Ablative Fractional CO2 Laser Resurfacing for Atrophic Acne Scars During and After Oral Isotretinoin: A…

Cohort studyDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]· Jul 2026

Ablative Fractional CO2 Laser Resurfacing for Atrophic Acne Scars During and After Oral Isotretinoin: A Single-Center Retrospective Cohort Study in Fitzpatrick III-VI Patients.

Zhe Sun, Zhuo Fan, Huiqiong Xiang

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Acne & RosaceaCohort studyClinical practiceQ2IF 1.2

Hyperpigmentation odds rose when laser treatment followed isotretinoin within 90 days.

Ablative Fractional CO2 Laser Resurfacing for Atrophic Acne Scars During and After Oral Isotretinoin: A Single-Center Retrospective Cohort Study in Fitzpatrick III-VI Patients.

Zhe Sun … Huiqiong Xiang

Dermatologic surgery · Jul 2026 · Q2 in Dermatology

Background

Have traditionally been delayed 6 to 12 months after isotretinoin because of concerns about abnormal scarring; evidence for fractional ablative CO2 laser is limited in higher Fitzpatrick skin types.

Purpose

To assess the safety and effectiveness of ablative fractional CO2 laser (AFCL) for atrophic acne scars during and after oral isotretinoin.

Methods

This was a single-center retrospective cohort of 106 patients (188 AFCL sessions) grouped as concurrent isotretinoin, ≤90 days since discontinuation, 91 to 180 days, or >180 days (control).

n = 106 patients

Results

hyperpigmentation risk rises when laser follows isotretinoin within 90 days

OR by subgroup · 95% CI

More results

Abnormal scarring occurred in 3/106 patients (2.8%) with no significant between-group difference (p = .762).

Concurrent isotretinoin was not associated with increased postinflammatory hyperpigmentation or abnormal scarring.

Higher density predicted delayed re-epithelialization.

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Conclusion · 1 of 3

AFCL during low-dose isotretinoin or within 6 months after isotretinoin discontinuation was not associated with increased abnormal scarring.

Conclusion · 2 of 3

Because delayed re-epithelialization was numerically more frequent during concurrent isotretinoin and density was associated with slower healing, conservative density selection and careful counseling remain appropriate.

Conclusion · 3 of 3

postinflammatory hyperpigmentation risk was elevated when treatment occurred within 90 days after discontinuation.

Ablative Fractional CO2 Laser Resurfacing for Atrophic Acne Scars During and After Oral Isotretinoin: A Single-Center Retrospective Cohort Study in Fitzpatrick III-VI Patients.

Ablative Fractional CO2 Laser Resurfacing for Atrophic Acne Scars During and After Oral Isotretinoin: A Single-Center Retrospective Cohort Study in Fitzpatrick III-VI Patients.

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