Efficacy and Safety of Fractional Erbium-doped Yttrium Aluminum Garnet Laser in Patients with Atrophic Acne Scars: A Prospective Interventional Study from North India

Context: Acne is a leading cause of facial scarring and managing atrophic acne scars remains a clinical challenge. Fractional photothermolysis has become a widely accepted treatment approach. Among available lasers, Erbium-doped Yttrium Aluminum garnet (Er: YAG) targets water-rich tissues with high precision and minimal thermal damage, making it suitable for superficial resurfacing. Aims: To evaluate the efficacy and safety of fractional Er: YAG laser in patients with atrophic acne scars through a prospective interventional study. Settings and Design: This 12-month, prospective, interventional study was conducted at the dermatology department of a tertiary care hospital in North India, enrolling consecutive patients who met the inclusion and exclusion criteria. Materials and Methods: All participants received four sessions of fractional Er: YAG laser treatment at 4-week intervals. Improvement was assessed using Goodman and Baron qualitative and quantitative and patient assessment scores before each session and 8 weeks post final session. Side effects were recorded, and standardized photographs were taken during each visit. Statistical Analysis Used: With the help of SPSS software version 27, paired t -test was used to compare pre- and posttreatment scores; P < 0.05 was considered statistically significant. Results: Of 32 enrolled patients, 29 completed the study. Improvement by at least one qualitative grade was seen in 72.4% of patients; 3.4% improved by two grades. Statistically significant differences in the mean quantitative scores were seen from 8 weeks onward ( P < 0.001). The common side effects included transient erythema and grid marks. Postinflammatory hyperpigmentation and acne flares were infrequent. Conclusions: Fractional Er: YAG laser is a safe and effective treatment for atrophic acne scars, providing steady improvement with minimal adverse effects, particularly beneficial for Fitzpatrick skin types III–V.