Reparative Effects of a Topical Antioxidant Serum Containing Vitamin C, Vitamin E, and Ferulic Acid After Ablative Fractional CO2 Laser Treatment for Atrophic Acne Scars: A Randomized, Investigator-Blinded, Split-Face, Controlled Trial.

Abstract

BACKGROUND: Ablative fractional CO2 laser is effective for acne scar treatment but is often associated with side effects such as erythema and dyspigmentation, along with prolonged recovery time. AIMS: The study aimed to evaluate the post-procedure reparative effects of a combination of vitamin C, E, and ferulic acid (CE Ferulic) in Chinese patients with atrophic acne scars. METHODS: In this randomized, investigator-blinded, split-face, controlled trial, patients aged 18-50 with moderate-to-severe atrophic acne scars were randomly assigned to apply CE Ferulic to intervention-side face and normal saline (NS) to control-side face, immediately after ablative CO2 laser treatment for 14 days. Patients were further divided into once-daily and twice-daily application subgroups. During the 14-day follow-up, the wound healing (measured by scabbing stage on Day 7), erythema index (EI), melanin index (MI), skin hydration, and transepidermal water loss (TEWL) were evaluated. Direct assessment of scar improvement was not within the scope of this study. RESULTS: Sixty-four patients were included in the analysis. On Day 7, the intervention side showed a higher complete scab detachment rate than the control side (60.9% vs. 34.4%, p = 0.0026). EI and MI reduced significantly greater on the intervention side compared to the control side (Days 3, 7, and 14; p < 0.0001). On Day 14, the intervention side also demonstrated significantly better capability of maintaining skin hydration (p = 0.0367) and preventing TEWL (p = 0.0246) than the control side. CONCLUSIONS: This study found that CE Ferulic led to enhanced wound healing, reduced erythema and melanin levels, and improved skin hydration following laser treatment, suggesting its beneficial application in combination with laser treatment to accelerate skin recovery. TRIAL REGISTRATION: ChiCTR2300078214.