A comparative clinical and histopathological pilot study of different fractional CO₂ laser parameters in treatment of atrophic linear scars

Abstract

Background: Atrophic scars cause significant patient morbidity. Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different etiologies. Aims: To assess the efficacy and safety of different fractional ablative CO 2 laser parameters in treatment of linear atrophic depressed post-traumatic facial scars in adult male patients. Methods: A prospective pilot study of 20 adult male patients (skin types Π-Ⅳ, aged 18-45) with post-traumatic atrophic linear scars were divided into 2 groups each comprising 10 patients receiving different fractional CO 2 laser parameters. Both groups received 3 laser sessions, one month apart, and were followed for 2 months after the last treatment session. Clinical and histological assessments were done to all patients before treatment and 2 months after the last treatment session. Also, patient satisfaction and side effects were recorded. Results: The study showed statistically significant reduction in average scar volume in both groups (P < .01), with reduction in depth more obvious than reduction in width or length in both groups. There was a highly significant difference in overall scar improvement represented by scar volume between both groups (P < .01) with an average reduction in scar volume of 42.85% in group (a) compared with 35.29% in group (b). Also, there was a highly statistically significant increase in both epidermal and papillary and reticular dermis thickness in both groups after treatment. However, the difference between both groups was nonsignificant. Side effects were mild, well tolerated, and transient. Conclusion: Fractional CO 2 laser can be utilized as a safe and effective modality in treatment of post-traumatic linear atrophic scars of the face. Adjusting parameters toward increasing depth of penetration and decreasing thermal coagulative effect gives better results.

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“…Their results showed better improvement compared to our results that may be due to more treatment sessions per scar (6 sessions versus 3 in our research) and a longer period of follow up. In agreement with Rasheed et al [21] , who evaluated 20 male participants, with linear atrophic post-traumatic facial scarring and classified into two groups, to determine the effectiveness and safety of fractional CO 2 in treating these scarring with different parameters between the two treated groups. Their participants received three treatments sessions, each spaced out by four weeks.…”