The Effectiveness of Early Combined CO2 Ablative Fractional Laser and 595-nm Pulsed Dye Laser Treatment After Scar Revision

Treatment of erythematous acne scars using 595-nm pulsed dye laser combined with 1565-nm ResurFX nonablative fractional laser

BACKGROUND

Acne vulgaris is a common inflammatory disease associated with various sequelae after skin lesion remission. Acne erythema has been considered simple erythema or a vascular lesion; however, because the understanding of this disease has improved, acne erythema is currently considered an early scar with erythematous components.

AIMS

This study evaluated the efficacy of using both a 595-nm pulsed dye laser (PDL) and 1565-nm nonablative fractional laser (NAFL) for the treatment of erythematous scars caused by acne.

METHODS

Ninety patients with acne scars were equally randomized to two groups. Group A (n = 45) received treatment with the NAFL. Group B (n = 45) received treatment with the PDL and NAFL. Each patient underwent one treatment session and 4 weeks of follow-up.

RESULTS

Qualitative (χ2 = 12.415; p < 0.05) and quantitative (t = 2.675; p < 0.05) scores of Groups A and B were determined using a global scarring grading system and exhibited statistically significant differences. The quantitative score of Group A was higher than that of Group B (6.67 ± 3.46 vs. 4.98 ± 2.44). The erythema areas of the groups differed significantly after treatment, with Group B exhibiting more notable score improvements (5.00 [3.10, 7.10] vs. 2.80 [1.65, 4.60]; Z = 3.072; p < 0.05). The erythema regression rate of Group B (88.9%) was significantly higher than that of Group A (66.7%) (χ2 = 20.295; p < 0.001). Adverse events, including redness and swelling (86.6%), scabbing (78.8%), and purpura (36.6%), occurred within 7 days for 86.6% of patients.

CONCLUSIONS

The combined use of the PDL and NAFL is safe and effective for erythematous acne scars.

Advances in Photoelectric Therapy for the Early Intervention and Treatment of Traumatic Scars

Traumatic scar is a disease that affected approximately tens of millions of patients worldwide. According to the histological and morphological properties of scars, the traumatic scar typically includes superficial scar, atrophic scar, hypertrophic scar, and keloid. Its formation is a natural consequence of wound healing, regardless of whether the wound was caused by trauma or surgery. However, the production of scars has considerable impacts on the physical and mental health of patients, even causing substantial aesthetic and functional impairments. Prevention or early treatment of scars is the most suitable therapeutic method, including surgical and non-surgical procedures; nevertheless, the benefits of non-operative therapies for scars are quite limited, and surgical treatments are always hard to achieve satisfying outcomes. Through the application of innovative technologies such as lasers, intense pulsed light, and radiofrequency, significant progress has been made in the treatment of traumatic scars. This review highlights the current advancements of photoelectric therapy for the prevention and treatment of various traumatic scars, which may throw light on innovative therapeutic options for scar therapies.

Optimal Timing of Fractional CO 2 Laser on Cleft Lip Scars: A Single-Blind Randomized Controlled Cohort Study

OBJECTIVE

To determine the optimal time to apply a fractional CO 2 laser for the treatment of postsecondary repair scars in patients with cleft lip.

METHODS

Forty-two patients with linear scarring after cleft lip repair were recruited from November 2021 to October 2022. A single-blind, randomized, controlled cohort study was conducted to examine the impact of fractional CO 2 laser treatment compared with conventional conservative treatment. Thirty patients started laser treatment at 1 month ( n = 10), 3 months ( n = 10), and 6 months ( n = 10) postoperatively, and 12 patients were in the control group. Each patient was treated with high-energy low-density fractional CO 2 laser treatment 3 times at an interval of 1 month. The Vancouver Scar Scale (VSS) was used for scar evaluation to determine vascularity, pigmentation, pliability, and height.

RESULTS

The VSS scores decreased significantly after laser treatment ( p < .05), with the most significant improvement in scars in the group that started treatment 1 month after the surgery.

CONCLUSION

Early postoperative fractional CO 2 laser treatment of cleft lip scars is more effective than later treatment.

Improvement in linear depressed atrophic scar using 755-nm picosecond alexandrite laser vs. ablative fractional carbon dioxide laser

ABBREVIATIONS

AFL = ablative fractional laser, CO₂= carbon dioxide, LiOB = laser-induced optical breakdown, PIH = postinflammatory hyperpigmentation, mVSS = Modified Vancouver scar scale.

Glass-laser in skin resurfacing

Following our survey, we can appreciate that a variety of laser platforms exist to rejuvenate the skin by resurfacing the outer layer of the skin as well as heating the lower layers of the dermis. Based on reliable clinical effectiveness and a limited side effect profile, we can confirm that non-ablative fractionated technologies greatly improve the appearance of lentigines, rhytids, eliminate sun damage, attenuate scarring due to acne and other causes and treat hyper-pigmentation. The Fraxel® (Solta Medical) laser system delivers pulses across a wide range of density and energy levels. We determined that when increasing the pulse energy this led to an increase in thermolysis micro zone (MTZ) depth and width without damaging the surrounding tissue. Due to its performance and various clinical applications, Fraxel® Laser can be optimally considered to be the gold-standard for skin rejuvenation.

Update on management of keloid and hypertrophic scars: A systemic review

Numerous therapeutic strategies have been described for prevention and reduction of hypertrophic scars and keloids, but none of the treatments is effective in all patients. No universal consensus in treatment regimen has been established, and there is limited evidence-based literature to guide the correct management. The process of scar development is complex and requires deeper understanding of the molecular mechanisms that cause their development and recurrences. Despite many available modes of targeting keloid and hypertrophic scars, yet they remain an ongoing challenge to patients and clinicians. To date, no one therapy has been universally accepted as the gold standard for the treatment of all excessive scars nor has the capability of complete scar resolution The search of literature included peer-reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through May 2021 and references of respective articles and only the articles published in English language were included.