Skip to main content
Erschienen in: Lasers in Medical Science 7/2017

12.08.2017 | Original Article

Evaluation of nonablative fractional laser treatment in scar reduction

verfasst von: Hilal Gokalp

Erschienen in: Lasers in Medical Science | Ausgabe 7/2017

Einloggen, um Zugang zu erhalten

Abstract

Fractional lasers have been used for the improvement of scar tissue in the recent years but there has not been extensive research on their impact. The purpose of this study was to evaluate the efficacy of nonablative fractional laser (NAFL) on acne, burn, and surgery/traumatic scar. The scars were also categorized as atrophic, hypertrophic, and keloid, and treatment efficacy was investigated accordingly. This is a retrospective, single-center study. Scar tissues were treated using a nonablative fractional 1550-nm Erbium glass laser in high-energy parameters at 4-week interval for 4–8 sessions. The scar regression score (SRS) was used to determine the decrease in scar appearance. Forty-six patients with acne (n:18), burn (n:13), or surgery/traumatic (n:15) scar were included. The number of sessions was higher for burn patients while SRS in burn patients was lower than in patients with acne or a surgical/traumatic scar. Evaluation according to scar types showed that atrophic scars had a significantly better response to NAFL treatment. This study indicates that NAFL treatment with the high-energy parameters has better outcomes in atrophic acne scars, while the success rate is considerably low in post-burn and keloid scars.
Literatur
2.
Zurück zum Zitat Dreno B, Khammari A, Orain N, Noray C et al (2007) ECCA grading scale: an original validated acne scar grading scale for clinical practice in dermatology. Dermatology 214:46–51CrossRefPubMed Dreno B, Khammari A, Orain N, Noray C et al (2007) ECCA grading scale: an original validated acne scar grading scale for clinical practice in dermatology. Dermatology 214:46–51CrossRefPubMed
3.
Zurück zum Zitat Alster TS, Handrick C (2000) Laser treatment of hypertrophic scars, keloids, and striae. Semin Cutan Med Surg 19:287–292CrossRefPubMed Alster TS, Handrick C (2000) Laser treatment of hypertrophic scars, keloids, and striae. Semin Cutan Med Surg 19:287–292CrossRefPubMed
4.
Zurück zum Zitat Cohen BE, Brauer JA, Geronemus RG (2016) Acne scarring: a review of available therapeutic lasers. Lasers Surg Med 48:95–115CrossRefPubMed Cohen BE, Brauer JA, Geronemus RG (2016) Acne scarring: a review of available therapeutic lasers. Lasers Surg Med 48:95–115CrossRefPubMed
5.
Zurück zum Zitat Fife D (2016) Evaluation of acne scars: how to assess them and what to tell the patient. Dermatol Clin 34:207–213CrossRefPubMed Fife D (2016) Evaluation of acne scars: how to assess them and what to tell the patient. Dermatol Clin 34:207–213CrossRefPubMed
6.
Zurück zum Zitat Sardana K, Manjhi M, Garg VK, Sagar V (2014) Which type of atrophic acne scar (ice-pick, boxcar, or rolling) responds to nonablative fractional laser therapy? Dermatol Surg 40:288–300CrossRefPubMed Sardana K, Manjhi M, Garg VK, Sagar V (2014) Which type of atrophic acne scar (ice-pick, boxcar, or rolling) responds to nonablative fractional laser therapy? Dermatol Surg 40:288–300CrossRefPubMed
7.
Zurück zum Zitat Berman B, Maderal A, Raphael B (2017) Keloids and hypertrophic scars: pathophysiology, classification, and treatment. Dermatol Surg 43:3–18 Berman B, Maderal A, Raphael B (2017) Keloids and hypertrophic scars: pathophysiology, classification, and treatment. Dermatol Surg 43:3–18
8.
Zurück zum Zitat Ogawa R, Ono S, Akaishi S, Dohi T et al (2016) Reconstruction after anterior chest wall keloid resection using internal mammary artery perforator propeller flaps. Plast Reconstr Surg Glob Open 4:1049CrossRef Ogawa R, Ono S, Akaishi S, Dohi T et al (2016) Reconstruction after anterior chest wall keloid resection using internal mammary artery perforator propeller flaps. Plast Reconstr Surg Glob Open 4:1049CrossRef
9.
Zurück zum Zitat Anthonissen M, Daly D, Janssens T, Van den Kerckhove E (2016) The effects of conservative treatments on burn scars: a systematic review. Burns 42:508–518CrossRefPubMed Anthonissen M, Daly D, Janssens T, Van den Kerckhove E (2016) The effects of conservative treatments on burn scars: a systematic review. Burns 42:508–518CrossRefPubMed
10.
Zurück zum Zitat Manstein D, Herron GS, Sink RK, Tanner H et al (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438CrossRefPubMed Manstein D, Herron GS, Sink RK, Tanner H et al (2004) Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 34:426–438CrossRefPubMed
11.
Zurück zum Zitat Saedi N, Petelin A, Zachary C (2011) Fractionation: a new era in laser resurfacing. Clin Plast Surg 38:449–461CrossRefPubMed Saedi N, Petelin A, Zachary C (2011) Fractionation: a new era in laser resurfacing. Clin Plast Surg 38:449–461CrossRefPubMed
12.
Zurück zum Zitat Carniol PJ, Hamilton MM, Carniol ET (2015) Current status of fractional laser resurfacing. JAMA Facial Plast Surg 17:360–366CrossRefPubMed Carniol PJ, Hamilton MM, Carniol ET (2015) Current status of fractional laser resurfacing. JAMA Facial Plast Surg 17:360–366CrossRefPubMed
13.
Zurück zum Zitat Naouri M, Atlan M, Perrodeau E, Georgesco G et al (2011) High-resolution ultrasound imaging to demonstrate and predict efficacy of carbon dioxide fractional. Dermatol Surg 37:596–603CrossRefPubMed Naouri M, Atlan M, Perrodeau E, Georgesco G et al (2011) High-resolution ultrasound imaging to demonstrate and predict efficacy of carbon dioxide fractional. Dermatol Surg 37:596–603CrossRefPubMed
14.
Zurück zum Zitat Finlay V, Burrows S, Kendell R, Berghuber A et al (2017) Modified Vancouver Scar Scale score is linked with quality of life after burn. Burns 43:741–746CrossRefPubMed Finlay V, Burrows S, Kendell R, Berghuber A et al (2017) Modified Vancouver Scar Scale score is linked with quality of life after burn. Burns 43:741–746CrossRefPubMed
15.
Zurück zum Zitat Duncan JA, Bond JS, Mason T, Ludlow A et al (2006) Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg 118:909–918CrossRefPubMed Duncan JA, Bond JS, Mason T, Ludlow A et al (2006) Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg 118:909–918CrossRefPubMed
16.
Zurück zum Zitat Bijlard E, Uiterwaal L, Kouwenberg CA, Mureau MA et al (2017) A systematic review on the prevalence, etiology, and pathophysiology of intrinsic pain in dermal scar tissue. Pain Physician 20:1–13PubMed Bijlard E, Uiterwaal L, Kouwenberg CA, Mureau MA et al (2017) A systematic review on the prevalence, etiology, and pathophysiology of intrinsic pain in dermal scar tissue. Pain Physician 20:1–13PubMed
17.
Zurück zum Zitat Akaishi S, Ogawa R, Hyakusoku H (2008) Keloid and hypertrophic scar: neurogenic inflammation hypotheses. Med Hypotheses 71:32–38CrossRefPubMed Akaishi S, Ogawa R, Hyakusoku H (2008) Keloid and hypertrophic scar: neurogenic inflammation hypotheses. Med Hypotheses 71:32–38CrossRefPubMed
18.
19.
Zurück zum Zitat Waibel J, Wulkan AJ, Lupo M, Beer K et al (2012) Treatment of burn scars with the 1,550 nm nonablative fractional erbium laser. Lasers Surg Med 44:441–446CrossRefPubMed Waibel J, Wulkan AJ, Lupo M, Beer K et al (2012) Treatment of burn scars with the 1,550 nm nonablative fractional erbium laser. Lasers Surg Med 44:441–446CrossRefPubMed
20.
Zurück zum Zitat Morton LM (2014) The evolution of laser surgery for acne and other scarring processes. Semin Cutan Med Surg 33:169–175CrossRefPubMed Morton LM (2014) The evolution of laser surgery for acne and other scarring processes. Semin Cutan Med Surg 33:169–175CrossRefPubMed
21.
Zurück zum Zitat Tan JK (2004) Psychosocial impact of acne vulgaris: evaluating the evidence. Skin Therapy Lett 9:1–3PubMed Tan JK (2004) Psychosocial impact of acne vulgaris: evaluating the evidence. Skin Therapy Lett 9:1–3PubMed
22.
Zurück zum Zitat Fife D (2011) Practical evaluation and management of atrophic acne scars: tips for the general dermatologist. J Clin Aesthet Dermatol 4:50–57PubMedPubMedCentral Fife D (2011) Practical evaluation and management of atrophic acne scars: tips for the general dermatologist. J Clin Aesthet Dermatol 4:50–57PubMedPubMedCentral
23.
Zurück zum Zitat Patel PA, Bailey JK, Yakuboff KP (2012) Treatment outcomes for keloid scar management in the pediatric burn population. Burns 38:767–771CrossRefPubMed Patel PA, Bailey JK, Yakuboff KP (2012) Treatment outcomes for keloid scar management in the pediatric burn population. Burns 38:767–771CrossRefPubMed
24.
Zurück zum Zitat Kim HS, Lee JH, Park YM, Lee JY (2012) Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: a pilot study. J Cosmet Laser Ther 14:89–93CrossRefPubMed Kim HS, Lee JH, Park YM, Lee JY (2012) Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: a pilot study. J Cosmet Laser Ther 14:89–93CrossRefPubMed
25.
Zurück zum Zitat Park SH, Kim DW, Jeong T (2012) Skin-tightening effect of fractional lasers: comparison of non-ablative and ablative fractional lasers in animal models. J Plast Reconstr Aesthet Surg 65:1305–1311CrossRefPubMed Park SH, Kim DW, Jeong T (2012) Skin-tightening effect of fractional lasers: comparison of non-ablative and ablative fractional lasers in animal models. J Plast Reconstr Aesthet Surg 65:1305–1311CrossRefPubMed
26.
Zurück zum Zitat Bogdan Allemann I, Kaufman J (2010) Fractional photothermolysis—an update. Lasers Med Sci 25:137–144CrossRefPubMed Bogdan Allemann I, Kaufman J (2010) Fractional photothermolysis—an update. Lasers Med Sci 25:137–144CrossRefPubMed
27.
28.
Zurück zum Zitat Bloom BS, Brauer JA, Geronemus RG (2013) Ablative fractional resurfacing in topical drug delivery: an update and outlook. Dermatol Surg 39:839–848CrossRefPubMed Bloom BS, Brauer JA, Geronemus RG (2013) Ablative fractional resurfacing in topical drug delivery: an update and outlook. Dermatol Surg 39:839–848CrossRefPubMed
29.
Zurück zum Zitat Cavalie M, Sillard L, Montaudie H, Bahadoran P et al (2015) Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases. Dermatol Ther 28:74–78CrossRefPubMed Cavalie M, Sillard L, Montaudie H, Bahadoran P et al (2015) Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases. Dermatol Ther 28:74–78CrossRefPubMed
30.
Zurück zum Zitat Connolly KL, Chaffins M, Ozog D (2014) Vascular patterns in mature hypertrophic burn scars treated with fractional CO2 laser. Lasers Surg Med 46:597–600CrossRefPubMed Connolly KL, Chaffins M, Ozog D (2014) Vascular patterns in mature hypertrophic burn scars treated with fractional CO2 laser. Lasers Surg Med 46:597–600CrossRefPubMed
31.
Zurück zum Zitat Bach DQ, Garcia MS, Eisen DB (2012) Hyperpigmented burn scar improved with a fractionated 1550 nm non-ablative laser. Dermatol Online J 18:12PubMed Bach DQ, Garcia MS, Eisen DB (2012) Hyperpigmented burn scar improved with a fractionated 1550 nm non-ablative laser. Dermatol Online J 18:12PubMed
32.
Zurück zum Zitat Jensen JD, Keane C, Huang CC, Northington ME (2014) Ablative fractionated CO2 resurfacing yields excellent result for severely atrophic traumatic scar on the face. J Drugs Dermatol 13:861–862PubMed Jensen JD, Keane C, Huang CC, Northington ME (2014) Ablative fractionated CO2 resurfacing yields excellent result for severely atrophic traumatic scar on the face. J Drugs Dermatol 13:861–862PubMed
33.
Zurück zum Zitat Shumaker PR, Kwan JM, Landers JT, Uebelhoer NS (2012) Functional improvements in traumatic scars and scar contractures using an ablative fractional laser protocol. J Trauma Acute Care Surg 73:116–121CrossRef Shumaker PR, Kwan JM, Landers JT, Uebelhoer NS (2012) Functional improvements in traumatic scars and scar contractures using an ablative fractional laser protocol. J Trauma Acute Care Surg 73:116–121CrossRef
34.
Zurück zum Zitat Uebelhoer NS, Ross EV, Shumaker PR (2012) Ablative fractional resurfacing for the treatment of traumatic scars and contractures. Semin Cutan Med Surg 31:110–120CrossRefPubMed Uebelhoer NS, Ross EV, Shumaker PR (2012) Ablative fractional resurfacing for the treatment of traumatic scars and contractures. Semin Cutan Med Surg 31:110–120CrossRefPubMed
35.
Zurück zum Zitat Weiss ET, Chapas A, Brightman L, Hunzeker C et al (2010) Successful treatment of atrophic postoperative and traumatic scarring with carbon dioxide ablative fractional resurfacing: quantitative volumetric scar improvement. Arch Dermatol 146:133–140CrossRefPubMed Weiss ET, Chapas A, Brightman L, Hunzeker C et al (2010) Successful treatment of atrophic postoperative and traumatic scarring with carbon dioxide ablative fractional resurfacing: quantitative volumetric scar improvement. Arch Dermatol 146:133–140CrossRefPubMed
36.
Zurück zum Zitat Brightman LA, Brauer JA, Anolik R, Weiss E et al (2009) Ablative and fractional ablative lasers. Dermatol Clin 27:479–489CrossRefPubMed Brightman LA, Brauer JA, Anolik R, Weiss E et al (2009) Ablative and fractional ablative lasers. Dermatol Clin 27:479–489CrossRefPubMed
37.
Zurück zum Zitat Hsiao FC, Bock GN, Eisen DB (2012) Recent advances in fractional laser resurfacing: new paradigm in optimal parameters and post-treatment wound care. Adv Wound Care 1:207–212CrossRef Hsiao FC, Bock GN, Eisen DB (2012) Recent advances in fractional laser resurfacing: new paradigm in optimal parameters and post-treatment wound care. Adv Wound Care 1:207–212CrossRef
38.
Zurück zum Zitat Chan HH, Manstein D, Yu CS, Shek S et al (2007) The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians. Lasers Surg Med 39:381–385CrossRefPubMed Chan HH, Manstein D, Yu CS, Shek S et al (2007) The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians. Lasers Surg Med 39:381–385CrossRefPubMed
Metadaten
Titel
Evaluation of nonablative fractional laser treatment in scar reduction
verfasst von
Hilal Gokalp
Publikationsdatum
12.08.2017
Verlag
Springer London
Erschienen in
Lasers in Medical Science / Ausgabe 7/2017
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-017-2303-x

Weitere Artikel der Ausgabe 7/2017

Lasers in Medical Science 7/2017 Zur Ausgabe