Treatment of Surgical Scars Using a 595-nm Pulsed Dye Laser Using Purpuric and Nonpurpuric Parameters: A Comparative Study

Abstract

Many studies have examined laser treatment of scars, but cosmetic results have been variable. Although no studies have examined the effect of purpura on scar improvement using the pulsed dye laser (PDL), many clinicians believe inducing purpura results in better and quicker improvement. To determine whether PDL treatment of fresh surgical scars with purpura-inducing settings improves clinical appearance more than non-purpura-inducing settings or no treatment. Twenty-six subjects with surgical scars enrolled in this prospective study. Scars were divided into three equal segments; treatment was randomized: 595-nm PDL with purpuric (1.5ms) or nonpurpuric (10ms) settings or no treatment. Fluences were adjusted to Fitzpatrick skin type. Scars were treated three times, 1month apart, beginning at suture removal. Outcome measures included Vancouver Scar Scale (VSS) and blind clinical ratings. The nonpurpuric condition showed significant improvement on the VSS total score, vascularity, and pliability ratings. The purpuric condition demonstrated a trend for improvement on the VSS total. According to blind observer ratings, all conditions improved, without differences between groups. Nonpurpuric settings on the PDL resulted in significant improvements in the appearance of fresh surgical scars for vascularity, pliability, and VSS total scores, although all scar segments improved over time.