{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:07:48Z","timestamp":1785535668867,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Differences in clinical efficacy based on the fluence of fractional picosecond laser treatment for acne scars are unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the efficacy and safety of low\u2010fluence versus high\u2010fluence fractional picosecond Nd:YAG 1064\u2010nm laser treatment in acne scar patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this 12\u2010week, investigator\u2010blinded, randomized, split\u2010face study, 25 patients with moderate\u2010to\u2010severe acne scars received three sessions of high\u2010fluence laser treatment (1.0\u2009J\/cm<jats:sup>2<\/jats:sup>) on one side of their face and low\u2010fluence (0.3\u2009J\/cm<jats:sup>2<\/jats:sup>) on the other side every 4\u2009weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4\u2009weeks. The histological analysis compared the acne scars obtained before and 4\u2009weeks after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At their last visit, 88.00% and 92.00% of the subjects achieved &gt;30% reduction in scar counts on the low\u2010 and high\u2010fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4\u2009weeks after the last treatment. Although the high\u2010fluence side showed a greater reduction in scar counts (\u221266.73%) than the low\u2010fluence side (\u221262.13%), the two sides had no significant difference in the grading scores. The high\u2010fluence side showed significantly more severe pain and higher side\u2010effect scores immediately and 4\u2009weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low\u2010fluence side.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The low\u2010fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high\u2010fluence setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phpp.12922","type":"journal-article","created":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T14:49:55Z","timestamp":1698590995000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The efficacy and safety of low\u2010 versus high\u2010fluence fractional picosecond Nd:<scp>YAG<\/scp> 1064\u2010nm laser in the treatment of acne scars: A randomized split\u2010face comparison 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