Efficacy of 2940 nm Multifractional Er: YAG Lasers in Self-inflicted Razor Blade Incision Scars

Deliberate self-harm (DSH) can be defined as self-inflicted injury without an intention to suicide, and it may result in scar formation with a particular shape.

There is no treatment algorithm for DSH scars, nor is there a gold standard for the treatment of hypertrophic scars. Therefore, we aimed to share our experience with Er: YAG laser treatment of self-inflicted razor blade incision scars.

The study involved 18 patients with DSH scars treated with fractional ablative Er: YAG laser (MCL 31 Asclepion laser Technologies) between 2017 and 2020, with the parameters of 40 J/cm² , 300 µs, and 4 Hz. The sessions were repeated by increasing 10 joules in every session with 4-week intervals until reaching a maximum of 80 joules. The patients were evaluated retrospectively by two different dermatologists in terms of scar improvement over digital photographs taken before and 4 weeks after the treatment. Evaluations have been made based on a 4-point score (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement).

After the third session, 90.9% of the patients showed a moderate improvement. After the fourth session, only 27.2% of the patients had a good, and 63.2% of the patients had a moderate improvement rate.

Er: YAG laser is a safe and effective treatment method for the hypertrophic scars induced by razor blades. Also, we believe that combined treatments with other treatment modalities will provide better results in DSH scars.