Fractional CO₂ Laser (SCAR3 Scanner) for a Hypertrophic Retracting Cleft Lip Scar: A Case Report

BACKGROUND Scars, particularly those that are hypertrophic and retracting, are a major difficulty in dermatological and plastic surgery. Laser therapy offers a versatile approach to managing hypertrophic lip scars, addressing aspects of scar tissue, such as vascularity and collagen. CASE REPORT This case report describes a 43-year-old woman treated for a hypertrophic, retracting lip scar using fractional CO₂ laser (10 W, 1500 µs dwell time, D-pulse, 500 µm spacing, stack 1, double pass). Two sessions, 56 days apart, led to marked aesthetic and psychosocial improvement without complications. Post-treatment care included 7 days of antibiotic ointment, followed by sun protection and nightly silicone gel. Images were captured before and after the second treatment. During the procedure, the patient reported a perceived pain level of 3 on a scale of 1 to 5, indicating a moderate and tolerable level of discomfort. The Modified Vancouver Scar Scale (mVSS) chart indicated an overall improvement in scar characteristics, especially in pliability, vascularity, and pigmentation, with minimal changes in height; pain and pruritus levels remained unchanged from before the therapy. After treatments, the patient expressed extreme satisfaction with the results achieved. She reported being "extremely content and satisfied" with the improvement in her scar after laser treatment. No significant adverse effects were observed. The estimated reduced daily activity time was approximately 1 week after each session, with normal activities resumed shortly thereafter. CONCLUSIONS This case highlights the potential of CO₂ laser treatment in managing a complex hypertrophic and retracting scar, leading to notable esthetic improvement and a positive impact on the patient's emotional well-being.