## 4 Discussion
[31] reported a 49.5% reduction in roughness volume, a 46% reduction in roughness-affected area, and a 24.6% decrease in maximum depth depression following five sessions of 1540-nm non-ablative fractional Er:glass laser therapy, measured using the Antera 3D system. Furthermore, [PERSON] and [PERSON] [32] conducted a randomized split-face clinical trial comparing a 1550-nm fractional erbium-doped glass laser with fractional bipolar radiofrequency. The effectiveness of the treatment was assessed using three complementary methods: evaluation of acne scar improvement by three independent dermatologists based on photographic comparisons, quantitative analysis of skin texture using the VISIA(r) Complexion Analysis System, and patient-reported satisfaction using a graded scale. The study concluded that the erbium- glass laser is an effective and safe modality for treating atrophic acne scars in patients with Fitzpatrick skin types III to V. Specifically, the mean acne scar improvement grades rated by independent dermatologists were 2.86 \(\pm\) 0.42 (on a 0-4 scale), while patients rated the improvement at 2.89 \(\pm\) 0.57. Texture analysis also showed a statistically significant reduction in surface irregularities, with a mean texture score reduction of 2.94 \(\pm\) 1.84 (\(p\) < 0.001) after treatment. This reliance on subjective assessments can introduce variability and limit the robustness of findings. Incorporating quantitative methods, such as GLCM analysis, offers a more objective and reproducible approach to evaluating therapeutic outcomes, enabling more precise verification of treatment efficacy. The conducted GLCM analysis is particularly useful for the quantitative assessment of acne scars. Notably, the analysis of homogeneity and contrast based on the GLCM enables the identification of even subtle changes that are imperceptible to the naked eye. Additionally, the method's repeatability (unlike the subjective visual evaluation by a specialist) and its ability to quantitatively compare acne-related changes, such as those observed before and after therapy, provide unique opportunities for verifying the effectiveness of various scar treatment methods. However, to achieve high sensitivity and specificity and to accurately reflect the scar severity, it is crucial to capture high-quality, reproducible skin images. Proper lighting selection plays a key role in obtaining clinical photographs that are suitable for further analysis. The significant improvements observed in both the contrast and homogeneity parameters align with the clinical expectations of smoother and more uniform skin post treatment. Moreover, the distinct responses of individual RGB channels highlight the value of channel-specific analyses in capturing diverse aspects of skin texture changes. Specifically, the blue and green channels may serve as more sensitive indicators of surface-level improvements, while the red channel provides complementary information on deeper skin changes. One aspect that is worth considering in future studies is the selection of pixel distance and angular direction in GLCM analysis. While this study utilized a pixel distance of 1 and an angle of 45\({}^{\circ}\), these parameters may not be universally optimal for all types of scars. For instance, increasing the pixel distance could help capture broader textural patterns. Similarly, other angles, such as 0\({}^{\circ}\) or 90\({}^{\circ}\), might better align with the specific orientation or structure of certain scar types. Recent advances in artificial intelligence (AI)-assisted imaging highlight the potential for further enhancing acne scar assessment. AI-based methodologies, particularly machine learning (ML) algorithms, have been successfully integrated with biomedical imagingtechniques such as Light-Sheet Fluorescence Microscopy (LSFM) to improve post-imaging analysis and automate feature detection [33]. While our study relies on the GLCM method for quantitative texture analysis, incorporating AI-driven techniques could provide deeper insights into treatment efficacy.