A randomized controlled pilot study on ablative fractional CO2 laser for consecutive patients presenting with various scar types.

BACKGROUND: Although ablative fractional laser is the gold standard for acne scars, evidence is still lacking for other types of scars.

OBJECTIVE: To evaluate the efficacy and safety of the ablative fractional 10,600-nm CO2 laser in the treatment of various scar types.

MATERIALS AND METHODS: The authors performed an intraindividual single-blinded randomized controlled split-lesion trial. Adult patients received 3 laser treatments at 8-week intervals for scars existing at least 1 year. Primary end points were the Physician Global Assessment (PhGA) and the assessment of adverse effects.

RESULTS: Twenty-five consecutive patients with atrophic (52%) or hypertrophic (48%) scars located mainly on the body (84%) were included in the study. At 6-month follow-up of 21 patients, the PhGA showed no statistically significant difference between the treated and untreated side of the scar (p = .70). Persistent erythema, postinflammatory pigmentary changes, and scarring after ulceration (n = 3) were observed as side effects.

CONCLUSION: In this trial involving various types of scars, the efficacy of ablative fractional CO2 laser could not be confirmed. The authors presume that different types of scars have a different response to treatment. Future studies should aim to identify the type of scars that may benefit from ablative fractional laser therapy.