摘要
Panwadee THONGJAROENSIRIKUL 医师
皮肤科医师
Evolving paradigms in dermatologic surgery: the efficacy of picosecond lasers for hypertrophic scar management
Objectives: This study aimed to evaluate the efficacy and safety of using fractional picosecond laser 1064-nm for treatment of hypertrophic mammoplasty scar in Asians.
Introduction: Hypertrophic scars refer to an abnormal increase in collagen production during wound healing. Previous studies have demonstrated that the scars resulting from mammoplasty can adversely impact patients' psychosocial functioning and overall quality of life. Although the treatment of hypertrophic scars is still challenging, recent research has revealed promising outcomes with the use of a picosecond laser at a wavelength of 1064-nm. While pulsed-dye laser treatment at wavelengths of 585-nm or 595-nm has been shown to be highly effective, it requires high maintenance and periodic dye replacement.
Materials / method: The study included 14 patients with bilateral hypertrophic mammoplasty scars. One side of the scar was randomly selected for treatment with 4 sessions of picosecond laser at 1064-nm, with a 4-week interval. Scar height was measured using a caliper, while skin texture, volume of elevation, melanin index, and erythema index were quantified using the Antera® 3D. The Patient and Observer Scar Assessment Scale was evaluated by a blinded dermatologist and patients. All assessments were conducted at baseline, 1 month after each treatment, and at 1, 3, and 6 months following the last treatment.
Results: 13 out of 14 subjects completed the study protocol. The height of the treated-side hypertrophic scar decreased significantly at 1 month after 3 treatment sessions, and 1 and 3 months after completing 4 sessions when compared to baseline and the control group. However, at the 6-month follow-up, there was no significant difference in scar height between both groups. When analyzed by Antera®3D, the erythema index in the lasered scar decreased significantly at 1, 3, and 6 months after the last treatment compared to before treatment. However, no significant difference was found between both groups.
Conclusion: The use of fractional picosecond laser at 1064-nm seems to be both effective and safe for treating hypertrophic mammoplasty scars in Asians, as it significantly enhances the scar's overall appearance, according to both the Patient and Observer Scar Assessment Scale (POSAS) observer and patient scales. Interestingly, picosecond laser treatment also resulted in a significantly faster reduction in scar height compared to no treatment.
披露 - Panwadee THONGJAROENSIRIKUL
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