Comparative efficacy and safety of fractional carbon dioxide and erbium-based fractional lasers for atrophic acne scars: A systematic review and meta-analysis.
Lasers Med SciSep 10, 2026 (epub)
Xin Song, Bing-Wei Zhi
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In 30 seconds
This systematic review and meta-analysis compared the efficacy and safety of fractional carbon dioxide (CO₂) and erbium-based fractional lasers for treating atrophic acne scars in 130 participants. The analysis found that erbium-based lasers had a lower probability of achieving >50% clinical improvement compared to CO₂ lasers (RR, 0.69; 95% CI, 0.49-0.97).
Key findings
- Erbium-based lasers had a lower probability of >50% clinical response than CO₂ lasers (RR, 0.69; 95% CI, 0.49-0.97).
- Fractional CO₂ laser was associated with greater treatment-related pain (MD, 1.86; 95% CI, 1.33-2.39).
- CO₂ laser resulted in longer downtime compared to erbium lasers (MD, 3.67 days; 95% CI, 1.90-5.44).
- No significant differences were found for post-inflammatory hyperpigmentation or acneiform events.
Why it matters
Understanding the comparative efficacy and safety of these laser treatments is crucial for clinicians to make informed decisions regarding the management of atrophic acne scars, balancing treatment outcomes with patient tolerability.