 [IQR: 0.0\u20130.2]) than the no\u2010peel group (0.2 [IQR: 0.2\u20130.4]) at Week 6. The Mann\u2013Whitney <jats:italic>U<\/jats:italic> test showed a statistically significant difference (<jats:italic>z<\/jats:italic>\u2009=\u20092.427, <jats:italic>p<\/jats:italic>\u2009=\u20090.015, exact <jats:italic>p<\/jats:italic>\u2009=\u20090.016). Re\u2010epithelialization time was comparable (Day 6.4 in peel group vs. Day 6.2 in control group), and no significant difference was observed in acne scar improvement (scar reduction: 1.27\u2009\u00b1\u20090.59 vs. 1.36\u2009\u00b1\u20090.63, <jats:italic>p<\/jats:italic>\u2009=\u20090.694). No adverse events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The novel peel effectively reduces PIH risk following fractional CO<jats:sub>2<\/jats:sub> laser resurfacing without affecting scar outcomes. While it offers a promising approach for Fitzpatrick III\u2013V patients, further studies with larger cohorts are needed to validate its long\u2010term efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.70366","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:29:54Z","timestamp":1753874994000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Novel Peel to Prevent Post\u2010Inflammatory Hyperpigmentation After <scp>CO<sub>2<\/sub><\/scp> Resurfacing for Acne Scars"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1818-0543","authenticated-orcid":false,"given":"Xiaozhun","family":"Hang","sequence":"first","affiliation":[{"name":"Queensland Institute of Medical Research Berghofer  Herston Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5946-1786","authenticated-orcid":false,"given":"Davin Sui","family":"Lim","sequence":"additional","affiliation":[{"name":"Cutis Clinic  Indooroopilly Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2021.11.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.113451"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328243"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1329413"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1899"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20512"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2019.03.002"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000200"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.12.012"},{"key":"e_1_2_11_11_1","volume-title":"Laser Complications","author":"Prohaska J. 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