Study on different fractional CO₂ laser parameters combined with halometasone in treatment of chronic eczema

This prospective study aimed to investigate the efficacy and safety of fractional CO₂ laser with different parameters, in combination with topical halometason, for the management of chronic eczema. Each lesion of the patients were divided into four groups and given fractional CO₂ laser treatment with different parameter and a negative control. After treatment, all four groups were treated with topical halometasone cream once daily for a week. The modified Eczema Area and Severity Index (mEASI) scores were evaluated before treatment, 1-week post-treatment and 4-weeks post-treatment respectively. Numerical rating scale was used to assess the pain degree during the treatment and other adverse reaction were recored. The results suggest that the efficacy of CO₂ fractional laser combined with halometasone cream in the treatment of chronic eczema is better than that of halometasone treatment alone. The efficacy at 4 weeks after treatment was better than at 1 week after treatment. The efficacy varied depending on the laser parameters used. In group B (30 mJ) and group C (50 mJ) with the same spot spacing (0.6 mm), the higher energy group showed faster onset and better efficacy at 1 week post-treatment. However, at 4 weeks, both groups exhibited similar efficacy but the higher-energy group experienced more pain. In group A (1.0 mm) and group B (0.6 mm) with the same energy parameter (30 mJ), dot spacing had little effect on the efficacy at 1 week after treatment. At 4 weeks, the group with smaller dot spacing (0.6 mm) showed better long-term efficacy. This study suggests that the clinical application of CO₂ fractional laser treatment for chronic eczema requires careful selection of therapeutic parameters, and the recommended parameters from this study are 30 mJ energy, 0.6 mm dot spacing, but further research is warranted to confirm these findings.