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Early intervention: fractional-laser scar treatment

New research suggests that single treatment of a surgical scar with an ablative CO2 fractional laser is not only safe and efficacious, but preferred by patients.

Past studies have shown that early treatment of post-surgical scars with pulsed dye and non-ablative fractional lasers improves scar appearance, but there have been few studies involving ablative fractional lasers similarly used.


Study Methods

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The new research involved 20 subjects between the ages of 20 and 90 who had facial non-melanoma skin cancer. Following Mohs surgery to remove tumors, subjects with a linear scar of 4 cm or greater were enrolled. On the day of suture removal, all subjects had one-half of their scar randomly selected and treated with a 10,600 nm CO2 fractional laser. The untreated half served as a control.

The new research involved 20 subjects between the ages of 20 and 90 who had facial non-melanoma skin cancer. Following Mohs surgery to remove tumors, subjects with a linear scar of 4cm or greater were enrolled. On the day of suture removal, all subjects had one-half of their scar randomly selected and treated with a 10,600nm CO2 fractional laser. The untreated half served as a control.

Independent blinded observers, who had graded each scar half with the Vancouver scar scale (VSS) immediately prior to treatment, evaluated and graded them 12 weeks after treatment. Subjects completed a visual analog scale (VAS) at the same time points.

Study Results

The observers found a significant decrease in VSS in both control and treated halves of the scar. They did not find a statistically significant difference in VSS but did find a statistically significant difference in patient VAS. No side effects of the laser treatment were noted.

“Our study reveals that early intervention of surgical scars with ablative fractional lasing is safe and preferred by patients since it may ‘get the scars better faster,’ ” study author Joseph F. Sobanko, M.D., director of dermatologic surgery education at the University of Pennsylvania’s Perelman School of Medicine, tells Cosmetic Surgery Times. “This is an avenue of research that should be explored further to identify optimal settings for prophylactic scar treatment.”

The study was selected as the Editor’s Choice in the January 2015 issue of Lasers in Surgery and Medicine (LSM).

Reader Reaction: Laser Treatment of Scars

 

Reader Reaction: Laser Treatment of Scars

"VSS was the only observation that was blinded. The patients undoubtedly knew which half of the scars had been treated with the laser and which had not and, therefore, their observations were worthless from a scientific point of view, which is the only point of view that matters here — unless we are going to throw science out the window, in which case you can find much cheaper snake oil than laser ablation. My second point is that the headline of the article is misleading, because, in fact, there was no proven benefit from the procedure."

Thomas Larry Smith, M.D., Alexandria, Va.

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