Surgical scars to improve

Fractional photothermolysis is a promising treatment for surgical scars, including those that have failed to fully respond to other treatments, a small study suggests. In 13 patients with various types and ages of surgical scars, fractional resurfacing using Reliant Technologies Inc.'s 1,550-nm, erbiumdoped fiber laser (Fraxel) resulted in greater than 75% improvement in nine patients and at least 51%-75% improvement in an additional two patients.

The remaining two patients achieved between 25% and 50% improvement. The patients were treated for scars resulting from Mohs surgery, excision, trauma, or plastic surgery, and most underwent a total of three treatments (range, two to eight). Treatments were administered at energy levels of 670 mJ, with final densities of 312-2,500 microthermal zones per square centimeter. Outcomes were based on physician assessment of photographs that were taken at baseline and at 2 weeks following final treatment.

All the characteristics that we looked at improved, including atrophy, hypertrophy, hyperpigmentation, and erythema. Traditional scar treatment involves use of the pulsed dye laser, but it appears that fractional resurfacing may provide better depth of penetration. Admittedly, many of the scars were new, and were possibly still undergoing remodeling, but even older scars showed similar improvement. Scars that had failed to respond fully to prior therapies also responded to the Fraxel laser. It appears that this laser can be used as monotherapy for treating scars, or as an adjunct to other treatments.