<p>Topical 5 fluorouracil cream versus combined 5 flurorouracil and fractional erbium YAG laser for treatment of severe hypertrophic scars</p>

Abstract

BackgroundTopical 5 fluorouracil (5-FU) has been reported as one of the standard treatments for hypertrophic scars (HTS). Ablative fractional laser was found to have promising results in the delivery of topical drugs into the skin by creating vertical channels through which the drugs can penetrate the skin. So far there have been no comparative studies performed to compare both modalities in the same patient and same anatomical region, especially in severe HTS.ObjectiveThe aim of this study was to compare the effectiveness of topical 5-FU and combined topical 5-FU and laser in treating severe HTS.Patients and methodsTwenty-four severe HTS lesions were treated by 5-FU monotherapy and 5-FU combined with ablative fractional erbium YAG laser. Each lesion was divided into two parts. One part was treated with topical 5-FU twice weekly for 8 months. The other part was treated with combined topical 5-FU and ablative fractional erbium YAG laser once per month for 8 months. The scars’ improvement was evaluated by Vancouver scar scale (VSS) and skin analysis camera.ResultsThe assessment by VSS showed a significant reduction in the mean height, pliability, and vascularity of the lesions which were treated with combined approaches compared to 5-FU monotherapy. Pain and ulceration occurred at a higher rate in the combination therapy group.ConclusionTreatment of severe HTS with combined 5-FU and ablative fractional erbium YAG laser is more effective than 5-FU alone.