Ablative fractional laser treatment of hypertrophic burn and traumatic scars: a systematic review of the literature

Buhalog, Brittany; Moustafa, Farah; Arkin, Lisa M.; Lee, Kachiu C.; Siwy, Katherine; Donelan, Matthias B.; Hultman, C. Scott; Shumaker, Peter R.

doi:10.1007/s00403-020-02135-5

Cited by 16 publications

(9 citation statements)

References 37 publications

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“…[46][47][48] Fractional ablative laser for treatment of acne scars results in 26% to 83% improvement in appearance 46 and has been used in patients with FST I-V. A review of FAL treatment for hypertrophic scars also showed significant improvement in 22 of the 23 studies, with adverse events noted in 2.54% of treatments, which included skin discoloration, erythema, and blistering. 48 Erythema and edema are expected during the first week. Erythema intensity is proportional to density and energy used and typically resolves after 3 to 14 days.…”

Section: Discussionmentioning

confidence: 99%

“…Fractional ablative laser is used alone or in conjunction with topical chemicals for treatment of atrophic acne scars, rhytids, traumatic and hypertrophic scars, and skin laxity. [46][47][48] Fractional ablative laser for treatment of acne scars results in 26% to 83% improvement in appearance 46 and has been used in patients with FST I-V. A review of FAL treatment for hypertrophic scars also showed significant improvement in 22 of the 23 studies, with adverse events noted in 2.54% of treatments, which included skin discoloration, erythema, and blistering. 48 Erythema and edema are expected during the first week.…”

Section: Discussionmentioning

confidence: 99%

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Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations

et al. 2022

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BACKGROUND Lasers and energy-based devices (EBD) are popular treatments for skin rejuvenation and resurfacing. Achieving desired outcomes and avoiding complications require understanding the effects of these devices at a histologic level. Currently, no comprehensive review summarizing the histologic effects of laser and energy-based treatments exists. OBJECTIVE To describe how lasers and EBD alter skin histology and improve the overall understanding of these devices. MATERIALS AND METHODS A PubMed search was conducted for studies with histologic analysis of fractional picosecond laser, fractional radiofrequency microneedling, nonablative lasers, and ablative lasers. RESULTS Fractional picosecond lasers induce intraepidermal and/or dermal vacuoles from laser-induced optical breakdown. Fractional radiofrequency microneedling delivers thermal energy to the dermis while sparing the epidermis, making it safer for patients with darker skin phototypes. Fractional nonablative lasers induce conical zones of coagulation of the epidermis and upper dermis. Ablative lasers vaporize the stratum corneum down to the dermis. Traditional ablative lasers cause diffuse vaporization while fractional ablative lasers generate columns of tissue ablation. CONCLUSION Lasers and EBD are effective for skin resurfacing and rejuvenation and have different mechanisms with disparate targets in the skin. Safe and effective use of devices requires understanding the histologic laser-tissue interaction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations

et al. 2022

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“…According to IGA and PGA, 13.43% & 41.78% of scars had >50% improvement, respectively. Various types of outcome assessment parameters have been used earlier in the literature making comparison between the studies difficult 2 …”

Section: Discussionmentioning

confidence: 99%

Factors affecting the outcome of fractional carbon dioxide laser resurfacing of various types of scars in skin of color

Kaur

Rupla

Dinesh

et al. 2021

J of Cosmetic Dermatology

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Background Fractional laser resurfacing has been used widely in management of scars. However, data for post‐traumatic and post‐burn scar are limited in skin of color. Aims This retrospective study assessed the efficacy of fractional ablative carbon dioxide laser in treatment of various types of scars other than acne scars. We also tried to find out the effect of different factors like skin type, duration, shape, location, and color of the scars on the outcome. Materials and methods Forty‐two patients with 67 scars including post‐traumatic (43), post‐burn (15), post‐surgical (5), and post‐folliculitis (5) scars treated during 2019–2020 were analyzed. The improvement was graded according to investigator and patient global assessment (IGA & PGA) through percentage improvement and quartile scale. Results Overall, there was 45.4% and 32.7% of improvement according to PGA and IGA, respectively. Scars with >50% improvement were recorded in 13.43% of the scars with IGA and 41.78% with PGA. Early scars, scars without hyperpigmentation, lighter skin type, post‐traumatic scars had better results. There was no significant difference for other parameters like atrophic versus hypertrophic, facial versus extra facial, linear versus non‐linear, or the number of sessions. Conclusion Fractional carbon dioxide laser efficacious for non‐acne facial and extra facial scars in the skin of color. Early intervention could yield more satisfactory results.

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“…The ablative 2940 nm Er:YAG and 10 600 nm CO 2 lasers have been used in treating various types of scars. However, due to adverse effects such as edema, erythema, dyspigmentation, and significant downtime, a search for a better alternative continues 10–14 . One of the options to reduce the downtime and risk for side effects is to use a non‐ablative wavelength and fractional delivery.…”

Section: Introductionmentioning

confidence: 99%

“…However, due to adverse effects such as edema, erythema, dyspigmentation, and significant downtime, a search for a better alternative continues. 10 , 11 , 12 , 13 , 14 One of the options to reduce the downtime and risk for side effects is to use a non‐ablative wavelength and fractional delivery. In recent years, new studies have shown that the fractional Q‐switched (nanosecond and picosecond) laser can be highly effective in the treatment of acne scars and other indications with minimal side effects.…”

Section: Introductionmentioning

confidence: 99%

Acne scar treatment using high‐energy fractional nanosecond Q‐switched 1064 nm laser

Mani

Zorman²

2021

J of Cosmetic Dermatology

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Acne vulgaris is one of the most common skin diseases; it will affect one out of two people in their lifetimes and about 80% of people aged between 11 and 30 years. [1][2][3] Acne scarring, a common complication, develops to some degree in the majority of acne sufferers. 4 Scars are divided into three general categories: ice-pick scars, rolling scars, and boxcar scars 5 and are a result of excessive inflammation, acne severity, physical manipulation of the skin, and a delay in seeking adequate treatment. 3 It affects people both physically and emotionally worldwide, regardless of sex, age, and ethnicity. 2,6 There is also a negative societal perception of acne scars. 7 Unfortunately, many cases of acne remain untreated or are treated sub-optimally, and patients that later develop acne scarring often need acne scarring treatment. None of the currently available treatments achieve a complete resolution of scars, and thus, prevention of scarring by early and aggressive acne treatment is the best option. 8 There are many different treatment modalities for acne scarring, such as chemical peeling, retinoids, dermabrasion, microneedling, subcision, surgical excision, dermal fillers, platelet-rich plasma (PRP), and different energy-based devices. Evidently, a combination of various treatment modalities gives better results than monotherapy. 8,9 Energy-based devices, such as intense pulsed light (IPL), radiofrequency, and lasers, have gained popularity as part of the scar treatment arsenal in recent years. The ablative 2940 nm Er:YAG and 10 600 nm CO 2 lasers have been used in treating various types of scars. However, due to adverse effects such as edema, erythema, dyspigmentation,

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Ablative fractional laser treatment of hypertrophic burn and traumatic scars: a systematic review of the literature

Cited by 16 publications

References 37 publications

Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations

Review of Lasers and Energy-Based Devices for Skin Rejuvenation and Scar Treatment With Histologic Correlations

Factors affecting the outcome of fractional carbon dioxide laser resurfacing of various types of scars in skin of color

Acne scar treatment using high‐energy fractional nanosecond Q‐switched 1064 nm laser

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