Pulsed Dye Laser vs Ablative Fractional CO2 Laser for Old Hypertrophic Scars Wound Repair and Regeneration

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• In this double-blinded split-scar study, 30 patients with old hypertrophic scars (>3 years' duration) were treated with pulsed dye laser (PDL) to half the scar and ablative fractional CO2laser (FrCO2) to the other half monthly for 3 months. There was improvement as assessed by the Vancouver Scar Scale (VSS) on both the PDL-treated (mean 51.54) and the FrCO2-treated (62.28) sides, with no statistically significant difference between scores (P = .176). However, in VSS score breakdown, the FrCO2-treated sides demonstrated significantly improved pliability (P =.017) and height (P = .011). In histopathologic examination, the FrCO2-treated sides were superior to the PDL-treated sides in decreased collagen bundle thickness and increased elastic fibers.

• Both PDL and fractional CO2laser were effective in improving the appearance of old hypertrophic scars, but FrCO2significantly improved the height and pliability of the scars and was associated with more significant histopathologic changes.

– Kelly B. Scarberry, MD

Abstract

There is a continuous need to find out the best treatment for old hypertrophic scars (OHSs). Thirty patients with OHSs were included. Each scar was divided into right half treated with PDL (handpiece with a 7-mm spot, pulse duration of 1.5 ms and fluence of 6 J/cm2 ) and left half treated with FrCo2 laser (15 W, spacing 800 μm, dwelling time 600 μs and stack 3) once every month for three sessions. Scars were assessed before and after treatment clinically by Vancouver Scar Scale (VSS) and histologically using hematoxylin and eosin (H&E), Masson trichrome and orcein stains. Both halves showed statistically significant improvement after treatment. However, there was no statistically significant difference in VSS between them (P = 0.176). FrCo2 laser showed more significant improvement in pliability and height (Pp = 0.017, Ph = 0,011), while, PDL showed more significant improvement in vascularity (P = 0.039) of OHSs. Both PDL and ablative FrCo2 laser were effective in the treatment of OHSs, however, FrCo2 laser was more effective in improving OHSs pliability, and height which are the main concern in OHSs.

Wound Repair and Regeneration

Pulsed Dye Laser Versus Ablative Fractional CO2 Laser in Treatment of Old Hypertrophic Scars: Clinicopathological Study

Wound Repair Regen 2021 Feb 17;[EPub Ahead of Print], LH Elgarhy, RA El-Tatawy, D Abdelaziz, NN Dogheim 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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