Ultrapulsed Fractional CO2 Laser for the Treatmentof Post-traumatic and Pathological Scars

Background and Objective: Scar management is a long-term process. A variety of modalities have been employed and, depending on scar type, treatment may be invasive and/or conservative. The purpose of this study was to evaluate a new CO2 laser resurfacing for post-traumatic and pathological scars and to compare this device with classic dermabrasion. The new fractionated ultrapulsed CO2 laser (Ultrapulse Encore, Lumenis Ltd., Santa Clara, CA) is equipped with two types of scanners: the first, ActiveFX, is non-sequential while the second, DeepFX, is sequential and produces microspot. Materials and Methods: From September 2008 to November 2008, a study on 60 patients was performed. The patients (average age 47.3 years) enrolled in this study had severely scarred skin and were divided into two groups of 30 people. All patients were Caucasian with skin type II or III. Each scar was photographed and scored by the authors using the Manchester Scar Scale (MSS). Follow-up ranged from 12–15 months. Results: Sixty patients were analyzed in two homogeneous groups. Significant improvement in skin tone, texture and appearance of skin was noted in all patients treated with CO2 laser, lower improvement resulted with dermabrasion. Both subjects and investigators noted similar aesthetic improvement. No major complications were found for both groups and minor complications included transient erythema and edema. Conclusion: Fractional ultrapulsed CO2 laser resurfacing has proven to be both safe and effective. The efficacy and favorable side effects profile for this technology, with low incidence of pigmentary changes, make it a viable alternative for the treatment of moderateto- severe scars.