Ablative CO2 Research Articles

The effect of fractional microablative carbon dioxide laser therapy on vaginal atrophy in menopause women: A review

Vaginal atrophy is one of Genitourinary Syndrome of menopause. This condition occurs due to decreased estrogen levels during menopause. Epidemiological data obtained from several countries estimated that up to 50% of post-menopausal women experience symptoms of vaginal atrophy. This paper aims to conduct a systematic review, and this meta-analysis is to analyze the effect of micro ablative fractional CO2 laser therapy on vaginal atrophy in postmenopausal women. Data was collected online from Pubmed-MEDLINE, Scopus, EBSCO, Cambridge Core, ProQuest, Springer Link, Cochrane Library, and ClinicalTrials.gov databases. Tracking will be carried out in May-July 2023. The population of this study is the result of clinical trial research on the effect of microablative fractional CO2 laser therapy on vaginal atrophy in postmenopausal women. Meta-analysis showed that the VHI score was higher after therapy in the group that received micro ablative fractional CO2 laser compared to the group that received sham laser for vaginal atrophy in menopausal women. VAS scores were lower after administration in the group that received microablative fractional CO2 laser compared to the group that received sham laser for vaginal atrophy in menopausal women. The incidence of side effects in the CO2 laser group did not differ from the sham laser group. This study recommends an RCT study was conducted comparing micro ablative fractional CO2 laser compared to other energy-based devices such as erbium laser and radiofrequency on vaginal atrophy in postmenopausal women so that it can be used as a basis for further systematic review research and meta-analysis.

Efficacy of low energy fractional carbon dioxide laser therapy in management of post-surgical hypertrophic scars

Background: aberrant & accelerated wound-healing process that results in hypertrophic scarring causes extracellular matrix & collagen to deposit abnormally in the dermis. After tissue damage occurs, a defensive reaction called tissue repair occurs. Aim; in this review; we aimed to present the effectiveness of low-energy fractional carbon dioxide laser therapy in treating hypertrophic scars following surgery. Summary: A safe & effective approach for treating hypertrophic burn scars is fractional ablative CO2 laser therapy. Even though more treatment sessions have been necessary for satisfying outcomes, a big improvement can be seen after just one round of therapy. Combination therapy with other modalities can decrease the need for repetition of therapy as efficacy increases. Though, in some studies, combination therapy may shorten the duration of studied case downtime & in others, combination therapy may increase side effects. essential for laser energy setting needs to be adjusted for each hypertrophic scar condition. larger research population & longer follow-up period are recommended.

Clinical and dermoscopic assessment of ablative carbon dioxide laser versus intradermal heparin sodium in xanthelasma.

Ablative carbon dioxide (CO2 ) laser is still a cornerstone in the management of xanthelasma. However, post-laser complications such as post-inflammatory hyperpigmentation or scarring have to be considered. Heparin sodium was recently suggested as an effective therapeutic modality for xanthelasma. The aim of this work was to compare the therapeutic value of ablative CO2 laser versus intradermal heparin sodium in xanthelasma. This study was piloted on 30 xanthelasma patients, whose lesions were randomly categorized into two groups. Group A was managed with CO2 laser ablation (2 sessions scheduled every 4 weeks), whereas Group B was managed with intradermal heparin sodium injections (10 sessions scheduled every week). Pre- and post-treatments evaluations were done both clinically and dermoscopically. Significant reduction of xanthelasma lesions was reported in response to both therapeutic interventions. However, the ablative CO2 laser was more significantly effective than intradermal heparin sodium. Interestingly, intradermal injection of heparin sodium was nearly as effective as ablative CO2 laser in early (<2 years duration) grade I and II xanthelasma, with a lower incidence of post-therapy side effects. Intradermal injection of heparin sodium could be suggested as a safe and cost-effective therapeutic technique for early mild grade I and II xanthelasma. Moreover, it could be recommended as a pre-operative management of grade III and IV xanthelasma to reduce the lesions to be easily ablated with CO2 laser.

Sequential and Combined Efficacious Management of Auricular Keloid: A Novel Treatment Protocol Employing Ablative CO2 and Dye Laser Therapy—An Advanced Single-Center Clinical Investigation

Auricular keloids pose significant aesthetic and functional challenges, and traditional treatments often fall short in addressing these issues. Our study presents an innovative combined approach of ablative CO2 and dye laser therapy for improved keloid management. This treatment protocol was applied to 15 patients with auricular keloids after an initial multispectral analysis to assess keloid composition. The laser sequence was tailored per patient based on this analysis. Evaluations using the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale were carried out at baseline and at 3-week intervals post-treatment. The results showed a significant reduction in these scores at the final follow-up (p &lt; 0.05), suggesting improvements in keloid color, texture, and pliability, with minimal adverse events. Additionally, no recurrence of keloids was observed. Our findings indicate that this novel methodology of multispectral analysis followed by tailored laser therapy may offer a safe and effective solution for auricular keloids, promising enhanced keloid treatment and prevention of recurrence. However, further investigations, including randomized controlled trials, are needed to confirm and optimize this treatment protocol.

SMOOTH protocol: A pilot randomised prospective intra-patient single-blinded observational study for examining the mechanistic basis of ablative fractional carbon dioxide laser therapy in treating hypertrophic scarring.

Burn injuries are the fourth most common type of trauma and are associated with substantial morbidity and mortality. The impact of burn injury is clinically significant as burn injuries often give rise to exuberant scarring. Hypertrophic scarring (HTS) is a particular concern as up to 70% of burns patients develop HTS. Laser therapy is used for treating HTS and has shown positive clinical outcomes, although the mechanisms remain unclear limiting approaches to improve its effectiveness. Emerging evidence has shown that fibroblasts and senescent cells are important modifiers of scarring. This study aims to investigate the cellular kinetics in HTS after laser therapy, with a focus on the association of scar reduction with the presence of senescent cells. We will conduct a multicentre, intra-patient, single-blinded, randomised controlled longitudinal pilot study with parallel assignments to achieve this objective. 60 participants will be recruited to receive 3 interventional ablative fractional CO2 laser treatments over a 12-month period. Each participant will have two scars randomly allocated to receive either laser treatment or standard care. Biopsies will be obtained from laser-treated, scarred-no treatment and non-scarred tissues for immune-histological staining to investigate the longitudinal kinetics of p16INK4A+-senescent cells and fibroblast subpopulations (CD90+/Thy1+ and αSMA+). Combined subjective scar assessments including Modified Vancouver Scar Scale, Patient and Observer Scar Assessment Scale and Brisbane Burn Scar Impact Profile; and objective assessment tools including 3D-Vectra-H1 photography, DermaScan® Cortex, Cutometer® and ColoriMeter®DSMIII will be used to evaluate clinical outcomes. These will then be used to investigate the association between senescent cells and scar reduction after laser therapy. This study will also collect blood samples to explore the systemic biomarkers associated with the response to laser therapy. This study will provide an improved understanding of mechanisms potentially mediating scar reduction with laser treatment, which will enable better designs of laser treatment regimens for those living with HTS. ClinicalTrials.gov: NCT04736251.

Efficacy of Ablative Fractional Carbon Dioxide Laser Alone and Combined with Platelet-Rich Plasma in the Treatment of Androgenetic Alopecia

Abstract Androgenetic alopecia (AGA) is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Fractional CO2 laser treatment has effectively induced hair regrowth through the wound-healing process. Platelet-rich plasma (PRP) ensures local delivery of growth factors, modification of the inflammatory response, and stimulation of cell proliferation and differentiation within the target tissue. PRP therefore showed a beneficial effect in treatment of AGA. Aim of the Study The aim of this study is to evaluate and compare the efficacy and safety of ablative carbon dioxide (CO2) fractional laser alone or combined with platelets rich plasma therapy in the treatment of Male Androgenetic Alopecia. Patients and Methods The study included 35 patients suffering from AGA. All patients will receive bilateral ablative fractional CO2 laser treatment on the alopecic scalp and the right or left side of the scalp will be randomly selected to be covered with platelet-rich plasma and the other half of the scalp will be covered with saline after the laser at the same session. Results Combined ablative fractional CO2 laser treatment and platelet-rich plasma showed statistically significant improvement compared to ablative fractional CO2 laser alone.

Ablative Fractional CO2 Laser with or without Low Dose Isotretinoin in Treatment of Acne Scars: A Comparative Study

Abstract Background Acne scarring is one of the most common sequelae of acne vulgaris. The severity of acne scars correlates with acne duration, severity and delay in treatment of acne as well as positive family history. Patients who have acne scars frequently seek treatment options to improve appearance and quality of life. Aim of the Study The aim of this study was to assess the safety of combining low-dose isotretinoin with ablative fractional CO2 laser in patients with acne scars. Patients and Methods This study included 40 patients with different types of acne scars. There were 27 females and 13 males. The patients have divided into two groups; Group A received low-dose isotretinoin with full face AF Co2 laser session, while Group B was treated with full face AF Co2 laser session. The age of patients ranged from 18 to 45 years old, with the mean age was 27.2± 6.9 yrs in group A and was 27.5± 6.06 yrs in group B. Results Duration of wound healing, PIH and pain were parallel in both groups with no significant difference between them. No other complications were reported as keloid formation, secondary infection, edema, milia or acneform eruption in study groups. Satisfactory results were reported in most of the patients. Conclusion Our study concluded that using low-dose isotretinoin with AF Co2 laser session safe procedure with normal wound healing and no keloid or hypertrophic scars formation.

Efficacy of Fractional Carbon Dioxide Laser versus Fractional Carbon Dioxide Laser with Platelet-Rich Plasma in Treatment of Striae Distensae in a Tertiary Care Center: A Comparative Study.

Striae distensae are atrophic scars that are often cosmetically distressing. The efficacy of fractional carbon dioxide (CO2) laser and platelet-rich plasma (PRP) in treating striae individually has been evaluated previously. However, not many studies described the combined efficacy of both. The aim of this study was to compare the efficacy and safety of fractional CO2 laser alone and in combination with PRP. Twenty-four patients with striae presenting bilaterally in the abdomen, upper limbs, and lower limbs were included. PRP was prepared by double-spin method and cell count was done to ensure at least fourfold concentration of platelets. The patients were treated CO2 laser on both sides and PRP on the left side along with laser, every month for three sessions. Digital photography and dermoscopy were done at baseline, every treatment session, and 6 months after treatment. Clinical improvement was assessed by comparing photographs and patient satisfaction before and after treatment. All patients showed improvement on both sides. In CO2-laser-treated patients, responses in 6 patients (25%) were moderate, 14 (56%) were good, and 4 (16.6%) were excellent. In CO2-laser and PRP-treated patients, responses in 5 patients (20.8%) were moderate, 11 (45.8%) were good, and 8 (33.3%) were excellent. Hyperpigmentation was the most common side-effect seen (19 patients) on both sides, which resolved spontaneously by 6 months. These results support the use of ablative CO2 fractional laser as effective and safe treatment modalities for striae. However, slightly better efficacy was noted with the addition of PRP.

Topical timolol maleate 0.5% after fractional carbon dioxide laser versus fractional carbon dioxide laser alone in treatment of acne scars: split face comparative study

Acne is a common inflammatory condition that mostly involves the face, chest and back. A number of different modalities had been employed for treating scars of which laser remains to be a pivotal choice. We aimed to compare the efficacy of topical timolol maleate 0.5% after fractional CO2 (AFCO2) laser versus fractional CO2 Laser alone for treatment of atrophic acne scars. A split-face comparative clinical experiment on 30 cases of atrophic post-acne scars that were treated on one side with ablative fractional CO2 laser followed by timolol application while with only ablative fractional CO2 laser on the other side. Following treatment, both sides demonstrated significant improvement with the laser + timolol treated side showing better improvement; yet not significantly higher than the laser only treated side. In conclusion, both topical timolol maleate 0.5% after fractional CO2 laser and fractional CO2 laser may achieve comparable significant improvement. The good safety profile, easy accessibility, low cost, and non-invasive nature merits the use of timolol in acne scars pending verification by larger sample reproduced and controlled trials.

Comparative Study Among CO2 Laser, Intralesional Vitamin D3, and Combined Intralesional Vitamin D3 and CO2 Laser in Treatment of Palmoplantar Warts.

Many therapeutic modalities are used for palmoplantar warts; whether destructive, such as chemical cautery, electrocautery, cryocautery, surgical removal, and laser ablation, or immunotherapeutic, stimulating the immune system against the virus such as intralesional vitamin D3 injection. To compare the efficacy of intralesional vitamin D injection combined with CO2 laser to the efficacy of either modality alone. Eighty age- and sex-matched patients with palmoplantar warts were divided into 4 groups: Group A received intralesional vitamin D3 injections, group B received ablative CO2 laser, group C received CO2 laser and intralesional vitamin D3 injection, and group D (control group) were injected intralesionally with normal saline. Assessment was performed clinically, photographically, and dermoscopically before and after treatment to evaluate the response, and then, another assessment was performed after 3 months to detect any recurrence. Complete clearance was seen in 90% of cases in group C, in 80% in group A, and in 75% in group B with no statistically significant difference. Intralesional vitamin D, CO2 laser, and the combination show comparable efficacy and recurrence rates. Intralesional vitamin D maybe a better option for people with a relative contraindication to CO2 laser.

Use of ablative fractional CO2 laser in facial rejuvenation: a prospective observational cohort study

Introduction: Over the years, techniques for treating facial aging have evolved, with oral, antioxidant, and nutritional treatments, topical cosmeceuticals, peelings, and technologies such as radiofrequency, infrared, intense pulsed light, and lasers. Currently, among the lasers used for rejuvenation, there are ablative and non-ablative ones. Objective: To show the effectiveness of ablative fractional CO2 laser in facial rejuvenation. Methods: The presented article is a study that shows the superiority in results when compared with other lasers and treatments, evaluating its side effects and recovery time. Results: the author presented the result through images that are in the work. Conclusion: The ablative fractional CO2 laser proved to be an important option for the treatment of facial rejuvenation, even with a technology that has more intense side effects and longer recovery periods compared to other fractional ablative lasers.

54 Prophylactic Antibiotics are Unnecessary for Routine CO2 Laser Burn Scar Treatment

Abstract Introduction Many providers utilize prophylactic cephalexin prior to Co2 ablation laser for hypertrophic scarring. Many providers use this as standard of treatment despite a paucity of high-quality literature supporting the practice. The purpose of this study is to report a single-center experience in performing laser-assisted delivery of triamcinolone and destruction of burn scars without the use of antibiotics. Methods This was a retrospective descriptive study from a single center with a new laser scar program. The first 14 patients received cephalexin 500mg by mouth every 6 hours starting the day of the procedure for 5 days and valaciclovir 1000mg by mouth daily for 5 days for their first two procedures- as per manufacturer recommendations. After that, cephalexin was no longer utilized nor were any antibiotics given at the start time of procedure. Valacyclovir is given on a case-by-case basis for patients with a history of cold sores, known herpes simplex, or extensive facial procedures. Burn team staff members followed up with the patients within 48 -72 hours by phone call. Burn staff called patients after each laser treatment to assess for any adverse reactions. Adverse reactions include open areas, rashes, or blisters to laser site. The two groups were compared with a Fisher’s exact test for number of infections. Results Patients who received cephalexin accounted for the first 28 cases and none developed an infection. In 201 cases without antibiotics, only one patient developed cellulitis (0.5%), p=1. This patient was noncompliant with restrictions on hand hygiene and used a cheap lotion with parabens, dyes, and perfumes on post operative day 2. Another patient experienced a self-limiting dermatitis on their back of uncertain etiology. In 36 cases, valacyclovir was given. None of the patients in either group developed vesicular lesions consistent with HSV. Conclusions There were no significant differences in number of infections whether patients treated with or without prophylactic antibiotics before laser treatment of hypertrophic burn scars. The authors continue to treat patients without administering prophylactic antibiotics. Applicability of Research to Practice laser programs are common in burn centers

A bibliometric and visualized research on global trends of scar, 2011–2021

ObjectivePathological scars are the results of abnormal wound healing, which not only affect the appearance, but may also be accompanied by significant psychosocial burdens. In this study, we aimed to conduct a bibliometric and visualized analysis on pathological scars and provide directions for future research. MethodsThe articles on scar research from 2011 to 2021 in the Web of Science Core Collection database were collected. The bibliometrics records were retrieved and analyzed with Excel, CiteSpace V and VOSviewer. ResultsA total of 944 scar research records published between 2011 and 2021 were collected. Publication output has shown an upward trend as a whole. China ranked first in terms of country contributions (418 publications, 5176 citations), while Germany, with only 22 studies published, had the highest average citation rate (57.18). Shanghai Jiaotong University was the institution with the largest number of related articles published, followed by the fourth military medical university, the University of Alberta and the Second military medical university. Wound repair and regeneration, Burns, Journal of Burn Care & Research, Journal of Cosmetic Dermatology published the most research in this field. Dahai Hu was the most prolific author, while Rei Ogawa was the most cited. The cluster analysis of the reference contributions and keywords indicated that current research hotspots mainly include pathogenesis, treatment strategies, and the safety evaluation of new scar treatment options. ConclusionThis study provides a comprehensive summary and analysis of the current status and research trends of pathological scars. International research interest in pathological scars is on the rise, and high-quality studies related to the field have also increased in the last decade. The pathogenesis of pathological scars, treatment strategies, such as fractional ablative CO2 laser and molecular targeted therapy, and the safety evaluation of new treatment options will be the focus of future research.

Fractional ablative laser therapy for the treatment of severe burn scars: A pilot study of the underlying mechanisms.

Ablative fractional resurfacing is clinically an efficient treatment for burn scar management. The aim of this pilot study was to investigate the poorly understood mechanisms underlying ablative fractional CO2 laser (AFL-CO2) therapy in relation to biomarkers S100 and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). S100 stains for Langerhans cells and neuronal cells, potentially representing the pruritus experienced. 11β-HSD1 catalyses the interconversion of cortisol and cortisone in cells, promoting tissue remodelling. Immunohistochemical analysis of S100 and 11β-HSD1 protein expression in the dermis and epidermis of the skin was performed on normal skin, before and after AFL-CO2 therapy. Data assessing outcome parameters was collected concurrently with the skin biopsies. 13 patients were treated with AFL-CO2 therapy. Langerhans cells decreased by 39% after 2nd treatment. Neuronal cells were overexpressed before treatment in the scar tissue by 91% but levels returned to that resembling normal skin. 11β-HSD1 expression in keratinocytes was significantly higher after laser treatment compared to before in scar tissue (p<0.01). No clear correlation was found in dermal fibroblast numbers throughout the treatment course. Whilst the role of the explored mechanisms and their association with clinical outcomes cannot conclusively be stated, this pilot study demonstrates promising trends that encourages investigation into this relationship.

A case report of Hailey-Hailey disease treated with fractional carbon dioxide laser.

Hailey-Hailey disease (HHD), or familial benign pemphigus, is a rare genetic condition characterized by recurrent blisters and erosions with a predilection for intertriginous areas. There is no specific treatment for HHD. Topical and systemic treatments tend to provide temporary remission. Alternative treatment (surgical interventions such as dermabrasion, excision, and laser) has been shown to prolong remission. Considering the risk of complications associated with surgical modalities, laser is often preferred as an alternative for patients failing to respond to first-line therapies. We report a case of recalcitrant HHD successfully treated with a fractional ablative CO2 laser procedure (wavelength of 10600 nm, power of 7-10 W, 2-3 passes) on a 35-year-old female. The patient has a 7-year history of therapy-resistant HHD. A 2-month followup showed substantially resolved lesions, with mild erythema and post-inflammatory hyperpigmentation in treated areas.

CO2 ablative fractional laser - mechanism of action and assessment of safety, effectiveness in the treatment and possible side effects based on a review of scientific literature

Introduction: Laser therapy has been used in medicine for many years. One of the most willingly used is the fractional ablative CO2 laser. As a result of its use, the improvement of pigmentation, skin texture and signs of aging are achieved. Laser therapy owes its popularity to its low invasiveness and good, long-lasting effects of the procedure. Despite its important role in aesthetic medicine, we should not forget about its participation in the treatment of scars, often extensive, causing troublesome symptoms to patients, the source of which is not only a defect of a cosmetic nature. Purpose of the work: The purpose of the study is to present mechanism of action, assessment of safety, effectiveness in the treatment and possible side effects based on a review of scientific literature. Material and methods: The work was based on a review of available medical publications on the use of the fractional ablative CO2 laser. The literature in the PubMed and Google Scholar databases was searched based on the following keywords: fractional ablative CO2 laser, mechanism of action, safety of use, side effects. Conclusion: The use of a fractional ablative CO2 laser causes the increased collagen production in the dermis. This effect contributes to the elevation of the quantity and level of collagen arrangement, and also to the reduction of the visibility of the effects of photoaging. As a result, the skin in the treated area becomes thicker, and thus firmer. The pigmentation and texture are also being improved. The procedure is relatively slightly invasive, and the side effects are self-limiting in the most cases.

Efficacy and safety of ablative CO2 fractional laser and narrowband intense pulsed light for the treatment of hypertrophic scars: a prospective, randomized controlled trial

Background and Objectives Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO2 fractional laser and narrowband intense pulsed light (IPL) compared to IPL alone in the treatment of hypertrophic scars. Materials and Methods This was a prospective, randomized controlled study enrolled 138 patients with hypertrophic scars. The participants were randomly divided into two groups: CO2-IPL and IPL group, and received three sessions at 10–14-week intervals for 3-month follow-up. Two independent plastic surgeons evaluated the treatments using the Patient and Observer Scar Assessment Scales (POSAS). Overall satisfaction was evaluated using the Patient Satisfaction Scale (PSS). Results 101 subjects completed the study. Compared to single IPL, the combination CO2-IPL group showed a significant improvement in itching, color, stiffness, thickness, and irregularity, except for pain, and an enhancement in vascularization, pigmentation, thickness, relief, and pliability of the scar, assessed by POSAS (p < .01). 100% patients in the combination group were satisfied compared to 84% in IPL alone. Conclusion The combination of CO2 fractional laser and narrowband IPL efficiently improved the appearance and profile of hypertrophic scars, offering a comprehensive and reliable approach for scar therapy.

Treatment Options for Multinucleate Cell Angiohistiocytoma: A Case Series and Review of the Literature.

Multinucleate cell angiohistiocytoma (MCAH) is an unusual fibrohistiocytic proliferation in the dermis with vascular hyperplasia. Numerous clinicopathological studies of MCAH have been published, but little has been written in relation to treatment. The aim of the present study is to review the therapeutical approaches for MCAH in the literature and to report the results of the different therapies followed at our institution. A literature review was conducted including all MCAH published cases that followed any therapy. Search terms included "multinucleate cell angiohistiocytoma" or "MCAH" and "treatment" or "therapy". Also, all cases of MCAH treated at our institution from 2010 to 2020 are reported. The literature search revealed 16 cases of MCAH treated with any of the therapeutic options. At our institution, 9 patients have been treated of MCAH between 2010 and 2020. Over 75% of them were female, and the median age was 56 years (range 47-73). More than 50% had lesions on the dorsum of the hands. Surgical excision was indicated in 2 patients, ablative CO2 laser was used in 1 patient and the 6 remaining ones followed vascular-targeted therapies (PDL and IPL). A satisfactory cosmetic result was achieved in all of them. We propose PDL therapy as a first-line treatment for MCAH since it achieves satisfactory esthetic results, while being well-tolerated. Selecting those amenable patients according to morphologic characteristics may be useful to avoid unsuccessful therapies. In MCAH with predominant fibrous stroma, surgery or CO2 laser may be the best option.

The Role of Fractional CO2 and Pulsed Dye Laser in Scar Management

Introduction: An estimated 100 million patients acquire scars of any type every year, a few of which will lead to hypertrophic, contracting scars or keloids. Management remains challenging and encompasses surgical and non-surgical treatment options. The introduction of fractional photothermolysis (FP) in 2004,marked a major advancement in treatment. Unlike classic non-fractional ablative lasers, FP uses well focused laser beams to create small columns of ablation called microscopic treatment zones (MTZ).FP has since been discovered to be particularly useful in relieving scar contractures with efficacy on improving functionality and cosmetic outcomes. We aim to present a case of a contracting scald burn over the buttocks improving exceptionally following pulsed dye (595 nm) laser and fractional resurfacing using an ablative CO2 (10600 nm) laser associated with transepidermal triamcinolone delivery. Materials and Methods: Case presentation of the management of a hypertrophic scar following a scald burn. Results: A 12 year old boy suffered a third degree scald burn on the right buttock requiring a split thickness skin graft. The follow-up was complicated by a contracting, hypertrophic scar with a negative impact on his soccer playing due to diminished running ability. we started treatment with pulsed dye laser (595 nm, handpiece of 12 mm, pulse duration of 6 ms, fluence of 5 à 6 J/cm2),fractional resurfacing treatments using an ablative fractional CO2 laser(10600 nm, Deep-Fx, 30 to 50 mJ/MTZ, 5% coverage)followed by topical triamcinolone application by the principle of fractional laser-assisted drug delivery. We applied a hydrocolloid dressing 24/7,wearing compression shorts and to massage the scar regularly. After a total of 19 treatments, we observed a smooth scar without any signs of contraction and a normal range of motion of the hip joint. The patient was highly satisfied with the functional and aesthetic result. Conclusion: Lasers are a safe and effective treatment option for traumatic scars. Choosing the appropriate laser with the appropriate dosimetry is one of the cornerstones to a good scar-management.

A COMPARATIVE STUDY ON EFFECTIVENESS OF CO2 LASER + MICRONEEDLING AND CO2 LASERIN PATIENTS WITHACNE SCARS

Introduction: Acne is one of the most common disorders. Quite often, acne results in scar formation due to the preceding inflammation causing either loss or gain of tissue. Ablative CO2 laser resurfacing and microneedling are proven effective modalities for the treatment of acne scarring. However, one out of two techniques is done exclusively in a patient. In the present study we have compared the sequential usage of CO2 laser + Microneedling Versus Only CO2 laser. Materials and Methods: A total of 50 patients were recruited for the study. 25 patients with moderate-to-severe acne scars underwent one sitting of fractional CO2 laser, followed by Microneedling after 3 weeks to follow the same sequence making total of four sittings over 6 months, while other 25 patients underwent total of four fractional CO2 laser sittings within a gap of 3 weeks each. Outcomes were based on GoodmanÂ’s Qualitative and Quantitative assessment. Results: Acne scarring improved significantly in all the 50 patients. Mean scar scores decreased to 9.05% as compared to 58.52% before treatment, decreasing by a mean of 49.47% in Group A, while in Group B, the mean scar scores decreased to 7.45% as compared to 30.20%, decreasing by a mean of 22.75%. Based on quantitative assessment of after treatment reduction of Acne Scars Comparing Group A and Group B. Very good reduction of acne scars was found in 2 (8%) patients in the Group A whereas in the Group B none of the patients had found the very good reduction. Good reduction of Acne scars was found to be in 12 patients (48%) in the Group A, whereas in the Group B was found in the 3 patients (12%), moderate reduction was found in the 10 patients (40%) in the Group A whereas in the group B had found in the 15patients (60%). It was found to be statistically significant association (P value= 0.001). This infers, maximum good reduction was found to be in association with the Group A than Group B. In the Group A, all the 25 patients presented with erythema, edema, needle impression and all the 25 patients in the Group B presented with the erythema respectively Conclusion: The use of combination therapy of CO2 laser + Microneedling and CO2 laser is more efficacious than CO2 laser alone. This combination present with more or less similar side effects as compared to monotherapy.