Prevention of unfavorable scars using early pulse dye laser treatments: a preliminary report

Hypertrophic scarring occurs frequently in the trunk and extremities, and sporadically in other areas even under favorable circumstances. Unfortunately, the existing methods of scar manipulation have not been effective in preventing these unfavorable scars. Established hypertrophic scars have been treated by Anderson and Parrish, Alster, and others using the 585-nm pulse dye laser. The current study is the first report of prevention of hypertrophic scarring using the 585-nm pulse dye laser in a large group of elective and traumatic incisions. Treatment within the first few weeks resulted in faster resolution of scar stiffness and erythema, and less frequent development of hypertrophic scarring. An unexpected finding was the substantial improvement in the quality of scarring in all areas of the body, attributed to the excellent color match of the treated scars. These observations suggest that early pulse dye laser treatments can change fundamentally the physiology of wound healing if applied in the early phases. This report provides the first clinical correlation between prophylactic laser reduction of scar microcirculation and prevention of excessive scar formation.