Abstract
Hypertrophic and keloid scars result from abnormal wound healing and can have a variable response to a number of available treatment modalities. The evolution of laser treatments in recent years has shown a wide range of clinical applications including their use in the treatment of scars. We investigated the effectiveness of a 1470 nm diode laser using an intralesional optical fibre delivery device in the treatment of hypertrophic and keloid scars. We evaluated its safety and efficacy as a novel and minimally invasive treatment alternative for scar modulation and volume reduction. A prospective cohort study was performed involving 21 patients with hypertrophic scars (HS) (n = 9) and keloids (n = 12) resulting from various aetiology. Patients were treated with one to three treatment sessions. Comprehensive evaluations were performed using the Vancouver Scar Scale, Doppler ultrasound, Cutometer, Mexameter and PeriCam PSI. Scar thickness was reduced by an average of 0.308 ± 0.138 cm (p < 0.001). In particular the two subgroups showed a significant 27.7% and 28.2% reduction in scar thickness of HS and Keloids, respectively. Scar firmness showed a significant improvement of 1.2% (p < 0.05) for HS, though for keloids this was 0.4% (p = 0.26). Keloids had a significant reduction in pigmentation at 21.3%. Blood perfusion had a significant reduction of 29.6% in HS and 22.7% in Keloids. Overall VSS total score improvement of 42% in the HS and at 37.9% in the Keloid subgroup. No adverse events such as hypo/hyperpigmentation, skin infection, or recurrence were reported. This study shows that the intralesional 1470 nm bare-fibre diode laser significantly improved hypertrophic and keloid scars based on both subjective and objective analyses and supports this type of laser therapy as a safe and effective minimally-invasive treatment option.
Highlights
Hypertrophic and keloid scars result from abnormal wound healing and can have a variable response to a number of available treatment modalities
A total of twenty-one patients with HSK were enrolled in this study which we divided in two subgroups
Our study showed that the 1470 nm laser can limit inflammation and decrease perfusion suppressing the development of aberrant scars by effectively reducing the thickness and inflammation of HSK (p < 0.05)
Summary
Hypertrophic and keloid scars result from abnormal wound healing and can have a variable response to a number of available treatment modalities. Overall VSS total score improvement of 42% in the HS and at 37.9% in the Keloid subgroup No adverse events such as hypo/hyperpigmentation, skin infection, or recurrence were reported. This study shows that the intralesional 1470 nm bare-fibre diode laser significantly improved hypertrophic and keloid scars based on both subjective and objective analyses and supports this type of laser therapy as a safe and effective minimally-invasive treatment option. Hypertrophic Scars (HS) and Keloids (K) are the result of abnormal wound healing and scar formation These pathological scars present as a continuous inflammation and histologically are characterized by fibroblasts proliferation, newly formed blood vessels and collagen deposition. If failed, surgery, laser and radiation therapies are considered favourable treatment o ptions[10]
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