Treatment of postburn hypertrophic scaring in skin of color with fractional CO2 laser - A prospective cohort study

Objective

To evaluate the efficacy of fractional CO2 laser therapy in treating mature hypertrophic burn scars.

Method

A prospective cohort study enrolled burn patients with postburn hypertrophic scars undergoing fractional CO2 laser treatment in Rawalpindi, Pakistan. Patients aged 12 to 80 years were included, receiving 4 laser sessions every 4-6 weeks. Demographic data and scar assessments using the Vancouver Scar Scale and Patient Observer Scar Assessment Scale were collected.

Results

Twenty-five patients with hypertrophic scars received treatment. Vancouver Scar Scale scores showed significant reductions, with improvements in scar vascularity (pre: 0.85 ± 1.085, post: 0.10 ± 0.300, P < .001), pigmentation (pre: 2.44 ± 0.673, post: 2.12 ± 0.900, P = .008), and pliability (pre: 2.29 ± 1.078, post: 1.39 ± 0.997, P < .001). Patients with Fitzpatrick skin types III and IV had notable Vancouver Scar Scale score improvements (P = .013, P < .001). Patient Observer Scar Assessment Scale scores also decreased significantly post-treatment (P < .001).

Conclusion

Fractional CO2 laser therapy shows promise in managing mature hypertrophic burn scars, with improvement in scar appearance, functionality, and symptom relief. Stratification by Fitzpatrick skin type highlights the need for further research to optimize treatment strategies, particularly in populations with darker skin tones. This study underscores the importance of further longitudinal studies on burn scars to enhance outcomes for all burn survivors.