1550-nm Erbium:Glass and 1927-nm Thulium Non-Ablative Fractional Lasers for the Treatment of Burn Scars

Abstract

Burn scars cause significant morbidity due to cosmetic disfigurement, contractures, associated symptoms such as pain and pruritus, and psychosocial distress. The treatment of scars has evolved with the availability of fractional laser devices. Ablative fractional lasers are frequently employed to treat burn scars, but their use is associated with prolonged downtime and an increased risk of side effects. Non-ablative fractional lasers, including the 1550-nm erbium:glass laser and the 1927-nm thulium laser, present a viable alternative in the treatment of burn scars in patients who desire a less aggressive, more gradual treatment approach. Non-ablative fractional resurfacing lasers have shown to be effective in improving thickness, pliability, pigmentary changes, and textural abnormalities in both early and mature scars. The purpose of this chapter was to review the evidence of non-ablative fractional lasers in managing scars, discuss treatment considerations, and provide two clinical examples of burn scars that were successfully treated with combination pulsed dye laser and non-ablative fractional lasers.