Ablative Fractional Carbon Dioxide Laser Research Articles

Fractional Ablative Carbon Dioxide Laser versus Fractional Non-Ablative 1410 nm Diode Laser in the Treatment of Acne Scars: A Clinical and Immunohistochemical Study

Background: Effectively managing acne scars while minimizing consequences is still a challenging task. The primary determinant in selecting and continuing therapy for a specific device is stimulating collagen production and dermal remodeling with the fewest possible complications. Objective: To evaluate the clinical and immunohistochemical results of ablative fractional carbon dioxide (FCO2) laser versus fractional non-ablative diode laser for treating facial acne scars. Methods and Materials: Thirty patients with atrophic acne scars were included in a split-face comparative study. Right and left facial sides received three sessions of FCO2 and diode laser, respectively, at one-month intervals. One month after the third session, patients were evaluated using photographs, the Goodman and Baron qualitative and quantitative global scarring grading system, the investigator’s global assessment, and patient satisfaction. A sample was collected from the area that had been treated, and the tissue was examined using hematoxylin and eosin (H–E) staining and immunohistochemistry staining for collagen I. Results: Goodman and Baron global scores showed a statistically significant difference compared to baseline on both sides of the face. However, there was no statistically significant difference between the two treatment modalities. Biopsy specimens showed an increased deposition of collagen I by both laser devices, which was validated and described by immunohistochemistry staining. Conclusion: Both FCO2 and fractional non-ablative diode lasers proved their efficacy in treating different types of acne scars. For patients who are interested in no downtime and no complications, fractional non-ablative diode laser is recommended as an efficient alternative modality.

Treatment of hypertrophic scars with ablative fractional carbon dioxide laser assisted with different topical triamcinolone delivery ways

ObjectivesAblative fractional carbon dioxide laser has been used with triamcinolone to treat hypertrophic scars, resulting in promising success rates. However, there are different topical triamcinolone delivery methods used in scar treatment. To assess the efficacy among the different triamcinolone delivery methods, this study was designed to compare the efficacy and safety of ablative fractional carbon dioxide laser followed by penetration and injection of topical triamcinolone into thicker hypertrophic scars (height score of VSS ≥2). Study design/materials and methodsWe performed a retrospective study of 155 thicker hypertrophic scar patients (height score of VSS ≥2), including 88 patients in the triamcinolone external application group and 67 patients in the triamcinolone intralesional injection group. One month after the patients had 3 treatment sessions at 4-week intervals, the scars were assessed by photography, the Vancouver Scar Scale (VSS), durometry and spectrocolorimetry. Any adverse effects were also evaluated. ResultsThe VSS scores and the hardness of the scars in both groups improved significantly compared to baseline. Moreover, the patients in the triamcinolone intralesional injection group had higher treatment efficacy (19.77 ± 21.25 %) based on their VSS scores than the patients in the triamcinolone external application group (5.94 ± 24.07 %), especially in the improvement of scar pliability, height and hardness. Meanwhile, in the triamcinolone injection group, more patients had mild and moderate improvement than in the triamcinolone application group. However, there were no differences in the distribution of the adverse effects in either group. ConclusionsThis study demonstrated that using the ablative fractional carbon dioxide laser followed by different topical triamcinolone delivery methods is effective and safe for thicker hypertrophic scar improvement. The method of using the ablative fractional carbon dioxide laser assisted with triamcinolone injection had a better therapeutic outcome in thicker hypertrophic scars, as compared with triamcinolone penetration.

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.

Cosmetic therapies for Chinese patients with acne taking concomitant or recent intake of oral isotretinoin: A retrospective study.

The current standard recommendation is to initiate the cosmetic therapies after discontinuing taking oral isotretinoin for at least 6 months. However, this recommendation has been questioned in several recent publications, and it is difficult to operate in clinical practice as early initiation of effective treatment is desirable for patients with acne sequelae. The purpose of this study is to evaluate the efficacy and safety of chemical peeling and light/laser or radiofrequency treatments combined with oral isotretinoin for patients with acne vulgaris and acne scars. A retrospective study of 511 patients on/or recently administered with isotretinoin treated with glycolic acid, intense pulsed light, nonablative fractional laser, fractional radiofrequency, and ablative carbon dioxide laser. A total of 1352 interventions were performed. The medical follow-up lasted for at least 1 year. The efficacy and safety of different procedures were evaluated. A total of 511 patients, who were treated with isotretinoin orally or stopped for <6 months, received 477 sessions of glycolic acid chemical peeling treatment, 588 sessions of intense pulsed light treatment, 61 sessions of nonablative fractional laser treatment, 101 sessions of fractional radiofrequency treatment, and 125 sessions of ablative fractional carbon dioxide laser treatment. No hypertrophic scars and keloids were found, and the incidence of serious adverse reactions such as scarring, erythema, blisters, and postinflammatory hyperpigmentation did not increase. It is safe to perform skin procedures in patients with acne and acne scars during or after discontinuation of isotretinoin for <6 months. Invasive treatments such as ablative fractional carbon dioxide laser treatment can be performed, as appropriate, by an experienced physician. The guideline of avoiding chemical and physical procedures in such patients taking oral isotretinoin should to revised.

Carbon dioxide laser treatment of burn-related scarring: Results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomized controlled trial

To investigate the impact of ablative fractional carbon dioxide laser (AFCO2L) on patient-reported outcomes measures, subjective scar appearance, dermal architecture, and gene transcription in early burn scars. Fifteen adult patients with a burn-related scar were recruited. Inclusion criteria were two non-contiguous scar areas of 1% total body surface area, similar baseline Vancouver scar scale (VSS) score and 3months since the time of injury. All participants acted as their own control. Scars were randomized to treatment or control. Treatment scars received three AFCO2L treatments at 6-week intervals. Outcome measures were recorded at baseline, 3, 6, and 12-months post-treatment. Measures included blinded VSS, Patient Observer Scar Assessment Scale (POSAS), Brisbane Burn Scar Impact Profile (BBSIP), blinded scar photo assessment, histological tissue analysis, and RNA sequencing analysis. No significant difference was found in VSS, scar erythema, or pigmentation. Patient POSAS improved in scar thickness and texture following AFCO2L. All elements of BBSIP improved in control and laser groups. AFCO2L-treated scars were scored better than control scars by blinded raters. RNA sequencing illustrated that AFCO2L induced sustained changes in fibroblast gene expression. AFCO2L treated scars had significantly altered scar thickness and texture 6 months post-laser and were rated better than controls on blinded photo analysis after 3 treatments. RNASeq results suggest laser treatment alters the transcriptome of treated fibroblasts for at least 3 months after treatment. Expansion of this research to study in more depth fibroblast changes in response to laser, as well as assessing the impact on daily activity and quality of life, will be beneficial.

Ablative fractional carbon dioxide laser combined with autologous platelet-rich plasma in the treatment of atrophic acne scars: A systematic review and meta-analysis.

Atrophic acne scars are the most common cutaneous seqaule of acne vulgaris, representing 80%-90% of all acne scars. Ablative fractional carbon dioxide (FCO2 ) laser is the gold standard treatment for atrophic scars. Additionally, platelet-rich plasma (PRP) is suggested to accelerate the healing process and collagen synthesis. The aim of the present systematic review and meta-analysis was to determine the efficacy and safety of PRP combined with Ablative FCO2 laser in the treatment of moderate to severe atrophic acne scars. Randomized controlled trials (RCTs) that have compared PRP in combination with ablative FCO2 laser to ablative FCO2 laser alone with respect to the efficacy and safety measures were included. We have systematically explored Embase, Medline, and CENTRAL databases via Ovid. The outcomes that our systematic review sought to evaluate were clinical improvement, patient satisfaction, and Goodman and Baron's qualitative acne scar score. The dichotomous outcomes were presented as odds ratio (OR) while the continuous outcomes were presented as standardized mean difference (SMD). Eleven RCTs that represents 313 participants were included. The combined use of laser and PRP showed a statistically significant clinical improvement and patient satisfaction compared to the use of laser alone (OR=2.56, 95% CI 1.37-4.78 and OR=3.38, 95% CI 1.80-6.34, respectively). Also, a significant improvement in Goodman and Baron's score was achieved by combining PRP with laser (SMD=-0.40, 95% CI -0.65 to -0.14). The combined treatment of laser and PRP was highly synergistic, effective, and safe in treating moderate to severe atrophic acne scars.

A Single-Institution Experience About 10 Years With Children Undergoing Fractional Ablative Carbon Dioxide Laser Treatment After Burns: Measurement of Air Pressure-Induced Skin Elevation and Retraction Time (Dermalab) Including Standardized Subjective and Objective Scar Evaluation.

Laser treatment has gained more and more importance in the therapy of scars during the last years. Scientific work, especially in children, is scarce on this topic and mostly with an insufficient number of cases or only subjective descriptions. Our study included 77 children from 2012 to 2022 with scars after thermal injury. These were treated at least three times or more by CO2 laser or in combination with pulsed dyed laser (PDL). Beforehand, scar texture and elasticity were determined by a skin elasticity analysis system. Regarding the subjective evaluation, a questionnaire was given to the patients or their parents. Further criteria were the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS). A statistically significant improvement in elasticity was demonstrated in all scars of any age after each laser treatment. In addition, a significant correlation was found between the number of laser treatments and an increase in elasticity. The assessments of scars after one or more laser sessions by the observer as well as the patient showed a decreasing score in all categories with an increase in the number of laser therapies. The VSS score also improved significantly after each laser session. The mean score before treatment was about 7, after the first laser session, the mean score was already below 6 with a statistical significance. Ninety-six percent of the patients or their parents were satisfied with the laser therapy, and 90% wished to repeat the procedure. This work confirms, by means of the objectification by the scar measurement, the previous scientific works concerning a scar therapy by laser and emphasizes particularly that this can also be used without problems with children with symptomatic scars, contractures, or with cosmetically relevant scars.

723 Carbon Dioxide Laser Treatment Practices for Hypertrophic Burn Scars Amongst American Burn Association Burn Centers

IntroductionScarring is a major outcome of severe burn wound healing. Severe scars often persist and diminish quality of life by disfigurement, pain, and pruritis. In the last decade, utilization of ablative fractional carbon dioxide (CO2) laser therapy has become a popular treatment modality for severe burn scars. Although the efficacy of CO2 lasers for the treatment of hypertrophic burn scars has been established via systematic reviews, there have been no attempts to query the 63 American Burn Association (ABA) centers across the United States regarding specific treatment parameters involving serious, sometimes high, total body surface area (TBSA) burns.MethodsThroughout October and November of 2020, a Qualtrics survey consisting of 14 questions was administered to burn surgeons practicing at all 63 ABA burn centers across the United States. Topics assessed were specific laser parameters utilized (5), treatment preferences (2), peri-operative follow-up (5), scar assessment practices (1), and TBSA treatment tolerance (1).ResultsExploratory, descriptive data was analyzed. Surgeons practicing at 27 of the 63 total ABA burn centers responded to the survey (43% response rate). Data elucidates the level of variance regarding current initial management of hypertrophic burn scars via CO2 laser treatment. Surgeons demonstrated variation in the level of TBSA treatment tolerance and pulse energy settings, respectively.ConclusionsOur findings show a substantial amount of variation in several aspects of CO2 laser hypertrophic scar revision between ABA centers across the country, including preoperative evaluation, laser settings, treatment regimen, and postoperative recommendations . Standardization of care when utilizing ablative fractional CO2 lasers should be further explored.

Treatment of acne scars with fractional carbon dioxide laser in Asians: a retrospective study to search for predicting factors associated with efficacy.

Ablative fractional laser treatment has been extensively used for resurfacing atrophic acne scars. However, few studies have investigated how the parameters set during laser procedures affect efficacy. In this retrospective study, we examined the relationship between efficacy and Fitzpatrick skin type, gender, age, follow-up duration, energy, and treatment sessions utilizing ablative fractional carbon dioxide (CO2) laser in Asians with Fitzpatrick skin types III-IV. We then analyzed the relationship between outcome and adverse effects including hyperpigmentation. Three blinded dermatologists used the ECCA (Echelle d'Evaluation Clinique des Cicatrices d'Acnluation Clinique des Cicospectively review 82 of 1034 patients who presented at our institution for atrophic acne scar treatment between August 2013 and August 2019. Factors associated with efficacy, including age, gender, Fitzpatrick skin type, energy, treatment sessions, follow-up duration, and pigmentation, were analyzed. 82 patients met inclusion criteria. Patients underwent one to three CO2 laser treatment sessions. Parameter settings for individual patients were consistent across treatments. Mean ECCA scores decreased from 102.70 ± 24.95 to 87.28 ± 24.48 (p ≤ 0.001). The number of treatment sessions and duration of pigmentation lasting shorter than 3months positively correlated with better outcomes. All patients had erythema, which lasted longer than 3months in 16 patients (19.51%). Post-inflammatory hyperpigmentation (PIH) affected 60 patients (73.17%) and lasted longer than 3months in 26 patients (31.71%). One patient experienced hypopigmentation (1.22%), while 8 experienced acne flare-up (9.76%). Post-laser scars occurred in 2 patients (2.44%). Our data suggest that in atrophic acne scar treatment in Asians using fractional CO2 laser, 3 treatment sessions and duration of hyperpigmentation within 3months have better outcomes regardless of energy, gender, age, Fitzpatrick skin type, follow-up duration, and disease course.

Efficacy of ablative fractional carbon dioxide laser combined with autologous platelet‐rich plasma versus ablative fractional carbon dioxide laser and placebo in the treatment of striae gravidarum: A randomized clinical trial

Striae gravidarum (SG) is a connective tissue disorder seen commonly in primigravidas. It is associated with impairment in the quality of life. To determine the efficacy of ablative fractional carbon dioxide (CO2 ) laser combined with autologous platelet-rich plasma (PRP) versus ablative fractional CO2 laser and placebo in the treatment of SG. Randomized, double-blinded, and placebo-controlled trial. The study was conducted in 16 patients with SG. The assigned treatment area (abdomen) was divided into two sides and was randomly assigned to the PRP side and the control side. All patients received ablative fractional CO2 laser. Immediately after each laser procedure, the PRP side received autologous PRP, while the control side received plain normal saline solution (pNSS) as a placebo. The study was done for three sessions, at intervals of 4weeks. An independent assessor used the photographs taken at Weeks 6, 10, 14, and 16 to assess the clinical improvement. The patient satisfaction was reported at the same intervals. A quartile grading scale was used to measure both the clinical improvement and patient satisfaction. Data were analyzed using the Jonckheere-Terpstra test. Histopathology was done before treatment and at the end of the study period. The combination of ablative fractional CO2 laser and autologous PRP had better clinical improvement and patients' satisfaction compared with ablative fractional CO2 laser and placebo. However, both outcome measures were not statistically significant. Ablative fractional CO2 laser combined with autologous PRP appears to be an effective treatment in SG.

Skin Wound Tension Reduction Device Combined with Ablative Fractional Carbon Dioxide Laser to Reduce Scar Formation After Excision of Pediatric Facial Skin Lesions: A Prospective Cohort Study.

PurposeTo investigate the efficacy of skin wound tension reduction device (SWTRD) combined with ablative fractional carbon dioxide laser (CO2-AFL) for the prevention of scar formation following the excision of facial cutaneous lesions in children.MethodsPatients undergoing surgical excision of facial cutaneous lesions in our hospital between May 2019 and April 2021 were enrolled. After the excision of facial cutaneous lesions and based on the personal intents and conditions, patients were assigned to undergo SWTRD combined with CO2-AFL. Outcome evaluations were as follows: defect size, incision width, scar width, the Vancouver Scar Scale (VSS) and University of North Carolina 4P Scar Scale (UNC4P).ResultsA total of 25 pediatric patients (mean age, 9.88 years) were enrolled in the study. Following the treatment of SWTRD+CO2-AFL, scar widths were relatively narrow and the appearance of the incision scars was significantly improved. A significant reduction in the patient-reported UNC4P scores at 6 months (3, 1–4) was observed when compared with that at 2 months (0, 0–1) after surgery (p<0.001). A similar reduction in the VSS scar scale was also evident (6 months: 1, 0.75–2.5 vs 2 months: 6.5–8.5; p<0.001).ConclusionCombined SWTRD and CO2-AFL treatment effectively modulates the scar formation after the incision is healed and resulting in preventing scar widening, leading to the improvement of scar appearance, reduction in wound pain and pruritus and its overall prognosis.

Facilitated delivery of topical steroids after fractional ablative carbon dioxide laser benefits postthyroidectomy hypertrophic scar

Background: Thyroidectomy results in unsightly scarring at the anterior neck of the patient. Objectives: This prospective clinical study aimed to assess the effectiveness of laser assisted drug delivery (LADD) of topical steroid ointment for the treatment of postthyroidectomy hypertrophic scars. Methods: Five courses of a fractional ablative carbon dioxide laser combined with topical 0.05% clobetasol propionate were applied every 4 weeks to treat postthyroidectomy hypertrophic scars in ten adult female patients. The effectiveness was assessed by the patient themselves according to the Patient and Observer Scar Assessment Scale (POSAS) and by three different doctors according to photography evaluations before and 1 year after the first treatment. Results: Assessments of the scars by POSAS revealed significant improvements in terms of itchiness, color, softness, thickness, irregularity, and distorted appearance of the scars, albeit without any significant pain relief. In addition, all indicative characteristics of the scar, namely, vascularity, pigmentation, thickness, relief, pliability, surface area, and overall opinion, as assessed by the treating doctor and based on photographic evaluations by three different doctors, revealed significant improvements in the scars after treatment. Conclusion: In this study, we demonstrated that the topical delivery of steroids after fractional ablative carbon dioxide laser treatment showed an encouraging outcome in postthyroidectomy hypertrophic scarring.

Factors affecting the outcome of fractional carbon dioxide laser resurfacing of various types of scars in skin of color.

Fractional laser resurfacing has been used widely in management of scars. However, data for post-traumatic and post-burn scar are limited in skin of color. This retrospective study assessed the efficacy of fractional ablative carbon dioxide laser in treatment of various types of scars other than acne scars. We also tried to find out the effect of different factors like skin type, duration, shape, location, and color of the scars on the outcome. Forty-two patients with 67scars including post-traumatic (43), post-burn (15), post-surgical (5), and post-folliculitis (5) scars treated during 2019-2020 were analyzed. The improvement was graded according to investigator and patient global assessment (IGA & PGA) through percentage improvement and quartile scale. Overall, there was 45.4% and 32.7% of improvement according to PGA and IGA, respectively. Scars with >50% improvement were recorded in 13.43% of the scars with IGA and 41.78% with PGA. Early scars, scars without hyperpigmentation, lighter skin type, post-traumatic scars had better results. There was no significant difference for other parameters like atrophic versus hypertrophic, facial versus extra facial, linear versus non-linear, or the number of sessions. Fractional carbon dioxide laser efficacious for non-acne facial and extra facial scars in the skin of color. Early intervention could yield more satisfactory results.

Effectiveness and safety of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide laser treatment for hypertrophic scar: a retrospective study.

Hypertrophic scars can be caused by various injuries and lead to a decrease in quality of life of those affected. This study was performed retrospectively in our center to investigate the safety and effectiveness of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide (CO2) laser treatment in patients with hypertrophic scar. This was a retrospective study performed in a single center between January 2019 and December 2020. All patients with hypertrophic scars receiving fractional micro-plasma radio-frequency treatment, ablative fractional CO2 laser treatment, or combined therapy of both were recruited to the study. The participants were then divided into a single therapy group or combined therapy group. The Vancouver scar scale was used to score and subsequently assess the effectiveness of scar treatment and the changes of scar thickness. Some adverse complications were also recorded to evaluate the safety of treatments. A subgroup analysis was then performed to investigate the differences of effectiveness and safety of combined therapy in scar patients at the early stage and late stage. A total of 64 patients with hypertrophic scars were enrolled in this study, including 45 receiving combined treatment, and 19 receiving single treatment. There was no significant difference in demographic data between the two groups. Notably, combined therapy could more effectively reduce the score of Vancouver scar scale (P=0.026) without significantly increasing the incidence of adverse complications. However, no significant difference was observed in scar thickness between the two groups. Moreover, multiple treatments could further increase the effectiveness of combined therapy according to either the score of Vancouver scar scale or the thickness of scars. Subgroup analysis revealed that combined therapy could reduce the score of Vancouver scar scale and scar thickness in patients much more at the early stage than at the late stage (P=0.032 and 0.042, respectively). This study revealed that fractional micro-plasma radio-frequency treatment combined with ablative fractional CO2 laser treatment could be more effective in improving hypertrophic scars then single therapy. Also, multiple treatments could enhance the effectiveness of combined treatment, and patients should be encouraged to receive treatment as early as possible.

A Single-Institution Experience With Standardized Objective and Subjective Scar Evaluation While Undergoing Fractional Ablative Carbon Dioxide Laser Treatment.

Laser treatment of burn scar has increased in recent years. Standard components of scar evaluation during laser scar revision have yet to be established. Patients who began laser scar revision from January 2018 to 2020, underwent at least three treatments, and completed evaluations for each treatment were included. Patients underwent fractional ablative carbon dioxide laser scar revision and pre- and postprocedure scar evaluations by a burn rehabilitation therapist, including Patient and Observer Scar Assessment Scale, Vancouver Scar Scale, our institutional scar comparison scale, durometry, and active range of motion measurements. Twenty-nine patients began laser scar revision and underwent at least three treatments with evaluations before and after each intervention. All patients improved in at least one scar assessment metric after a single laser treatment. After the second and third treatments, all patients improved in at least three scar assessment metrics. Range of motion was the most frequently improved. Durometry significantly improved after the third treatment. Patients and observers showed some agreement in their assessment of scar, but observers rated overall scar scores better than patients. Patients acknowledged substantial scar improvement on our institutional scar comparison scale. Burn scar improves with fractional ablative laser therapy in a range of scar ages and skin types, as early as the first session. Improvements continue as additional sessions are performed. This work suggests baseline evaluation components for patients undergoing laser and a timeline for expected clinical improvements which may inform conversations between patients and providers when considering laser for the symptomatic hypertrophic scar.

The Effectiveness of Laser Therapy for Hypertrophic Burn Scars in Pediatric Patients: A Prospective Investigation

Abstract Laser therapy has become a valuable treatment option for hypertrophic burn scars. Improvements in scar symptoms have been achieved using the ablative fractional carbon dioxide laser as well as the pulsed dye laser. However, research regarding the use of laser therapy among pediatric patients remains limited. Thus, the aim of this study was to investigate the effectiveness of using laser therapy to improve hypertrophic burn scars in a pediatric population using a comprehensive scar assessment protocol. A pragmatic, single-center, prospective observational study was conducted at a tertiary pediatric hospital. Twenty participants with hypertrophic burn scars were included. Laser procedures were administered at approximately two month intervals and scars were evaluated at five time points over one year using the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, conventional ultrasound, ultrasound elastography, and a multi-probe skin analysis device. Seventy-one laser procedures were performed with most participants receiving treatment with both the ablative fractional carbon dioxide laser and the pulsed dye laser at the same session (83%). From baseline to study completion, significant improvements in all scar measures were observed (p &amp;lt; .05). In particular, improvements in overall scarring and in specific scar properties including thickness, stiffness, and color were found (p &amp;lt; .05). To the best our knowledge, this is the most comprehensive study to date to evaluate the effect of laser treatment on hypertrophic burn scars in a pediatric population. Our findings suggest that laser therapy is a beneficial treatment for burn-injured children as evidenced by the improvements in subjective and objective scar assessment measures.

Snail Soothing and Repairing Cream Improves Skin Hydration after Ablative Fractional CO2 Laser: A Split-Face Randomized Double-Blinded Placebo-Controlled Trial

Background: Ablative fractional carbon dioxide laser (AFCO2) resurfacing causes transient skin barrier disruption characterized by decreased skin hydration and increased transepidermal water loss (TEWL). Snail Soothing and Repairing (SSR) cream, containing several glycoproteins with potential antimicrobial and antioxidant effects, may benefit skin hydration promotion after the laser treatment. Objective: To evaluate the efficacy and safety of SSR cream in skin hydration promotion after AFCO2 resurfacing. Method: The study was a double-blinded, split-face, placebo-controlled trial in participants aged 18–50 years with atrophic acne scars on both cheeks. After AFCO2 resurfacing, participants applied the product or placebo on either cheek twice daily for 14 days. Corneometry, TEWL, colorimetry, and clinical assessments (edema, erythema, crusting, pruritus, and tightness score) were evaluated at baseline, day 7, and day 14 after AFCO2 resurfacing. Results: From 22 participants in the study, the SSR cream-treated sides showed significantly higher corneometry levels than placebo-treated sides at day 14 (p = 0.033), while TEWL and colorimetry levels were not different at any study visits. Pruritus and tightness scores of the SSR side were lower, but not significant, than the placebo. Other clinical assessments (edema, erythema, and crusting) showed similar results. No significant adverse events took place. Conclusion: The SSR cream significantly improved skin hydration, highlighting skin barrier restoration after AFCO2 resurfacing, with a good safety profile.

A split-face study of moisturizer containing Centella asiatica extract after ablative fractional carbon dioxide laser resurfacing

A split-face study of moisturizer containing Centella asiatica extract after ablative fractional carbon dioxide laser resurfacing

29 The Effectiveness of Laser Therapy for Hypertrophic Burn Scars in Pediatric Patients: A Prospective Investigation

Abstract Introduction Laser therapy has emerged as a valuable treatment option for hypertrophic burn scars over the past decade. Improvements in scar symptoms have been found using the ablative fractional carbon dioxide laser (AFCL) as well as the pulsed dye laser (PDL). However, research regarding the use of laser therapy among pediatric burn patients remains limited. Thus, the aim of this study was to investigate the effectiveness of using laser therapy to improve hypertrophic burn scars in a pediatric population using a comprehensive set of subjective and objective scar assessment tools. Methods A single-center, prospective observational study was carried out at a tertiary pediatric hospital. Twenty participants with hypertrophic burn scars that had not received previous laser treatment were included. Laser procedures were administered at approximately two-month intervals and each participant attended five study visits over the course of one year. A comprehensive set of scar assessment tools including the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, conventional ultrasound, ultrasound elastography, and a multi-parameter skin analysis device were used to evaluate scar properties at each study visit. Results Seventy-one laser procedures were carried out with most participants receiving treatment with both the AFCL and the PDL at the same session (83%). All participants underwent at least three laser procedures with no complications noted. From baseline to study completion, statistically significant improvements in all scar measures, both subjective and objective, were observed (p &amp;lt; 0.05). More specifically, improvements in overall scarring and in specific scar properties including thickness (p &amp;lt; 0.05), stiffness (p &amp;lt; 0.05), and color (p &amp;lt; 0.05) were found. Conclusions To our knowledge, this is the most comprehensive study to date to evaluate the effect of laser treatment on hypertrophic burn scars in a pediatric population. Our findings suggest that laser therapy is a highly beneficial treatment for burn-injured children that should be integrated into current scar treatment practices. In addition to obtaining strong evidence to support the use of laser therapy, we utilized rigorous scar assessment and laser treatment protocols that can be easily adopted by other clinicians.