Clinical efficacy of the fractional ablative CO₂ laser stacking method for depressed scars

Depressed scars, which are unsightly outcomes of trauma or skin lesions, can lead to significant physical and mental stress. Various treatments have been developed to alleviate these burdens, among which the laser stacking method has proven effective. In this study, we compared the outcomes of laser stacking treatments with those of single-pulse ablative laser treatments for depressed scars. Eighty patients with depressed scars were divided into two therapeutic groups: the ablative laser stacking therapy group (Group 1, n = 40) and the single pulse ablative laser therapy group (Group 2, n = 40). The scars were evaluated using the modified Vancouver Scar Scale (mVSS) before and after treatment. Patient-completed questionnaires were also utilized. Comparative analyses were conducted both before and after treatment, as well as between the two groups. Eighty scars from each patient underwent the complete laser treatment protocols. Group 1 showed significantly greater improvement in the mVSS indices for pigmentation, vascularity, pliability, and height than group 2 (P < 0.05). In terms of patient-reported outcomes, group 1 rated better than group 2 across three indices: appearance, alleviation of concavity, and overall improvement (P < 0.05). Ablative laser stacking therapy effectively alleviated depressed scars, demonstrating significant improvement in both observer- and patient-reported outcomes. An energy level of 20-30 mJ was employed, resulting in more favorable outcomes compared to a single pulse laser application of 10-15 mJ. Our findings highlight the benefits of the stacking method, which shows notable improvements while minimizing complications. Further research involving various protocols may optimize clinical outcomes and patient satisfaction.