Synergistic Sequential Emission of Fractional 1540 nm and 10 600 Lasers for Abdominal Postsurgical Scar Management: A Clinical Case Report

Keloid and Hypertrophic Scars Treatment

BACKGROUND

Hypertrophic scars are contained within the site of injury and may regress over time, while keloids spread beyond the borders of the initial injury and do not regress. On histologic examination, hypertrophic scars tend to have collagen in a wavy, regular pattern, whereas keloids have no distinct pattern of collagen.

OBJECTIVE

To retrospectively analyze improvement in keloid and hypertrophic scars characteristics following treatment with Ablative 10600 nm and a non-Ablative 1570 nm Hybrid Laser Device.

METHODS

Treatment parameters with the ProScan Hybrid Mode were 40 W/1.3-1.5 ms for the CO2 and 12 W/4 ms for the 1570 nm in a 1:1 ratio. Outcomes were assessed based on physician scar grading as measured by the Vancouver Scar Scale and patient-reported satisfaction. Excel was used for data analysis, and a p value < 0.05 was considered statistically significant. Adverse events and patient pain were also recorded.

RESULTS

A total of 31 hypertrophic scars and 30 keloid scars were treated. There was a significant reduction in Vancouver Scar Scale scores for both hypertrophic and keloid scars (62% ± 8% and 58% ± 7%; p = 2.6E-17 and p = 8.29E-26, respectively). In a scar-based comparison, a statistically significant difference was observed for all measures reflecting favorable outcomes for hypertrophic scars (VSS, p = 1.1E-05; satisfaction, p = 0.0112; pain, p = 0.00081). Only one adverse event was reported, a superficial burn treated with topical antibiotics.

CONCLUSIONS

The device was found to be safe and effective, with promising results for the treatment of hypertrophic and keloid scars.

LEVEL OF EVIDENCE II

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Fractional CO₂ Laser Therapy for Effective Treatment of Facial Traumatic Hypertrophic Scar: A Case Report

BACKGROUND Hypertrophic scars occur when there is an excessive wound-healing response in the skin. Fractional, or fractionated, carbon dioxide (CO₂) laser therapy uses narrow shafts of light to smooth the skin surface and stimulate dermal collagen, which tightens the skin. This case report describes a 57-year-old woman with a traumatic hypertrophic scar of the face treated with fractional carbon dioxide laser therapy. The purpose of this case report was to highlight the role of fractional CO₂ laser therapy in treatment of a facial traumatic hypertrophic scar in a patient after a motor vehicle crash. CASE REPORT A 57-year-old female patient presented with a hypertrophic, rigid, post-traumatic scar on the left side of her face following a motor vehicle crash. For the hypertrophic scar removal, the patient underwent 1 treatment session with fractional CO₂ laser using the µ-Scan DOT scanning system. After 1 laser treatment session, the photographic documentation, which permits monitoring the treatment's effectiveness in esthetic improvement, showed a significant improvement in scar texture and color. In addition, a significant reduction in scar height was observed following laser therapy. Fractional laser treatment with the device was very well tolerated by the patient, who reported no pain or discomfort, complications, or adverse effects either during treatment or in the follow-up period (3 months). CONCLUSIONS This report demonstrates the cosmetic application of fractional carbon dioxide laser therapy in a case of hypertrophic scar with the use of an effective therapeutic protocol that did not require the use of suturing.

Striae distensae treatment: evaluating laser efficacy and safety

BACKGROUND

Striae distensae (SD) are common skin lesions that are difficult to treat and affect quality of life. Laser and light are emerging non-invasive therapies that have proven successful in treating SD. Recently, hybrid laser devices offering simultaneous fractional ablative and non-ablative laser treatment have been reported to benefit various skin conditions.

OBJECTIVE

To evaluate the improvement of SD treated with a hybrid laser system and to analyze associations with patient characteristics.

METHODS

We performed a retrospective study in which 28 adults with SD were treated with a hybrid laser device. Efficacy was evaluated by the assessment of aesthetic improvement by the Global Aesthetic Improvement Scale (GAIS) of 1-10 and by patients' satisfaction using a scale of 0-10 satisfaction scale. Pain and adverse events were monitored. Statistical analysis was used to examine the potential impact of various factors on treatment outcomes.

RESULTS

The mean GAIS score was 7.36 ± 1.06 with a positive correlation with patient satisfaction (r = 0.685) and a weak negative correlation with patient age (r = -0.0057). Skin type and body area did not show significant associations with GAIS scores (P > 0.05 for both). No adverse events were observed.

CONCLUSION

This study demonstrates the potential of the hybrid laser system as a safe and effective method to achieve satisfactory aesthetic results with minimal downtime, making it a promising treatment approach for SD. Treatment outcomes were independent of patient characteristics, further supporting its widespread use.

Efficacy and Safety of Carbon Dioxide Laser System in the Treatment of Scalp Sebaceous Adenoma With the Use of a New Scanner Unit

Sebaceous adenoma (SA) is a rare solitary tumor that preferentially affects the forehead and scalp. The objective of this case report was to determine the efficacy and safety of a 10,600-nm carbon dioxide (CO2) laser device in the treatment of large scalp SA, using a new scanning system which allows to speed up the removal of the lesion. A 65-year-old male with SA on the scalp area underwent one session with the CO2 laser system. For this procedure, a new scanner system with 7-inch or 4-inch focal handpieces were used. A local anesthesia with lidocaine was performed before laser treatment. Some possible side effects such as dyschromia, burning sensation, bleeding and mild to moderate post-treatment erythema, itching, crusting, and edema, were checked. In order to monitor the effectiveness of the treatment, clinical photos that documented the patient lesion were captured before treatment and at 1 month of follow-up. The clinical and aesthetic results observed after laser procedure were excellent, with a complete remission of patient's scalp SA lesion at 4 weeks' follow-up. Patient satisfaction was very high, and no side effects were observed. This laser system technology allows for precise, effective, and targeted action on the lesions treated while simultaneously protecting the surrounding areas, ensuring the best possible re-epithelialization.

Clinical Evaluation and Experience in Treatments Performed with Fractional CO2 Laser on Latin American Skin: An Observational Retrospective Study

Background: The carbon dioxide (CO₂) laser is an ablative system that evaporates, remodels, and coagulates tissues, becoming therefore a gold standard piece of equipment for the treatment of dermatological pathologies and esthetic imperfections. Objective: To evaluate the efficacy and safety of CO₂ laser treatments in different patients' skin pathologies. Methods: A total of 705 patients with an age range between 18 and 70 years, with phototypes on the Fitzpatrick scale III, IV, V, and VI, were enrolled from October 2021 to May 2022, and were treated using the CO₂ laser system. Results: Ninety-six patients were treated with fractional CO₂ laser, used for skin rejuvenation and stretch marks. One patient presented reactivation of herpes simplex, 10 postinflammatory hyperpigmentation that resolved after 3 months with depigmenting agents, 6 with persistent erythema. A total of 13 patients with rhinophyma were treated, and no complications were observed; a total of 64 patients with wrinkles were treated. They improved in 6 months. A total of 340 patients were treated for seborrheic keratosis, papulosa nigra dermatosis, fibropapillomas, sebaceous hyperplasias, verruca vulgaris, and condylomata acuminata. One patient presented with a complication hypopigmented macule. A total of 136 patients underwent treatment for laser ablation of intradermal nevi and verrucous epidermal nevi, without complications. A total of 56 patients were treated with keloids and hypertrophic scars. One patient presented with ulceration of a keloid that resolved with the application of clostridiopeptidase A and chloramphenicol after 2 weeks. Conclusions: The use of the CO₂ laser in any phototype and race, which are factors with a high incidence in Latin America, provides a safe and effective result for different dermatological pathologies.