Impact of pentoxifylline on efficacy, safety, tolerability, and treatment satisfaction of fractional carbon dioxide laser in patients with burn scars: a pilot blinded randomized controlled trial.

Burn scars are significant consequence of thermal burn injuries, causing cosmetic concerns and potentially leading to symptomatic discomfort or functional limitations; therefore, continuous adoption of novel methods is warranted to improve outcomes. This study aims to assess and compare the effectiveness, safety, and satisfaction of fractional CO2 laser treatment alone versus its combination with oral pentoxifylline at a dosage of 400 mg twice daily for four months in patients with hypertrophic/keloid burn scars. In a assessor and analyst blinded randomized controlled trial, patients with hypertrophic/keloidal thermal burn scars were allocated into two intervention groups. Both groups underwent treatment with a fractional CO2 laser, while one group additionally received oral pentoxifylline at a dosage of 400 mg twice daily for four months. The assessment of scar improvement was performed using the modified Vancouver Scar Scale (mVSS) at baseline and during subsequent follow-up sessions. Significant improvements were noted within both groups, with mVSS scores decreasing from 7.73 to 4.73 in the CO2 laser group and from 7.36 to 3.91 in the combination therapy group (p < 0.001 for both). However, the between-group difference in mVSS score reduction was not statistically significant (p = 0.39). Confidence intervals for the mean change in mVSS scores from baseline to endpoint were [2.45, 3.10] for the CO2 laser group and [3.15, 3.85] for the combination therapy group. The combination therapy group also showed a more pronounced improvement in pigmentation subscore of mVSS and higher patient satisfaction rates. No adverse effects were reported in either group. Fractional CO2 laser with or without Pentoxifylline appears to be an effective and safe option for the improvement of hypertrophic/keloidal burn scars. Patient satisfaction seems to increase when the laser is combined with oral Pentoxifylline. Nevertheless, further studies involving larger patient cohorts are warranted to draw more robust conclusions.