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Fractional Photothermolysis for the Treatment of Hypertrophic Scars: Clinical Experience of Eight Cases

BACKGROUND Hypertrophic scars are common problems and represent a challenging condition to treat. Fractional photothermolysis has been effective at resurfacing photodamaged skin, acne scars, and atrophic scars, but there are few reports on its use for hypertrophic scars. OBJECTIVE To evaluate the safety and efficacy of 1,550‐nm erbium‐doped fiber laser treatment of hypertrophic scars in eight patients. METHODS Eight patients (skin phototypes II‐IV) with hypertrophic scars received monthly treatments with a 1,550‐nm erbium‐doped fiber laser. Energy settings ranged from 35 to 50 mJ, and eight to 10 passes were applied with treatment levels 6 to 8. An independent physician evaluator assessed the treatment response by comparing pre‐ and posttreatment clinical photographs using a quartile grading scale (grade 1, ≤25%=minimal to no improvement; grade 2, 26‐50%=moderate improvement; grade 3, 51‐75%=marked improvement; grade 4, >75%=near total improvement. RESULTS At four weeks after the last treatment session, a mean grade of 2.4 was achieved based on an independent physician's clinical assessment. Improvement in pigmentation occurred in all hyperpigmented scars. CONCLUSION Hypertrophic scars can be effectively and safely improved with 1,550‐nm erbium‐doped fiber laser treatment. The authors have indicated no significant interest with commercial supporters.