Treatment of scars with a pulsed Er:YAG laser

BACKGROUND: Numerous revision procedures such as surgical excision, intralesional steroid injection, cryotherapy, dermabrasion, soft tissue augmentation, chemical peeling and laser therapy are available for the correction of various types of scars. Recently, Er:YAG laser resurfacing has proved to be a useful and safe means for several kinds of scars. OBJECTIVE: The purpose of this study was to assess the efficacy and safety of pulsed Er:YAG laser scar resurfacing for the various types of scars induced by trauma, burns, or surgery. METHODS: This study included 36 patients with various types of scars resulting from picking, scratching, knife injury, laceration, car accident, simple surgical excision, focal burn and focal inflammation. Twelve of these patients were treated for hypertrophic scars, 20 for depressed scars, and four for burn scars. The pulsed Er:YAG laser with a 2-mm handpiece at the setting of 500-1200 mJ/pulse at 3.5-9 W was used. Photographs were obtained at baseline and 2-week intervals postoperatively. The results of laser treatment were assessed by two independent physicians and the surgeon according to contour, skin texture and color. RESULTS: In all, 9 of 12 hypertrophic scars, 17 of 20 depressd scars, and two of four burn scars were improved more than 50%. In one patient who had a depressed scar, minimal postinflammatory hyperpigmentation was observed 3 months after laser treatment. Mild erythema was sustained 4 months after laser treatment in one patient with a depressed scar and in all patients with burn scars. No other side effects were observed. CONCLUSION: A pulsed erbium:YAG laser is an effective and safe treatment modality for scar revision.