Background: Acne scars significantly impact skin texture and esthetics, necessitating effective treatment modalities. This study evaluates the efficacy of erbium glass laser therapy in improving atrophic acne scars using advanced image analysis techniques. Materials and methods: Twenty patients with mild to moderate atrophic scars underwent two sessions of 1550 nm erbium glass laser treatment. The clinical photographs were analyzed using a Gray-Level Co-occurrence Matrix (GLCM) to assess changes in contrast and homogeneity across the grayscale and RGB channels. The analysis revealed statistically significant improvements post-therapy, including reduced contrast and increased homogeneity, indicating a smoother and more uniform skin texture. The blue and green channels demonstrated the greatest sensitivity to surface-level textural changes, while the red channel exhibited the smallest differences, reflecting its deeper penetration and reduced sensitivity to surface alterations. Conclusions: These findings underscore the value of quantitative imaging techniques in dermatology for objectively evaluating therapeutic outcomes and optimizing treatment strategies. Erbium glass laser therapy emerges as a non-invasive and effective solution for acne scar management.

Background: Acne scarring presents a significant esthetic and psychological concern, commonly classified into atrophic and hypertrophic types. Effectively managing these lesions often involves the use of therapeutic strategies such as laser treatments, dermabrasion, and fillers. This study investigates the efficacy of 1550 nm erbium glass laser therapy in the treatment of atrophic acne scars through a quantitative assessment. Material and Methods: Participants with mild to moderate atrophic acne scars received two sessions of fractional erbium glass laser therapy at one-month intervals. Skin density and epidermal thickness were measured using a high-frequency ultrasound device (DUB SkinScanner), while the Antera 3D imaging system facilitated a comprehensive analysis of skin parameters, including texture, volumetric depressions, and pigmentation. Results: The use of this therapy led to significant improvements across multiple parameters. Skin density and epidermal thickness increased. Significant reductions were observed in fold depth, pore volume, and depression volume, indicating enhanced smoothness and minimized scar appearance. Improvements in texture roughness and pigmentation contributed to a visually coherent skin surface. Conclusions: Fractional erbium glass laser therapy effectively ameliorates the appearance of atrophic acne scars by increasing skin density, reducing dermal depressions, and improving texture and pigmentation uniformity. The Antera 3D system and high-frequency ultrasound device demonstrated high efficacy in capturing subtle changes, supporting its value in clinical applications for optimizing treatment parameters.