Evaluation of the Efficacy and Safety of Fractional CO₂ Laser With and Without Intradermal Botulinum Toxin A in the Treatment of Inflammatory Facial Acne Vulgaris.
Evaluation of the Efficacy and Safety of Fractional CO₂ Laser With and Without Intradermal Botulinum Toxin A in the Treatment of Inflammatory Facial Acne Vulgaris: A Split-face Randomized Controlled Trial.
The goal of this clinical trial is to learn if fractional CO₂ laser (FCO₂) with and without intradermal Botulinum Toxin A can treat inflammatory facial acne vulgaris in adult patients of both genders. It will also learn about the safety and tolerability of fractional CO₂ laser (FCO₂) with and without intradermal Botulinum Toxin A in patients with inflammatory facial acne vulgaris.
The main questions it aims to answer is:
- Does fractional CO₂ laser (FCO₂) work effectively in inflammatory facial acne vulgaris?
- is fractional CO₂ laser (FCO₂) well tolerated in inflammatory facial acne vulgaris?
- Is fractional CO₂ laser (FCO₂) monotherapy comparable to fractional CO₂ laser (FCO₂) combined with intradermal Botulinum Toxin A in terms of efficacy and safety in inflammatory facial acne vulgaris?
Researchers will compare fractional CO₂ laser (FCO₂) monotherapy to fractional CO₂ laser (FCO₂) combined with intradermal Botulinum Toxin A to see if crisaborole works as effective and is as well-tolerated in inflammatory facial acne vulgaris.
Participants will:
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Visit the Dermatology clinic to undergo a single session of intradermal Botulinum Toxin A injection to one randomized hemi-face.
- Then 2 weeks later, they will visit the Dermatology LASER clinic to start fractional CO₂ laser (FCO₂) sessions every 4 weeks, also for checkups and photography.
- They will receive a total of 3 FCO₂ LASER sessions (4 weeks apart).
- Then 12 weeks after the last session, they will visit the clinic for follow up, photography and documentation.
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Keep a diary of their symptoms
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
The proposed study is a single-center prospective split-face open-label, assessor-blinded randomized controlled clinical trial that will enroll adult patients with inflammatory facial acne vulgaris who will be recruited at the Dermatology outpatient clinic at Kasr Alainy University Hospitals.
The study aims to evaluate the efficacy, safety, and tolerability of fractional CO₂ laser (FCO₂) with and without intradermal Botulinum Toxin A in the treatment of inflammatory facial acne. The study will involve 24 patients with inflammatory facial acne. The purpose and nature of the study will be explained to all patients. Written informed consent for participation, treatment, and photography will be obtained from each patient prior to enrollment in the study.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Riham M Mohamed, MD, MSc., PhD
- Numero di telefono: +201066239360
- Email: riham.mohye@cu.edu.eg
Luoghi di studio
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Cairo, Egitto
- Faculty of Medicine, Cairo University
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Contatto:
- Riham M Mohamed, MD, MSc., PhD
- Numero di telefono: +201066239360
- Email: riham.mohye@cu.edu.eg
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Patients with inflammatory facial acne with Global Evaluation Acne (GEA) scale (2-4).
- Both genders.
- Aged 18 - 45 years.
- Willingness and ability to comply with the requirements of the protocol.
Exclusion Criteria:
- Patients with exclusively non-inflammatory acne, very severe nodulocystic acne (GEA > 4), or non-facial acne.
- Patients who were using or have discontinued systemic treatment for acne within 12 weeks prior to enrollment in the study. For oral isotretinoin, a washout period of 24 weeks was strictly applied.
- Patients who were using or had discontinued topical acne treatments within 4 weeks prior to baseline of the study.
- Patients who underwent, planned, or had discontinued facial procedures (e.g., chemical peels, laser, depilation) within 4 weeks prior to baseline in the treatment area.
- Patients with active skin infections, such as herpes simplex virus (HSV), impetigo, or other bacterial, viral, or fungal skin infections.
- Patients with neuromuscular disorders, e.g., myasthenia gravis.
- Patients with known hypersensitivity or contraindications to botulinum toxin or FCO₂ laser therapy.
- Patients with other facial rashes that might have interfered with accurate assessment.
- Pregnancy or lactation.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Comparatore attivo: Fractional CO₂ Laser
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The treatment protocol comprises two overlapping passes over acne lesions, while perilesional and uninvolved skin receives a single pass. Laser settings were standardized at 15 W power, 550 μm dot spacing, 400 μs dwell time, using SmartTrack scanning mode with single stack emission. A square pattern with a 10/10 ratio and 100% spot size will be applied.
Altri nomi:
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Sperimentale: Fractional CO₂ laser combined with intradermal microbotox injection.
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The treatment protocol comprises two overlapping passes over acne lesions, while perilesional and uninvolved skin receives a single pass. Laser settings were standardized at 15 W power, 550 μm dot spacing, 400 μs dwell time, using SmartTrack scanning mode with single stack emission. A square pattern with a 10/10 ratio and 100% spot size will be applied.
Altri nomi:
Intradermal botulinum toxin injection will be performed to one randomized hemi-face in each patient 2 weeks prior to starting FCO2 LASER sessions.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Percentage change in lesion count
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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lesion count will be performed to each hemi-face respectively upon enrollment and at the end of treatment period and at the follow up visit (3 months past cessation of treatment). |
Upon enrollment, at 12 weeks and at 24 weeks
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Global Acne Grading System (GAGS)
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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With separate right and left cheek scoring in concordance with the split-face design. In 1997, Doshi et al. introduced the Global Acne Grading System (GAGS), which divides the face, chest, and back into six areas. Each area is graded from 0 to 4 based on the severity of the worst lesion. These individual scores are summed to produce a total score. Patients are classified as follows: 1-18 indicates mild acne, 19-30 indicates moderate acne, 31-38 indicates severe acne, and over 39 indicates very severe acne (Doshi, Zaheer and Stiller, 1997). |
Upon enrollment, at 12 weeks and at 24 weeks
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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The investigator Global Assessment Scale (IGA)
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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is a clinician-rated scale used to evaluate overall acne severity and treatment response based on a global assessment of lesion appearance. It grades acne from clear (0) to severe (4) |
Upon enrollment, at 12 weeks and at 24 weeks
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Cardiff Acne Disability Index (CADI)
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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Acne-related quality of life will be assessed using the CADI, a validated acne-specific quality of life questionnaire developed by Motley and Finlay in 1992 to assess the psychological and social impact of acne vulgaris. It consists of five items scored on a four-point scale, with higher scores indicating greater impairment. It remains widely used in clinical research due to its simplicity and reliability (Motley and Finlay, 1992) |
Upon enrollment, at 12 weeks and at 24 weeks
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Patient satisfaction score
Lasso di tempo: At 24 weeks
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Patient satisfaction will be assessed using a 5-point Likert scale to evaluate patients' subjective perception of treatment outcomes. On the Likert scale, patients will rate their overall satisfaction as 1 = very dissatisfied, 2 = dissatisfied, 3 = neutral, 4 = satisfied, and 5 = very satisfied. |
At 24 weeks
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The Post-Acne Hyperpigmentation Index (PAHPI)
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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is a validated scoring system developed to assess the severity of PIH based on lesion number, size, intensity, and distribution, with weighted scores assigned to each domain. The total PAHPI score ranges from 6 to 22, with higher scores indicating greater severity of post-acne hyperpigmentation. The index has demonstrated good reliability and validity in evaluating post-inflammatory hyperpigmentation associated with acne vulgaris (Khee et al., 2021). |
Upon enrollment, at 12 weeks and at 24 weeks
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Post-inflammatory erythema grading system
Lasso di tempo: Upon enrollment, at 12 weeks and at 24 weeks
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is a clinician-based assessment tool used to evaluate the severity and extent of post-acne erythema following inflammatory acne lesions. It provides a standardized clinical evaluation of erythematous post-acne changes (Shucheng et al., 2024). |
Upon enrollment, at 12 weeks and at 24 weeks
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Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024 May;90(5):1006.e1-1006.e30. doi: 10.1016/j.jaad.2023.12.017. Epub 2024 Jan 30.
- Kakpovbia EE, Young T, Milam EC, Qian Y, Yassin S, Nicholson J, Hu J, Troxel AB, Nagler AR. Efficacy of topical treatments for mild-to-moderate acne: A systematic review and meta-analysis of randomized control trials. J Eur Acad Dermatol Venereol. 2025 Apr;39(4):775-784. doi: 10.1111/jdv.20154. Epub 2024 Jun 29.
- Ibrahim SM, Farag A, Hegazy R, Mongy M, Shalaby S, Kamel MM. Combined Low-Dose Isotretinoin and Pulsed Dye Laser Versus standard-Dose Isotretinoin in the Treatment of Inflammatory Acne. Lasers Surg Med. 2021 Jul;53(5):603-609. doi: 10.1002/lsm.23356. Epub 2020 Nov 13.
- Hammoda TM, Ahmed NA, Hamdino M. Fractional CO2 laser versus 1064-nm long-pulsed Nd:YAG laser for inflammatory acne vulgaris treatment: a randomized clinical trial. Lasers Med Sci. 2023 Aug 18;38(1):187. doi: 10.1007/s10103-023-03855-6.
- Gad El-Karim MA, Hegazy MS, Maged A, Fawzy SK, Abdelghani R. Efficacy and safety of combined fractional carbon dioxide laser and topical timolol maleate 0.5% solution versus topical timolol maleate 0.5% solution alone in inflammatory facial acne; a randomized split face controlled study. Lasers Med Sci. 2025 Feb 1;40(1):58. doi: 10.1007/s10103-025-04308-y.
- Calvisi L, Diaspro A, Sito G. Microbotox: A prospective evaluation of dermatological improvement in patients with mild-to-moderate acne and erythematotelangiectatic rosacea. J Cosmet Dermatol. 2022 Sep;21(9):3747-3753. doi: 10.1111/jocd.14692. Epub 2022 Mar 21.
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Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
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Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie della pelle
- Eruzioni Acneiformi
- Malattie delle ghiandole sebacee
- Malattie della pelle e del tessuto connettivo
- Acne vulgaris
- Aminoacidi, peptidi e proteine
- Proteine
- Fattori biologici
- Idrolasi
- Enzimi
- Enzimi e coenzimi
- Tossine botuliniche
- Metalloendopeptidasi
- Endopeptidasi
- Idrolasi peptidiche
- Metalloproteasi
- Proteine batteriche
- Tossine batteriche
- Tossine, biologiche
- Tossine botuliniche, tipo A
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- MS-379-2025
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