CO2 Laser Research Articles

Comparative study between fractional CO2 laser (10,600nm) and microneedling in treatment of morphea: dermoscopic and histopathological evaluation.

Morphea is a chronic inflammatory fibrosing disorder. Since fibrosis is the hallmark of both scars and morphea, our attention was raised for the possible use of Fractional Ablative CO2 lasers and microneedling as treatment modalities for morphea. To compare the efficacy and safety of Fractional Ablative CO2 lasers and microneedling in the treatment of morphea. This comparative cross-sectional study was conducted on 30 patients with morphea, diagnosed clinically and histopathologically. These patients were divided into two groups; Group 1 (n = 15) received treatment with Fractional Ablative CO2 laser, and Group 2 (n = 15) received microneedling treatment. Each patient in both groups underwent a total of three sessions, one session per month. Treatment assessment was performed 1 month after the last session using Photographic documentation, clinical evaluation with the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT), dermoscopic imaging and histopathological evaluation with Hematoxylin and Eosin (H&E) and Masson's Trichrome stains. Additionally, patient satisfaction and side effects were evaluated at the end of treatment. A statistically significant decrease in the clinical score (LoSCAT) of morphea was observed in both the Fractional CO2 laser and microneedling groups at the end of treatment. Furthermore, the histopathological score significantly improved in both groups regarding dermal vasculature, infiltrate, epidermal and dermal changes, and adnexal and periappendiceal fat. A high degree of satisfaction was reported among patients in both groups. Both factional CO2 and microneedling are safe, effective, and well-tolerated modalities for the treatment of morphea.

Cryoblebbing with 5-fluorouracil versus cryoblebbing with melanocyte keratinocyte transplant procedure or cryoblebbing alone in treatment of stable vitiligo.

Both the surgical non-cultured melanocyte-keratinocyte transplant procedure (MKTP) and intradermal injection of 5-Fluorouracil (5-FU) are effective in the treatment of vitiligo. Intrablisters injection of MKTP was done in one study with better results than MKTP application after ablative CO2 laser of the reciepient area. However, intrablister injection of 5-FU was not done before. To compare the efficacy of 5-FU, MKTP after preparation of the recipient site by cryoblebing in the treatment of stable vitiligo. Treatment efficacy was evaluated clinically, histopathologically, and immunohistochemically. This prospective, single-blinded, randomized comparative study included 20 patients with stable vitiligo in 128 areas. The recipient sites were prepared by cryoblebbing. The blisters were injected with either a suspension of MKTP in area A (MKTP group, 49 areas), 5-FU in area B (5-FU group, 48 areas) or left without injection in area C (control group, 31 areas). The assessment was performed 6months after the procedure based on the percentage of repigmentation, histopathologically and immunohistochemically for the pigmented lesions. Six months after treatment, the mean percentage change in repigmentation was 82.96% ± 31.46% in the MKTP group, 44.79% ± 39.38% in the 5-FU group, and 28.23% ± 24.00% in the control group.The median of the percent change was 100%, 37.5% and 25% in MKTP group, 5-FU group and control group, respectively, with a significant difference (P < 0.001) between the groups. After treatment, H&E-stained sections from the repigmented lesions showed the reappearance of melanocytes (MCs) and melanin pigmentation, especially in the MKTP group followed by 5-FU. Immunohistochemical staining revealed large MCs with an increased density of reactions and dendricity with positive expression of Melan A, and HMB45 especially in the MKTP and 5-FU groups. Intrablister injection with 5-FU appears to be effective for the management of stable vitiligo with less efficacy than MKTP.

Preparation and performance study of a Tm3+-doped silica optical fiber by sol-coating and laser drawing technology

High-concentration Tm3+-doped silica optical fibers have significant application value in areas such as single-frequency lasers. This paper investigates the sol-coating in the silica capillaries process and CO2 laser drawing technology and successfully fabricates a Tm3+-doped single-mode silica optical fiber. The core composition adopts a Tm-La-Al-Si system; the Tm3+ doping concentration is 0.5 mol%; the core and cladding diameters are 5 and 130 µm, respectively; and the numerical aperture (NA) is 0.28. A laser seed source with a wavelength of 1940 nm is established, and the laser gain characteristics of the optical fiber are tested. The small-signal net gain coefficient at the wavelength of 1940 nm is measured to be 0.15 dB/cm. The sol-coating method employed in this study enhances the doping concentration of Tm ions, while the laser drawing technique mitigates ion diffusion effects. The results indicate that this Tm3+-doped silica fiber preparation method offers a novel, to the best of our knowledge, approach for manufacturing high-concentration doped silica fibers and holds significant reference value for related research fields.

Fractional CO2 laser combined with narrow-band ultraviolet B (NB-UVB) phototherapy versus NB-UVB monotherapy in vitiligo patients: prospective, self-controlled, and randomized trial.

Vitiligo is a chronic depigmenting condition that causes amelanotic macules and patches on the skin. Despite various treatment options, treating vitiligo is a challenge. This study aimed to evaluate the combination of laser CO2 fractional and narrow-band ultraviolet B (NB-UVB) versus NB-UVB monotherapy in vitiligo patients. This was a prospective, self-controlled, and randomized trial. Ten patients with symmetrical vitiligo lesions on both sides of their body and who had a history of insufficient response to conventional therapies were included in this trial. Group A received three sessions of fractional CO2 laser at 1-month intervals during NB-UVB phototherapy which was performed three times a week for three months. Patients in group B only received phototherapy same as group A. The primary endpoint was the repigmentation rate. The mean age was 34.40 ± 11.93 years (range of 19-63). After the intervention, repigmentation was better in group A and the difference was statistically significant (P = 0.025). Patients in group A showed a better reduction of VASI score than group B (39.12 ± 27.81 Vs. 44.45 ± 30.77), although it was not statistically significant (P = 0.518). VETF and VIDA outcomes were slightly better in Group A than B, but it was not statistically significant (P = 0.317 and P = 0.180, respectively). The results of this study indicated that combining fractional CO2 laser with NB-UVB is superior to NB-UVB monotherapy, providing a promising modality in vitiligo patients.

Establishing an animal model for post-inflammatory hyperpigmentation following fractional CO2 laser application.

Post-inflammatory hyperpigmentation (PIH) is a common cosmetic concern, often leading to significant psychological distress for the patients. With the widespread application of lasers including ablative fractional resurfacing (AFR) with a 10,600nm CO2 laser, PIH caused by lasers is becoming increasingly common. But due to the absence of an appropriate animal research model, our understanding of pathophysiological mechanisms and preventive strategies for PIH remains limited. This study aimed to establish an animal model to investigate PIH following AFR CO2 laser application, focusing on the dynamic changes in melanin, inflammatory cytokines, growth factors, and skin structures as PIH developed. We employed pigmented guinea pigs as our experimental subjects and conducted our research in two phases. In the first phase, we utilized three modes of AFR CO2 laser to identify which laser mode could induce PIH by monitoring dynamic melanin changes. In the second phase, the laser mode that most reliably induced PIH was applied to re-establish the PIH model. Pathophysiological changes during PIH progression were investigated through histopathological observations, real-time quantitative polymerase chain reaction, and two-photon microscopy. We successfully established a replicable animal model for PIH following AFR CO2 laser application. We observed a significant increase in inflammatory cytokines and growth factors within the skin tissue by the second week, with stable pigmentation becoming apparent by the third week. Our research provides a promising animal model for understanding and further investigating the mechanisms of PIH after laser procedures. V (animal study).

Idiopathic Scrotal Calcinosis Treated with a Combination of Surgical Excision and Carbon Dioxide Laser.

Idiopathic Scrotal Calcinosis Treated with a Combination of Surgical Excision and Carbon Dioxide Laser.

Comparison of Carbon Dioxide Laser and Surgical Excision for the Treatment of Eyelid Margin Benign Tumors: A Prospective, Randomized, and Single-blind Study.

This study aims to compare the safety and efficacy between carbon dioxide (CO2) laser excision and surgical excision for the treatment of eyelid margin benign tumors. In this single-center, prospective, randomized, and single-blind study, 32 patients diagnosed with eyelid margin benign tumors were enrolled from February 2019 to February 2020 and randomly divided into 2 groups. The sexes, ages, tumor size (length×width), scar, procedure time, physicians' assessment score, patients' satisfaction score, and complications were recorded. Histologic analyses were obtained in all patients. No significant difference in baseline data (sexes, ages, and tumor size) was found between the 2 groups. The mean scar length at 1-week post-treatment in the CO2 laser excision group was significantly shorter than surgical excision group (0.3±0.1 versus 0.5±0.1cm, P<0.05), and procedure time in CO2 laser excision group was significantly shorter than surgical excision group (5.8±1.5 versus 26.7±6.4min, P<0.05). There was no statistically significant difference in the physicians' assessment score and patients' satisfaction score between the 2 groups. During the follow-up period, no severe complications were observed. Compared with surgical excision, CO2 laser excision was a rapid procedure and associated with favorable cosmetic outcomes.

PDO screw threads versus fractional CO2 laser, after subcision, for atrophic acne scar remodelling: a randomized group-based comparative study.

Atrophic acne scars present a significant therapeutic challenge. While subcision with various adjunctive treatments, including fractional CO₂ lasers and polydioxanone (PDO) threads, has been employed for scar remodeling, comparative evidence on their efficacy remains limited. This study aims to compare the clinical efficacy and patient satisfaction between subcision with fractional CO₂ laser and subcision with PDO screw threads in managing atrophic acne scars. A randomized, controlled study was conducted on 40 patients with atrophic acne scars. Patients were assigned to two groups: Group A underwent subcision with PDO screw threads insertion, and Group B underwent subcision followed by fractional CO₂ laser resurfacing. Outcomes were assessed using the Goodman and Baron grading system, Antera 3D imaging, and patient satisfaction. Significant scar improvement was observed in both groups, with Group B demonstrating greater reduction in scar severity and depth (p = 0.022). While Group A showed faster recovery and lower downtime, Group B yielded higher patient satisfaction scores. Subcision combined with fractional CO₂ laser resulted in superior long-term scar improvement, although PDO threads provided quicker recovery. The choice of treatment may depend on patient preferences and scar characteristics.

Comparative study between fractional CO2 laser alone versus fractional CO2 laser combined with topical dutasteride in treatment of male androgenic alopecia

Androgenic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by marked hair follicle miniaturization. AGA is a challenging skin condition with limited treatment results. Laser light can promote hair growth at specific wavelengths. The efficacy of fractional CO2 laser in scalp AGA treatment was reported in a few studies. We aimed to compare the efficacy of fractional CO2 laser alone versus the combination of fractional CO2 laser with topical dutasteride in the treatment of male AGA. 30 male patients with AGA were enrolled in the study; they were divided into two groups. All patients received three sessions of ablative fractional CO2 laser one month apart on the scalp, where group (I) patients were subjected to laser sessions only, and group (II) patients were subjected to topical dutasteride, first immediately after each session and secondly fifteen days after each session. The evaluation was done according to dermoscopy (DermLite® DL4) and photographic assessment. Patient satisfaction and side effects were reported. According to the global photo assessment, the combination of fractional CO2 laser with topical dutasteride showed a statistically significant improvement compared to the fractional CO2 laser alone group. The combination of fractional CO2 laser with topical dutasteride is more efficient in improving male androgenic alopecia than fractional CO2 laser alone according to the investigator’s global assessment. There was a significant improvement in all dermoscopic parameters in both groups.

Fractional CO2 Laser and Minoxidil in the Treatment of Alopecia Areata, A Comparative Study.

Alopecia areata (AA) is a chronic inflammatory disease that affects the hair follicles and sometimes the nails. It usually presents as a single or multiple patches of hair loss on the scalp, but any hair-bearing skin can be involved. AA treatment depends on the severity and extent of the disease. To evaluate the efficacy of combined fractional CO2 (FCO2) laser with topical minoxidil 5% solution versus topical minoxidil 5% solution alone in the treatment of AA. The study included 150 patients with AA. The patients were collected from outpatient clinics of the Dermatology and Venerology Department, Tanta University Hospitals. Patients were divided into three groups; 60 patients were treated with topical minoxidil 5% solution, 60 patients were treated with FCO2 laser combined with topical minoxidil 5% solution, and the third group of 30 patients represented the control group treated with topical saline. Compared to the placebo group, there was a statistically significant improvement in hair growth in the combination group and minoxidil group. In the combination group, 80% of patients showed excellent improvement, 13.3% of patients showed very good improvement, and 6.7% of patients showed good improvement. In the minoxidil group, 53% of patients showed excellent improvement, 40% of patients showed very good improvement, and 6.7% of patients showed good improvement after 3 months of therapy. Side effects were minimal and transient in both groups. Topical minoxidil 5% solution either alone or in combination with FCO2 laser could be considered a safe and tolerable method for AA treatment.

Evaluation of the efficacy, safety, and satisfaction rate of topical latanoprost in patients with hypopigmented burn scars treated with fractional CO2 laser: a double-blind randomized controlled clinical trial.

Burn scars present psychological and social challenges for patients, classified into atrophic and hypertrophic types. Treatments like corticosteroid injections, laser therapy, and platelet-rich plasma (PRP) injections are commonly recommended for hypertrophic scars, while regenerative medicine and fractional CO2 lasers are linked to some degree of improvement for atrophic scars. Hypopigmented and depigmented burn scars pose ongoing challenges for healthcare providers and patients, with therapies such as intense pulsed light and fractional CO2 laser showing variable effects in treating these conditions. This study evaluates the effectiveness of latanoprost, a prostaglandin analog, in combination with fractional CO2 laser for repigmentation of hypopigmented burn scar lesions. During the study, patients were treated with 0.005% latanoprost eye drop or normal saline twice a day for 6months and underwent six monthly fractional CO2 laser sessions. Treatment instructions were provided by the physician, and patients were instructed to report any complications and avoid using other medications in the treatment area. Assessments included photography at the start of the study and in three follow-up sessions at three-month intervals. Improvement was assessed using the Subject Global Aesthetic Improvement Scale (SGAIS) by both the physician and patients. Patient satisfaction was evaluated using a Grade scale, and side effects were monitored in all follow-up sessions. In the third follow-up session, physicians assessing the Subject Global Aesthetic Improvement Scale (SGAIS) observed that a higher proportion (85.7%) of cases in the fractional CO2 laser with latanoprost group achieved a grade of 4 (50-74% improvement). In the placebo group, 0% of patients achieved grade 4, and 71.4% were classified as grade 2 (0-24% improvement), indicating a significant difference (P-value: 0.0001). Patient satisfaction, measured by the "Grade scale to evaluate patient satisfaction" index, revealed a notable contrast between the two groups, with average satisfaction scores of 8.50 ± 0.65 and 4.64 ± 1.00 for the fractional CO2 laser with latanoprost and placebo groups, respectively, indicating a statistically significant difference (P = 0.0001). Furthermore, throughout the study, no severe side effects were reported by any of the patients. Prostaglandin analogs, particularly latanoprost, have proven to be effective in promoting repigmentation of hypopigmented and depigmented burn scar lesions. When this topical medication is combined with fractional CO2 laser treatment, it enhances the laser's efficacy and overall effectiveness in treating the lesions. This combination is crucial for improving hypopigmented scar treatment by enhancing both the laser's effectiveness in scar improvement and the delivery of latanoprost through the laser. WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? : Hypopigmented burn scars are one of the manifestations of burns that are resistant to treatment. These scars not only cause discomfort for patients but also present a treatment challenge for physicians. In previous studies, latanoprost and bimatoprost, analogs of prostaglandin PGF2a, showed effectiveness in repigmenting vitiligo lesions. However, no study has examined the role of these topical drugs in treating hypopigmented and depigmented burn scars. WHAT DOES THIS STUDY ADD? : The fractional CO2 laser caused significant repigmentation in hypopigmented lesions of burn scars. 64.3% of the patients who received this intervention showed grade 2 improvement (0-24% improvement), 7.1% showed grade 3 improvement (25-49% improvement), and 28.6% showed no improvement (grade 1) in the third follow-up session based on the SGAIS criteria as evaluated by the patients. The combination of CO2 fractional laser and latanoprost caused significant repigmentation in hypopigmented burn scar lesions. 85.7% of patients showed grade 4 improvement (50-74% improvement), and 14.3% showed grade 3 improvement (25-49% improvement) and 0% showed no improvement (grade 1) in the third follow-up session based on the SGAIS criteria as evaluated by the patients. The combination of CO2 fractional laser and latanoprost was significantly more effective than CO2 fractional laser alone based on the SGAIS criteria, as evaluated by physicians and patients in all three follow-up sessions. Additionally, the satisfaction of the patients in the combined treatment group was significantly higher than that of the CO2 fractional laser treatment group.

Study on the efficacy of fractional CO2 laser treatment for vaginal relaxation syndrome combined with recurrent bacterial vaginitis

To investigate the efficacy and mechanisms of fractional CO2 laser treatment for Vaginal Relaxation Syndrome (VRS) combined with recurrent bacterial vaginitis. Patients with VRS and recurrent bacterial vaginitis were randomly assigned to an intervention group (n = 60) receiving fractional CO2 laser therapy in addition to metronidazole, or a control group (n = 60) receiving metronidazole alone. Post-treatment assessments included vaginal relaxation, vaginal health index (VHI) scores, lactobacilli distribution, vaginal pH, recurrence rates, and the correlation between lactobacilli distribution and VHI. (1) Vaginal relaxation improved significantly in the intervention group compared to both pre-treatment and the control group (P = 0.000). (2) VHI scores and lactobacilli distribution improved in both groups post-treatment, with significantly higher scores in the intervention group (P = 0.000). (3) The intervention group exhibited a significantly lower vaginal pH compared to pre-treatment and the control group (P = 0.001). (4) Recurrence rates were significantly lower in the intervention group (8.33%) compared to the control group (36.67%) (P = 0.000). A strong positive correlation was found between lactobacilli distribution and VHI in the intervention group (r = 0.79, P < 0.001). Fractional CO2 laser combined with conventional therapy improves VRS and recurrent bacterial vaginitis outcomes, reduces recurrence, and enhances vaginal microecology.Trial registration: Chinese Clinical Trial Registry, Registration number ChiCTR2400094125.

Energy-based interventions for genitourinary syndrome of menopause: a systematic review of randomized controlled trials and prospective observational studies.

Hormone treatments for genitourinary syndrome of menopause (GSM) symptoms have limitations. There is interest in nonhormone therapies, including energy-based interventions. Benefits and harms of energy-based interventions are not currently well known. The aim of this study was to assess the benefits and harms of energy-based therapies (eg, CO2 laser, Er:YAG laser, and radiofrequency) for GSM. Outcomes of interest are the eight "Core Outcomes in Menopause" and include the following: dyspareunia, vulvovaginal dryness, vulvovaginal discomfort/irritation, dysuria, change in most bothersome symptom, quality of life, treatment satisfaction, and treatment adverse effects. Eligible studies included English language randomized controlled trials (RCT) or prospective observational studies of energy-based treatments with ≥8 weeks follow-up in postmenopausal women with ≥1 GSM symptom and studies of any design reporting adverse effects ≥12 months postintervention. Ovid/MEDLINE, Embase, and CINAHL were searched from inception to December 11, 2023 using vocabulary and natural language terms, along with free-text words. Two authors extracted data and assessed the quality of included studies. We identified 32 unique studies (16 RCT; 1 quasi-RCT; 15 nonrandomized). Ten RCT and the quasi-RCT were rated low to moderate risk of bias (RoB) and underwent data extraction. Included studies evaluated CO2 laser (k = 7), Er:YAG laser (k = 3), or radiofrequency and CO2 laser (k = 1). CO2 laser compared with sham (k = 4) may result in little to no difference in dysuria, dyspareunia, or quality of life (low certainty of evidence [COE]). CO2 laser compared with vaginal conjugated estrogens cream (k = 2) may result in little to no difference in dyspareunia, dryness, discomfort/irritation, dysuria, or quality of life (low COE). Treatment effects on all other outcomes and effects of Er:YAG laser or radiofrequency on any outcome are very uncertain (very low COE). Studies noted few adverse events and no serious adverse events. CO2 laser resulted in little to no difference in outcomes compared with sham or vaginal estrogen; the evidence is very uncertain on the effect of energy-based interventions versus all other comparators for all other outcomes. Adverse event reporting was limited. There is a need for further evidence assessing energy-based interventions.

Dissociation of Macromolecules in Laser-Heated Droplets Monitored by CD-MS.

Charge detection mass spectrometry (CD-MS) is used to monitor the dissociation of large (300 kDa to 20 MDa) protein complexes in droplets heated with a 10.6 μm CO2 laser. In this approach, electrospray ionization (ESI) is used to produce charged droplets containing macromolecular complexes. As the droplets travel from the ESI capillary tip to the entrance of the CD-MS instrument, they pass through a variable-power laser field, where they are rapidly heated and dissociate to produce fragments. The approach is illustrated for three model systems: glutamate dehydrogenase (GDH), a 334 kDa hexameric protein complex, which dissociates into protein monomers, dimers, and tetramers; the ∼3 MDa T = 3, and ∼4 MDa T = 4 hepatitis B virus VLPs (virus-like particles) that produce a distribution of protein dimer clusters; and the ∼20 MDa T = 7 human papillomavirus VLP, which dissociates primarily into small capsid protein clusters that are not well-resolved by CD-MS. The fragments produced by in-droplet activation provide information that is useful for characterizing the structures of the intact antecedent complexes. A discussion of the advantages and current limitations of this approach is presented.

Fractional carbon dioxide laser treatment for refractory exfoliative cheilitis

Fractional carbon dioxide laser treatment for refractory exfoliative cheilitis

Assessing the Long-Term Effectiveness of Fractional CO2 Laser Treatment in Perimenopausal Women with Genitourinary Syndrome of Menopause-Single Center Preliminary Study.

Background: Genitourinary Syndrome of Menopause (GSM) is a prevalent condition in postmenopausal women characterized by symptoms such as vaginal dryness, itching, and urinary tract issues due to declining estrogen levels. Despite its widespread impact on quality of life, GSM often remains underdiagnosed and without effective treatment. Methods: This study assessed the long-term efficacy of fractional CO2 laser treatment in alleviating GSM symptoms in perimenopausal women. The study involved 125 participants, with clinical evaluations conducted using vaginal pH, the Vaginal Health Index Score (VHIS), the Vaginal Maturation Index (VMI), and the Female Sexual Function Index (FSFI). Results: Results indicated significant improvements in these parameters, with pH levels decreasing, VHIS scores rising, and notable gains in VMI and FSFI observed up to 12 months post-treatment. This improvement has been validated through both subjective and objective assessments of GSM. Conclusions: The findings indicate that this method is effective and safe, with no significant side effects reported. However, conducting a long-term observational study on eventual longer protocol for maintaining the positive effect of this therapy should be conducted.

Clinical and histomorphometric evaluation of the vagina following treatment with CO2 laser, radiofrequency, and promestriene for genitourinary syndrome of menopause in breast cancer survivors on adjuvant therapy.

To perform clinical and histomorphometric evaluations of the vagina before and after treatment for genitourinary syndrome of menopause with CO2 laser, fractional radiofrequency, and promestriene in breast cancer survivors using adjuvant endocrine therapy. The study included women experiencing moderate to severe genitourinary syndrome of menopause. Following pre- and post-treatment protocols, participants graded their symptoms on a visual analog scale and underwent a gynecological examination to evaluate the Vaginal Health Index and obtain a vaginal biopsy. Subsequently, they were randomized to laser, radiofrequency, and promestriene groups. The energy groups underwent three consecutive monthly outpatient vulvovaginal treatments, while the control group received promestriene treatment for four months, followed by a post-treatment evaluation. Sixty-two women completed the study protocol (21 laser, 20 radiofrequency, and 21 promestriene). While histological differences (vaginal thickness [p=0.002] and number of stromal papillae [p=0.004]) were observed between the pretreatment samples of tamoxifen and anastrozole users, the symptoms did not differ between them. A decrease in symptom intensity (p<0.05) and an improvement in the Vaginal Health Index (p<0.001) were observed post-treatment, regardless of the type of adjuvant endocrine therapy used. Most pretreatment vaginal samples did not indicate histological atrophy, and no significant histological differences were observed after treatment. No clinical or histological damage was observed. CO2 laser and radiofrequency therapies could be considered alternative treatments for genitourinary syndrome of menopause in breast cancer survivors receiving adjuvant therapy. These treatments promoted significant improvements comparable to those delivered by promestriene, without histological or clinical tissue damage. NCT04081805.

Investigation on control of middle and high-spatial frequency errors of fused silica optics melt polished by CO2 lasers

Investigation on control of middle and high-spatial frequency errors of fused silica optics melt polished by CO2 lasers

Efficacy of CO2 laser with computerized scanner in the treatment of recalcitrant plantar warts: A retrospective case series

Efficacy of CO2 laser with computerized scanner in the treatment of recalcitrant plantar warts: A retrospective case series

Fractional CO2 Laser to Treat Surgical Scars: A System Review and Meta-Analysis on Optimal Timing.

Surgical scars with textural changes can be disfiguring and uncomfortable for patients. Various laser therapies have shown promise in softening and flattening these scars. Therefore, the authors conducted a systematic review and meta-analysis on the efficacy of fractional CO2 laser in treating surgical scars. This study aims to present evidence from controlled trials investigating the efficacy of ablative carbon dioxide fractional laser in treating surgical scars. A literature search of Medline (via PubMed), Ovid, Web of Science, and Embase for relevant trials was conducted before March 2024. After assessing for inclusion, data extraction was performed using Population, Intervention, Comparison, Outcomes and Study criteria (PICOS). Quality, validity, and risk of bias were assessed using the RevMan5.3 risk of bias assessment tool. A total of 14 controlled trials involving 492 participants or postsurgical scars were included in the system review and meta-analysis. Both in RCT and non-RCT settings, fractional CO2 laser therapy exhibited the same efficacious outcomes, with MD values of -0.63 (95% CI: -1.15 to -0.12; I2 = 70%; p = 0.02) and - 1.86 (95% CI: -2.65 to -1.07; I2 = 85%; p < 0.001), respectively. Moreover, furthermore analysis illustrated that initiating FRACTIONAL CO2 LASER treatment sessions at or within 1 month after surgery significantly reduced postoperative scars compared to control groups and groups on treatments initiated more than 3 months after surgery (MD: -1.66; 95% CI: -2.31 to -1.01; I2 = 89%; p < 0.001 and MD: -1.93; 95% CI: -2.24 to -1.62; I2 = 48%; p < 0.001). However, fractional CO2 laser treatment administered over 3 months after surgery did not significantly improve postoperative scars (MD: -0.17; 95% CI: -0.56 to 0.21; I2 = 37%; p = 0.37). The systematic review and meta-analysis provide robust support for the efficacy of fractional CO2 laser in treating surgical scars, particularly when administered at or within 1 month after surgery. One treatment session within 1 month after surgery also can produce significant results, but most clinical trials support 2-3 treatment sessions or more.