الفهرس 
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Abstract
Acne vulgaris is a common skin disorder of the pilosebaceous unit, affecting 80% of adolescents. Complications of acne include facial scarring and psychosocial stress.
Minimally invasive procedures are modalities used for scar remodeling. They enhance dermal ECM proteins without ablation of the epidermis, therefore, limiting side effects and minimizing down-time. Among these techniques, microneedling, which is considered the most established effective modality for atrophic post acne scars becoming popular all over the world.
Carboxytherapy, the cutaneous or transcutaneous administration of CO2 gas, has increased in its popularity in the field of asthetics and particularly for dermal rejuvenation and fat lipolysis. So, it is most officious in treatment of wrinkles, scars, stretch marks, wound healing and cellulite. However, CXT is considered uncommon addition to treatment modalities of atrophic post acne scars.
The aim of this study was to evaluate the efficacy of CXT in comparison with skin needling in the treatment of post acne scars.
In this study, 20 patients with post acne scars underwent 6 sessions of microneedling and CXT on right and left sides of the face respectively with 2 weeks interval. At 2 months after last session, clinical, histometrical and histopathological evaluation were done.
The present study showed significant improvement of total acne scars and its 3 subtypes after microneedling treatment with reduction percentage of 60.68%, 58.20%, 59.71% and 47.72% respectively with no significant difference between them.
Regarding CXT, there was significant improvement of total acne scars and 3 subtypes (icepicks, boxcar and rolling) with reduction percentage of 61.62% 64.62% , 48.01% and 55.93% respectively with no significant difference between them.
Comparing CXT and microneedling, there was no significant difference in the reduction percentage of acne scars in both sides of the face regarding the total acne scars with its 3 types (icepicks, boxcar and rolling).
Both microneedling and CXT showed no side effects apart from transient erythema and edema after each session.
Histopathological assessment revealed that the epidermis showed acanthosis and the keratinocytes became well organized. Histometrical evaluation showed highly significant increase in the mean thickness of the epidermis after treatment by microneedling and carboxytherapy with no significant difference between them.