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Patient- and Physician-Reported Outcome of Combined Fractional CO2 and Pulse Dye Laser Treatment for Hypertrophic
Insights
Combined laser therapy effectively treats pediatric hypertrophic scars, reducing pain and itching. This treatment is safe and well-tolerated by children, with minimal complications when administered by experienced teams.
Area of Science:
- Dermatology
- Pediatric Surgery
- Aesthetic Medicine
Background:
- Hypertrophic scars are common in children, causing pain, itching, and disfigurement.
- Ablative fractional CO2 and pulse dye laser therapies show promise for scar improvement.
- Limited data exist on laser treatment outcomes in pediatric patients, especially for non-burn scars and patient-reported results.
Purpose of the Study:
- To evaluate the safety and efficacy of repeated laser therapy for pediatric hypertrophic scars.
- To assess outcomes using patient- and physician-reported measures.
- To investigate scars resulting from burns and other causes.
Main Methods:
- Retrospective before-after analysis of laser treatments in pediatric patients.
- Outcome assessment using Patient and Observer Scar Assessment Scale, Vancouver Scar Scale, and Itch Man Scale.
- Analysis of laser- and anesthesia-related complications.
Main Results:
- Seventeen children with 27 scars received 102 laser treatments, primarily combined CO2 and pulse dye laser.
- Significant reduction in Vancouver Scar Scale and Patient and Observer Scar Assessment Scale scores post-treatment.
- Significant improvement in pruritus; no impact of patient age or timing on response.
- Low complication rates: 2% for laser treatment (wound infection) and 4% for anesthesia.
Conclusions:
- Combined laser therapy significantly enhances the quality of pediatric hypertrophic scars, alleviating pain and pruritus.
- The treatment demonstrates a favorable safety profile with a low incidence of complications.
- Experienced laser and anesthesia teams ensure safe and effective management of pediatric hypertrophic scars.
Background:
Hypertrophic scars are commonly seen in children and associated with pruritus, pain, functional impairment, and aesthetic disfigurement. Ablative fractional CO2 and pulse dye laser are emerging techniques to improve scar quality. Only limited data are available on children, nonburn scars, and patient-reported outcome. We aimed to investigate safety and outcome of repeated laser therapy for hypertrophic scars originating from burns and other conditions by means of patient- and physician-reported outcome measures.
Methods:
This was a retrospective before-after analysis of laser treatments in children with hypertrophic scars. Outcome was measured using Patient and Observer Scar Assessment Scale, Vancouver Scar Scale and Itch Man Scale. With respect to safety, laser- and anesthesia-related complications were analyzed.
Results:
Seventeen patients, aged 11.37 ± 4.82 years with 27 scars, underwent 102 distinct laser treatments, mainly combined CO2 and pulse dye laser (94%), with few CO2 only (6%). Vancouver Scar Scale total score before the first and after the first session decreased significantly from 7.65 ± 2.12 to 4.88 ± 1.73; Patient and Observer Scar Assessment Scale observer overall opinion also dropped from 5.88 ± 1.57 to 4.25 ± 1.70. Pruritus improved significantly. Patient age and timing of laser intervention did not have an impact on treatment response. Complications related to laser treatment were seen in 2% (wound infection, n = 2) and to anesthesia in 4% (insignificant n = 2, minor n = 1).
Conclusions:
Combined laser therapy significantly improves quality, pain, and pruritus of hypertrophic scars in children. When provided by experienced laser and anesthesia teams, it is safe with a low rate of complications.
