الفهرس 
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Abstract
Acne vulgaris affects a great population of adolescence, it represents a major problem especially its disfiguring post acne scar sequel, differ greatly in their morphology and clinical appearance. But the well known ice-pick and boxcar scars are the most difficult to treat.
Lasers have been introduced recently as a treatment modality for post acne scars. Ablative skin resurfacing by Er:YAG or CO2 lasers) are considered the gold standard, Non –ablative lasers are being widely used nowadays with moderate results. The idea of combining lasers in treatment of scars aims at gaining the benefits of each one and increasing their outcome by synergism .
Ablative Er:YAG laser resurfacing ablates skin and leaves a minimal thermal damage behind which is the nidus for collagen remodeling thereafter , the wounded ablated surface heals by the supporting cells nearby allowing formation of newly organized well ultra structural tissue.
Non–ablative: Nd:YAG laser functions by heating the dermis with initiation of cascade of dermal remodeling through the induction of cytokines which are involved in normal wound healing process.
In our study we treated 30 patients of bilateral icepick and boxcar post acne scars of the face. They were subdivided into 6 groups 5 patients in each, they received 3 subsequent sessions 1 month apart and were evaluated after the first and last session by two months;
In group 1: five patients received on the right facial side ER+ Delayed Nd:YAG and on the left side ER only.
In group 2: five patients received on the right facial side ER+ Delayed Nd:YAG and on the left side Nd:YAG only.
In group 3: five patients received on the right facial side ER+ Delayed Nd:YAG and on the left side ER+ immediate Nd:YAG .
In group 4 : five patients received on the right facial side ER+ Delayed Nd:YAG and on the left side Nd:YAG + ER
In group 5 : five patients received on the right facial side ER+ immediate Nd:YAG and the left side was untreated.
In group 6 : five patients received on the right facial side Nd:YAG+Er:YAG and the left side was untreated.
Our results yielded that there was no great difference between combined ablative and non-ablative protocols and ablative resurfacing alone. Non-ablative laser treatment did not improve outcome before the third session and their efficacy did not over-weigh either combined or non-combined protocols.