Background  There are limited data about the effect of different types of ablative lasers for the treatment of atrophic acne scars and its related clinical factors.

  Objective  To evaluate the effect of different types of ablative lasers in the treatment of facial atrophic acne scars and its related clinical factors.

  Methods  Clinical data about patients with atrophic acne scars who were treated with ablative lasers in the Laser Center of Dermatology Department in the Seventh Medical Center, Chinese PLA General Hospital from July 2014 to August 2022 were retrospectively analyzed, using fractional CO₂ laser (deep mode with 12.5-22.5 mJ energy density and 5-10% spot density), Er: YAG pixel laser (energy 800-1400 mJ and fluence 3-6 J/cm²) or plasma radiofrequency (three or four passes of the roller tip at 60 to 70 W) for two sessions with 1-12 months period. Photos of patients before and after two sessions of treatments were evaluated with the Echelle d’ Evaluation Clinique des Cicatrices d’ acne (ECCA) to determine the efficacy. According to the decline level of ECCA scores, patients were divided into effective group and non-effective group to ascertain the related clinical factors affecting efficacy.

  Results  Totally 61 patients (35 males and 26 females) were enrolled. ECCA scores declined from (110.16 ± 30.54) to (85.98 ± 25.03) after two sessions of treatments (P=0.000), and the clinical effective rate was 31.15%. Multivariate logistic analysis suggested that degree of scar severity was an independent risk factor for clinical outcome (OR=0.297, 95% CI: 0.090-0.976, P=0.046), while age had no significant effect on efficacy.

  Conclusion  Ablative lasers are effective in the treatment of atrophic acne scars, degree of scar severity is independent clinical factors affecting its efficacy.