CHICAGO The first reported treatment of fresh scars with fractional resurfacing shows the modality to be both safe and effective, which places the device in direct competition with the carbon dioxide laser.
"Fractional laser treatment using the 1,550-nm erbium fiber laser produced significant improvement in all characteristics of fresh scars," said Dr. Cameron Rokhsar, at the annual meeting of the American Society for Dermatologic Surgery.
Studies of carbon dioxide and, more recently, pulsed dye laser treatment, have shown improvements in the range of 50%-60%, which are on a par with dermabrasion, said Dr. Rokhsar of the division of dermatology at the Albert Einstein College of Medicine, New York.
Dr. Rokhsar's study included 10 patients who received half-scar treatment with the nonablative Fraxel SR 750 system at or within 2 weeks of suture removal. The untreated half of each scar served as the control. The study was sponsored through a research grant by Reliant Technologies Inc., manufacturer of the Fraxel laser system. Reliant provided the devices that were used in the study. Dr. Rokhsar is a consultant for the company.
Patients were 19-74 years old; the study excluded those with localized or systemic infections and those being treated with isotretinoin, Dr. Rokhsar said.
Half of each scar was treated every other week for 10 weeks (five sessions) using an energy level of 20 mJ and a density of 1,000-2,000 microthermal zones per square centimeter.
The patients were evaluated at 1 month and 3 months after the last treatment based on a quartile scale of 0-4 (0, no improvement; 2, 26%-50% improvement; 3, 51%-75% improvement; and 4, 76%-100% improvement), he explained.
After 3 months, all treated scar portions were rated as either 2 or 3. "The improvements were moderate to significant for all scar characteristics, with both the patients and the study investigators reporting that improvement scores for skin texture, pigmentation, and overall atrophic scar appearance were well correlated," Dr. Rokhsar said.
"The treatments were safe and well tolerated," he noted. At 1 month following the last treatment, "three subjects had mild erythema and a fourth had transient postinflammatory hyperpigmentation; all resolved by 3 months."
The bottom half of this vertical scar (starting at ruler edge) was resurfaced five times with a Fraxel laser. Courtesy Dr. Cameron Rokhsar