<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-2395</journal-id>
<journal-title><![CDATA[Revista da Sociedade Portuguesa de Dermatologia e Venereologia]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Soc Port Dermatol Venereol]]></abbrev-journal-title>
<issn>2182-2395</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Dermatologia e Venereologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-23952020000400048</article-id>
<article-id pub-id-type="doi">10.29021/spdv.78.4.1234</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[What Role for Carboxytherapy in the Treatment of Acne Scars?]]></article-title>
<article-title xml:lang="pt"><![CDATA[Qual o Papel da Carboxiterapia no Tratamento de Cicatrizes de Acne?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peixoto]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lascasas]]></surname>
<given-names><![CDATA[Joana Resse]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vedor]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad a Distancia de Madrid (UDIMA) Centro Internacional de Estudios de Córdoba ]]></institution>
<addr-line><![CDATA[Cordoba ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad a Distancia de Madrid (UDIMA) Centro Internacional de Estudios de Córdoba ]]></institution>
<addr-line><![CDATA[Cordoba ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad a Distancia de Madrid (UDIMA) Centro Internacional de Estudios de Córdoba ]]></institution>
<addr-line><![CDATA[Cordoba ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>78</volume>
<numero>4</numero>
<fpage>48</fpage>
<lpage>54</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-23952020000400048&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-23952020000400048&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-23952020000400048&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT   Introduction: Acne is an extremely prevalent condition. The healing of active acne lesions may result in the development of scars. Atrophic scars are the main scars caused by acne and result from the degradation of collagen fibers. Carboxytherapy is a minimally invasive method that involves the application of carbon dioxide subcutaneously through small infiltrations in the skin, which improves scar tissue by increasing collagen's deposition and reorganization. The aim of this study is to review the role of carboxytherapy in the treatment of atrophic facial scars, alone or in combination with other techniques.  Methods:  A literature search was conducted on several databases using MeSH terms &#8220;carboxytherapy&#8221;, &#8220;carbon dioxide/therapy&#8221; and &#8220;wounds&#8221; for guidelines, systematic reviews, randomized controlled trials, and observational studies, published over the last 20 years in Portuguese, English or Spanish languages.  Results:  A total of 129 articles were retrieved, of which four experimental studies and one case series were selected. Comparing the techniques of microneedling and carboxytherapy, both were considered non-invasive treatment modalities with equal effectiveness, tolerability and safety, resulting in similar histopathological changes. On the other hand, despite the improvement of acne scars in both treatment modalities, the results were significantly better in favor of carbon dioxide fractional laser, despite having more side effects than carboxytherapy. When these techniques are combined and carboxytherapy is used as a subcision method, there is a more marked and rapid improvement in the appearance of acne scars.  Discussion:  Carboxytherapy is a promising modality in the treatment of atrophic acne scars, alone or in combination with other techniques.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO   Introdução:  A acne é uma condição extremamente prevalente. A reparação de lesões ativas de acne pode resultar no desenvolvimento de cicatrizes. As cicatrizes atróficas são as principais cicatrizes causadas pela acne e resultam da degradação das fibras de colágeno. A carboxiterapia é um método minimamente invasivo que consiste na injeção subcutânea de dióxido de carbono através de pequenas infiltrações na pele. O ambiente hipercápnico gerado resulta no aumento da deposição e reorganização das fibras de colagénio, facilitando a cicatrização e melhorando o aspeto da pele. O objetivo deste estudo é rever a evidência relativa ao papel da carboxiterapia no tratamento de cicatrizes faciais atróficas, isoladamente ou em combinação com outras técnicas.  Métodos:  Foi realizada uma pesquisa bibliográfica em várias bases de dados usando os termos MeSH &#8220;dióxido de carbono/terapia&#8221; e &#8220;feridas e lesões&#8221; para normas de orientação, revisões sistemáticas, ensaios clínicos randomizados e estudos observacionais, publicados nos últimos 20 anos em português, inglês ou espanhol.  Resultados:  Foram identificados 129 artigos, dos quais quatro estudos experimentais e uma série de casos foram selecionados. Comparando as técnicas de microneedling e carboxiterapia, ambas foram consideradas modalidades de tratamento não invasivo, com igual eficácia, tolerabilidade e segurança, resultando em alterações histopatológicas semelhantes. Por outro lado, apesar da melhoria das cicatrizes de acne em ambas as modalidades de tratamento, os resultados foram significativamente melhores a favor do laser fracionado de dióxido de carbono, apesar de estarem associados a um perfil de efeitos adversos mais desfavorável em relação à carboxiterapia. Quando essas técnicas são combinadas e a carboxiterapia é usada como método de subcisão, há uma melhoria mais acentuada e rápida na aparência das cicatrizes de acne.  Discussão:  A carboxiterapia é uma modalidade promissora no tratamento de cicatrizes atróficas da acne, isoladamente ou em combinação com outras técnicas.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Acne Vulgar/tratamento]]></kwd>
<kwd lng="pt"><![CDATA[Cicatriz/tratamento]]></kwd>
<kwd lng="pt"><![CDATA[Dióxido de Carbono/uso terapêutico.]]></kwd>
<kwd lng="en"><![CDATA[Acne Vulgaris/therapy]]></kwd>
<kwd lng="en"><![CDATA[Carbon Dioxide/therapeutic use]]></kwd>
<kwd lng="en"><![CDATA[Cicatrix/therapy.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Layton]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Henderson]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Cunliffe]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A clinical evaluation of acne scarring and its incidence]]></article-title>
<source><![CDATA[Clin Exp Dermatol]]></source>
<year>1994</year>
<volume>19</volume>
<page-range>303-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jordan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cummins]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Burls]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laser resurfacing of the skin for the improvement of facial acne scarring a systematic review of the evidence]]></article-title>
<source><![CDATA[Br J Dermatol]]></source>
<year>2000</year>
<volume>142</volume>
<page-range>413-23</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jacob]]></surname>
<given-names><![CDATA[CI]]></given-names>
</name>
<name>
<surname><![CDATA[Dover]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kaminer]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acne scarring a classification system and review of treatment options]]></article-title>
<source><![CDATA[J Am Acad Dermatol]]></source>
<year>2001</year>
<volume>45</volume>
<page-range>109-17</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Duchêne-Marullaz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pharmacologie, pharmacologie clinique et effets thérapeutiques du gaz thermal de Royat Sem Hop]]></article-title>
<source><![CDATA[Ther]]></source>
<year>1977</year>
<volume>53</volume>
<page-range>361-2</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bartoletti CA]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Varlaro]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La carbossiterapia: una metodic in evoluzione]]></article-title>
<source><![CDATA[Riv Med Estetica]]></source>
<year>1997</year>
<volume>2</volume>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Varlaro]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Manzo]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Mugnaini]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bisacci]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Fiorucci]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[De Rango]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carboxytherapy effects on microcirculation and its use in the treatment of severe lymphedema]]></article-title>
<source><![CDATA[Acta Phlebol]]></source>
<year>2007</year>
<volume>8</volume>
<page-range>79-91</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parassoni L]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Varlaro]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Curri]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La carbossiterapia in tema di meccanismi d'azione]]></article-title>
<source><![CDATA[Riv Med Estetica]]></source>
<year>1997</year>
<volume>21</volume>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zenker]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carboxytherapy Carbon Dioxide injections in AesthetiC Medicine]]></article-title>
<source><![CDATA[Prime-journal.com]]></source>
<year>2012</year>
<page-range>42-50</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koutna]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carboxytherapy - new, non-invasive method of aesthetic medicine Cas Lek]]></article-title>
<source><![CDATA[Cesk]]></source>
<year>2006</year>
<volume>145</volume>
<page-range>841-3</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moftah]]></surname>
<given-names><![CDATA[NH]]></given-names>
</name>
<name>
<surname><![CDATA[El Khayyat]]></surname>
<given-names><![CDATA[MAM]]></given-names>
</name>
<name>
<surname><![CDATA[Ragai]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Alaa]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carboxytherapy versus skin microneedling in treatment of atrophic postacne scars a comparative clinical, histopathological, and histometrical study]]></article-title>
<source><![CDATA[Dermatol Surg]]></source>
<year>2018</year>
<volume>44</volume>
<page-range>1332-41</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Al Taweel]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
<name>
<surname><![CDATA[Al Refae]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Hamed]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Kamal]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparative study of the efficacy of Platelet-rich plasma combined with carboxytherapy vs its use with fractional carbon dioxide laser in atrophic acne scars]]></article-title>
<source><![CDATA[J Cosmet Dermatol]]></source>
<year>2019</year>
<volume>18</volume>
<page-range>150-5</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Orentreich]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Orentreich]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles]]></article-title>
<source><![CDATA[Dermatol Surg]]></source>
<year>1995</year>
<volume>21</volume>
<page-range>543-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abdel Kareem]]></surname>
<given-names><![CDATA[IM]]></given-names>
</name>
<name>
<surname><![CDATA[Fouad]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Ibrahim]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effectiveness of subcision using carboxytherapy plus fractional carbon dioxide laser resurfacing in the treatment of atrophic acne scars comparative split face study]]></article-title>
<source><![CDATA[J Dermatolog Treat]]></source>
<year>2020</year>
<volume>31</volume>
<page-range>296-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koutna]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Carboxytherapy in Aesthetic Dermatology - Experiences after the Treatment of 280 Patients]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Prendergast]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Stiffman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Aesthetic Medicine]]></source>
<year>2012</year>
<page-range>547-76</page-range><publisher-loc><![CDATA[Berlin ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Petukhova]]></surname>
<given-names><![CDATA[TA]]></given-names>
</name>
<name>
<surname><![CDATA[Foolad]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Prakash]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[VY]]></given-names>
</name>
<name>
<surname><![CDATA[Sharon]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
<name>
<surname><![CDATA[O&amp;apos;Brecht]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Objective volumetric grading of postacne scarring]]></article-title>
<source><![CDATA[J Am Acad Dermatol]]></source>
<year>2016</year>
<volume>75</volume>
<page-range>229-31</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Suh]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[KY]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[TI]]></given-names>
</name>
<name>
<surname><![CDATA[Jeong]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The efficacy and safety of subcision using CO2 gas combined with fractional laser for acne scars Clinical and microscopic evaluation]]></article-title>
<source><![CDATA[J Cosmet Laser Ther]]></source>
<year>2016</year>
<volume>18</volume>
<page-range>417-20</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Poli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Dreno]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Verschoore]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An epidemiological study of acne in female adults results of a survey conducted in France]]></article-title>
<source><![CDATA[J Eur Acad Dermatol Venereol]]></source>
<year>2001</year>
<volume>15</volume>
<page-range>541-5</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
