Early treatment with ablative CO2 fractional laser lessens nonmelanoma scar appearance

Conducted on 20 subjects between the ages of 20 and 90 that underwent Mohs surgery for nonmelanoma skin cancer of the face, an international team of researchers evaluated the safety and efficacy of a single treatment of a scar with an ablative CO₂fractional laser early in the post-surgical setting.

"Postoperative surgical scars can be a vexing problem for surgeons," stated Joseph F. Sobanko, MD, an assistant professor of dermatology and the Director of Dermatologic Surgery Education at the Perelman School of Medicine at the University of Pennsylvania (Philadelphia, PA), first author of the study. "Despite meticulous surgical technique, some facial scars will nevertheless depress and widen over time, likely due to weakened or inadequately replaced collagen fibers in the underlying dermis. The purpose of this study was to demonstrate that use of a 10,600-nm ablative carbon dioxide (CO₂) fractional laser early in the post-surgical setting was safe and could improve postoperative facial scars after a single treatment session via laser-induced neocollagenesis. While almost all the treated and untreated scar portions healed with an excellent aesthetic result, our pilot study also revealed a strong patient preference for this early intervention and provides evidence for future investigations into this scar prevention strategy."

"While previous studies have shown that early treatment of post-surgical scars with pulsed dye laser and nonablative fractional laser improve scar appearance, few prospective studies have analyzed the effects of an ablative fractional laser (AFL) when used early in the postoperative setting on surgical scars," says J. Stuart Nelson, MD, Ph.D., editor-in-chief of the journal Lasers in Surgery and Medicine, which published the research team's study. "Sobanko et al. present a prospective, randomized, evaluator-blinded, comparative split-scar study. This study used both objective and subjective grading to assess the effects of treating surgical facial scars with ablative fractional carbon dioxide (CO₂) laser one week post-surgery. Their study revealed facial wounds meticulously sutured in a layered manner do heal well; however, patients preferred early fractional CO₂ lasing of surgical scars. The use of the Vancouver Scar Scale failed to detect an objective difference between laser and control halves of scars. Additionally, the absence of significant adverse events suggests that AFL treatment of early postoperative scars is safe."

To read the study published in Lasers in Surgery and Medicine, please visit http://dx.doi.org/10.1002/lsm.22314.

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