Efficacy of 1064 nm Fractional Q-Switched Laser and Topical Isotretinoin: A Split-Face Randomized Clinical Trial

Abstract

Introduction: Acne scars are a common complaint amongst dermatology patients and treating these scars effectively can still be challenging. Multiple treatment approaches can be used on this matter, one of which is using various types of lasers. On the other hand, one of the most effective medical treatments for acne is topical retinoids, which can improve acne and prevent scarring. This study aimed to compare the combined effect of 1064 nm fractional Q-Switched Laser and topical isotretinoin with 1064 nm fractional Q-Switched Laser alone in the treatment of acne scars. Method: In this randomized clinical trial, 20 patients with bilateral acne scars were treated with Q-Switched laser on one side of the face and Q-Switched laser combined with topical isotretinoin on the other. Treatments were performed every 2 weeks for a total of three sessions. Scar improvement was assessed at 3 and 6 months by a blinded assessor concerning clinical features and using dermoscopic images by Fotofinder dermoscope. Statistical analyses were performed using repeated measures ANOVA. Results: Twenty patients (16 female and 4 male) with a mean age of 36.55 finished the study. The side treated with the combination therapy showed significantly better scar scores and percent change at both 3 and 6 months compared to the side treated with laser alone treatment (39.0 ± 2.60 vs. 23.9 ± 1.90; p-value < 0.001 after 6 months of treatment). No severe adverse effects were observed. Only one patient experienced transient erythema. Conclusion: The combination of topical isotretinoin and Fractional Q-Switched 1064 nm laser was more effective than the laser alone in reducing acne scars, with minimal side effects. © 2026 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.