Residual Scarring From Hidradenitis Suppurativa: Fractionated CO2 Laser as a Novel and Noninvasive Approach

Abstract

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin condition that can have a significant psychosocial impact, both with the active disease and with residual scarring. Although a wide variety of treatment options exist for HS, to our knowledge there are no reported modalities aimed specifically at treating HS scarring. We describe the case of an adolescent female who received medical management of intramammary HS followed by successful treatment with fractionated 10 600-nm carbon dioxide laser for her residual cribriform scarring. We believe there is great potential for the use of fractionated carbon dioxide laser to improve short- and long-term psychosocial outcomes of HS, promote physical scar remodeling, and possibly alter the disease process itself.

Hidradenitis suppurativa in children: The Henry Ford experience

“…Pediatric cases of HS are rare and often demonstrate endocrine aberrancy. Hidradenitis suppurativa has been reported in an infant with congenital adrenal hyperplasia, an obese girl younger than 8 after premature adrenarche, an obese prepubertal 8‐year‐old girl, and a 15‐year‐old girl with polycystic ovary syndrome .…”

Rapid healing of chronic ulcerations and improvement in range of motion after fractional carbon dioxide (CO2) treatment after CO2 excision of hidradenitis suppurativa axillary lesions: A case report

“…Recently, Krakowski et al 10 reported a case of a pediatric patient whose HS was controlled with medical management. However, she experienced psychological distress over the appearance of cribriform scarring in the inframammary region.…”

“…The scarring was treated with 2 sessions of fractional CO 2 laser separated by 2 months, which resulted in reduced erythema, improved texture, pliability, and appearance of the scar. 10 …”

Healing of chronic wounds with adjunctive ablative fractional laser resurfacing in two pediatric patients

“…Efficacy for AFR has been reported in a variety of dermatologic conditions in the pediatric population including scars related to hidradenitis suppurativa and burn scar‐related nail dystrophy, palliative treatment of lymphangioma circumscriptum, and for the fibro‐ fatty residua seen after involution of infantile hemangiomas . AFR employs high energy, short duration pulses from a 2,940‐nm or 10,600‐nm laser to vaporize tissue in a pixelated pattern at a depth and density determined by the operator .…”