{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:03:53Z","timestamp":1779789833106,"version":"3.53.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Pre\u2010defined dose parameters of fractional carbon dioxide (Fr:CO\n 2<\/jats:sub>\n ) laser used for acne scars are not aligned with the histological depth achieved by the laser, which predicts scar improvement.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To evaluate the baseline histological depth and architecture of different acne scars and compare the histological changes and clinical improvement after Fr:CO\n 2<\/jats:sub>\n laser.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a prospective study of atrophic acne scars\u2014ice\u2010pick, boxcar, or rolling. The patients were treated with three sessions of Fr:CO\n 2<\/jats:sub>\n laser with pre\u2010determined dosimetry at 3\u2010month intervals. Clinical evaluation was done at every visit using Echelle d'Evaluation clinique des Cicatrices d'acn\u00e9 (ECCA) scoring and individual atrophic acne scars count. Punch biopsy of predominant scars was taken pre\u2010 and 1\u2010month post\u2010treatment. The vertical depth of the scars was measured and histological changes in collagen and elastin were noted.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty\u2010three patients with atrophic acne scars were included (27 boxcar, 9 ice\u2010pick, and 7 rolling). Median histological depth of ice\u2010pick, rolling and boxcar scars in pre\u2010laser biopsies was 1606, 1546 and 1172\u2009\u03bcm respectively, which significantly reduced to 1024 (\n p<\/jats:italic>\n \u2009=\u20090.008), 858 (\n p<\/jats:italic>\n \u2009=\u20090.018) and 746.5\u2009\u03bcm (\n p<\/jats:italic>\n \u2009<\u20090.0001) after the final laser session. Significant correlations were noted between acne scar reduction efficiency (ASRE%) and histological parameters at 7\u2009months [ASRE% boxcar, increase in collagen grading (\n p<\/jats:italic>\n \u2009<\u20090.05); ASRE% rolling, increased scar vascularization (\n p<\/jats:italic>\n \u2009=\u20090.03) and ASRE% ice\u2010pick, increased surrounding dermal elastin (\n p<\/jats:italic>\n \u2009\u2264\u20090.05)].\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Fr:CO\n 2<\/jats:sub>\n laser intervention should be guided by scar\u2010specific depth assessment, enabling optimal dosing and correlating this with histological changes would determine clinical improvement in acne scars.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/phpp.70086","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T03:58:57Z","timestamp":1774756737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["What Are the Histological Changes Corresponding to Clinical Effacement of Atrophic Acne Scars After Fractional Carbon Dioxide Laser Intervention\u2014A Prospective Interventional Study in Skin of Color"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5969-9745","authenticated-orcid":false,"given":"Abhinav","family":"Bansal","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy Atal Bihari Vajpayee Institute of Medical Sciences and Research Institute, Dr. Ram Manohar Lohia Hospital New Delhi India"},{"name":"Maulana Azad Medical College New Delhi 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