This research is a prospective, randomized, open-labeled interventional study designed to evaluate the effectiveness of various treatment modalities for acne scars. The treatments assessed include Fractional CO2 laser and Microneedling Radiofrequency, both as standalone therapies and in combination with topical Epidermal Growth Factor. A total of sixty patients aged between fifteen and forty years with post acne scarring of grades two to four were enrolled. Patients were selected from the outpatient dermatology department of ASRAM Hospital, Eluru.

The participants were randomly divided into four equal groups of fifteen patients each. Group A received treatment with Fractional CO2 laser. Group B received Fractional CO2 laser along with topical application of Epidermal Growth Factor. Group C was treated using Microneedling Radiofrequency alone, and Group D received Microneedling Radiofrequency combined with Epidermal Growth Factor. Each patient underwent a total of four treatment sessions spaced one month apart. A final follow-up was conducted two months after the last session to assess treatment outcomes.

Efficacy and safety outcomes were assessed using the Goodman and Baron quantitative and qualitative scoring system to measure acne scar severity before and after treatment. Patient satisfaction was evaluated using a visual analogue scale. Side effects were monitored immediately after each session, one week after each session, and two months after the final session. Clinical photographs were taken to document visual improvements in scar appearance.

Data were entered into Microsoft Excel and statistical analysis was conducted using IBM SPSS trial version twenty six. Continuous data were expressed as mean with standard deviation and categorical data were reported in percentages. One way analysis of variance was used to compare the mean outcomes among the four groups. A p value less than zero point zero five was considered statistically significant. Confidence intervals were calculated at ninety five percent.

The study aims to identify the most effective and safest treatment approach for acne scars, particularly in individuals with darker skin tones where the risk of post inflammatory hyperpigmentation is higher. The research also explores whether the addition of Epidermal Growth Factor to either laser or radiofrequency treatments improves scar healing and patient satisfaction while minimizing side effects and downtime. The findings are expected to support clinical decision making by highlighting the optimal combination of therapies for acne scar management.