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Comparative study between fractional carbon dioxide laser versus retinoic acid chemical peel in the treatment of acanthosis nigricans

J Cosmet Dermatol. 2021 May 17. doi: 10.1111/jocd.14224. Online ahead of print.

ABSTRACT

BACKGROUND: Acanthosis nigricans (AN) is a common dermatological issue with several therapeutic modalities to treat. Despite retinoid is the first drug of choice in the treatment, the fractional-ablative carbon dioxide (CO2 ) laser has revealed as a promising procedure for the management of neck-AN, outstanding to its ability for superficial ablation of the skin surface, with trans-epidermal melanin elimination.

OBJECTIVES: To decide whether fractional-ablative CO2 laser or retinoic acid (5%) peel is the more effective and safe choice for AN treatment.

METHODS: In this study, twenty Egyptian cases with neck-AN were enrolled, where each case was exposed to four sessions with 2 weeks apart of both fractional CO2 laser on the right half of the neck and retinoic acid peel on the left half. Cases were assessed by a scoring system: Acanthosis Nigricans Area and Severity Index (ANASI) score, two blinded dermatologists, and dermoscopically pre and one-month post-treatment.

RESULTS: We found a highly statistically significant improvement among both treated groups regarding (ANASI) score, and dermatologist’s assessments. Bedside, the degree of sulci cutis, cristae cutis, brown-to-dark brown dots, and milia-like cysts dermoscopic signs improvement was evident in both treated groups. However, fractional CO2 laser shows the superior result to retinoic acid peel in the treatment.

CONCLUSION: Fractional CO2 laser and retinoic acid peel are considered effective modalities for neck-AN treatment. However fractional CO2 laser was more effective.

PMID:33998772 | DOI:10.1111/jocd.14224

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