Non-ablative 1927 nm Fractional Thulium Laser With Bimatoprost to Treat a Hypopigmented Burn Scar

Hypopigmented scars present a cosmetic and psychological burden, especially in patients of darker skin types. Novel strategies to restore pigment are limited and often ineffective. A 48-year-old woman presented with a complaint of hypopigmented burn scars on both arms. Two months prior, the patient received an intense pulsed light (IPL) treatment at a medical spa. At her initial consultation, she was prescribed Ruxolitinib (a Janus Kinase (JAK) inhibitor) 1.5% (Opzelura) cream to use each morning and tacrolimus 0.1% ointment (a calcineurin inhibitor) to use every night. After six weeks of applying topicals, she then received two non-ablative 1927 nm fractional thulium laser treatments with bimatoprost 0.03% ophthalmic solution (Latisse) six weeks apart while continuing her topical routine at home. After 18 weeks of treatment, most of the patient's pigment had returned. The laser created micro-channels for enhanced topical absorption, while the topical agents reduced inflammation and promoted melanogenesis. This combination offers a promising, non-invasive treatment for hypopigmented burn scars.