Hypertrophic Scar Outcomes in Fractional Laser Monotherapy Versus Fractional Laser-Assisted Topical Corticosteroid Delivery: A Randomized Clinical Trial

Manuskiatti, Woraphong; Kaewkes, Arisa; Yan, Chadakan; Ng, Janice Natasha C.; Glahn, Joshua; Wanitphakdeedecha, Rungsima

doi:10.2340/00015555-3781

Cited by 14 publications

(9 citation statements)

References 36 publications

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“…Adjuvant application of 5-fluorouracil cream and intralesional solution to scars after treatment with fractional ablative CO 2 laser was shown to be more effective than either therapy alone [50,51]. Adjuvant topical steroids were superior to intralesional steroids but showed no significant improvement in scar flattening when compared with monotherapy with fractional ablative laser [52].…”

Section: Scar Revisionmentioning

confidence: 99%

Update on lasers in pediatric dermatology: how primary care providers can help patients and families navigate appropriate treatment options and timelines

Osborn

Nieman

2023

Current Opinion in Pediatrics

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Purpose of review The use of lasers in pediatric dermatology is well established, but recent literature has expanded the evidence for specific timelines of treatment. Additionally, new devices and combinations with medical therapy have improved outcomes and treatment options for various conditions. Recent findings Pulsed dye laser remains the first-line laser for vascular lesions. Recent guidelines support early initiation of laser treatment in port-wine birthmarks to optimize outcomes. For hemangiomas, laser treatment can offer a meaningful addition to oral propranolol therapy. Lasers with shorter wavelengths offer improved outcomes with decreased downtime for pigmented lesions. General anesthesia in the pediatric population continues to be a controversial topic, and the decision to perform laser under general versus topical anesthesia requires discussion with family of risks and benefits. Summary Primary care providers can benefit their patients by prompt referral to dermatology for discussion of laser treatment. Port-wine birthmarks require referral in the first weeks of life so that laser treatment can be initiated if appropriate. Although many dermatologic conditions cannot be completely cleared or cured with laser, treatment can offer meaningful outcomes and benefit for patients and families.

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Section: Scar Revisionmentioning

confidence: 99%

Update on lasers in pediatric dermatology: how primary care providers can help patients and families navigate appropriate treatment options and timelines

Osborn

Nieman

2023

Current Opinion in Pediatrics

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“…Generally, various cutaneous injuries, such as burns, trauma and skin surgery, may cause pathological scarring of the dermis ( Limandjaja et al, 2021 ). At present, non-surgical treatment for HS includes laser therapy, compression therapy, silicone, injection with corticosteroids, however, these therapeutic strategies are limited ( Lee and Jang, 2018 ; Park et al, 2019 ; Manuskiatti et al, 2021 ). Hence, the development of new anti-scar therapies is necessary.…”

Section: Introductionmentioning

confidence: 99%

Lycorine Inhibits Hypertrophic Scar Formation by Inducing ROS-Mediated Apoptosis

Dong

Zhao

et al. 2022

Front. Bioeng. Biotechnol.

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Background: Hypertrophic scar (HS) is a fibrotic cutaneous disease with few effective therapies. Lycorine is a drug with pro-apoptotic ability and anti-fibrosis potential. This study aimed to test whether lycorine could trigger the apoptosis of hypertrophic scar fibroblasts (HSFs) to inhibit HS formation.Methods: The proapoptotic and anti-fibrosis effects of lycorine on the viability and apoptosis of human primary HSFs and their reactive oxygen species (ROS) production as well as a rabbit ear model of HS were determined by CCK-8, flow cytometry, Western blot, immunofluorescence, transwell migration, collagen gel contraction assays.Results: Lycorine treatment selectively decreased the viability of HSFs, and induced their apoptosis, but not normal fibroblasts (NFs). Lycorine treatment increased the relative levels of Bax and cleaved PARP expression, cytochrome C cytoplasm translocation, but decreased Bcl-2, caspase-3 and caspase-9 expression, the mitochondrial membrane potential (MMP) in HSFs. Lycorine inhibited the migration and contraction of HSFs, and reduced the expression of collagen I, collagen III and α-SMA. Mechanistically, lycorine treatment stimulated high levels of ROS production, leading to apoptosis of HSFs while treatment with NAC, a ROS inhibitor, significantly mitigated or abrogated the pro-apoptotic and antifibrotic activity of lycorine in HSFs. Moreover, lycorine treatment mitigated the severity of HS in rabbit ears by inducing fibroblast apoptosis.Conclusion: These results indicate that lycorine has a potent anti-fibrotic activity and is a potential drug for intervention of HS.

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“…Nonsurgical treatment is the preferred treatment, and surgical treatment is usually only suitable for the treatment of severe hypertrophic scar. Non-surgical treatments include compression therapy, silicone gels, topical 5-fluorouracil, and steroid injections (6)(7)(8)(9). However, due to the half-life of 5-fluorouracil and steroids, they cannot maintain a longterm effect and usually require multiple applications.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide laser treatment for hypertrophic scar: a retrospective study

Li¹,

Wang²,

Wang³

et al. 2021

Ann Palliat Med

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Background: Hypertrophic scars can be caused by various injuries and lead to a decrease in quality of life of those affected. This study was performed retrospectively in our center to investigate the safety and effectiveness of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide (CO 2 ) laser treatment in patients with hypertrophic scar.Methods: This was a retrospective study performed in a single center between January 2019 and December 2020. All patients with hypertrophic scars receiving fractional micro-plasma radio-frequency treatment, ablative fractional CO 2 laser treatment, or combined therapy of both were recruited to the study. The participants were then divided into a single therapy group or combined therapy group. The Vancouver scar scale was used to score and subsequently assess the effectiveness of scar treatment and the changes of scar thickness. Some adverse complications were also recorded to evaluate the safety of treatments. A subgroup analysis was then performed to investigate the differences of effectiveness and safety of combined therapy in scar patients at the early stage and late stage.Results: A total of 64 patients with hypertrophic scars were enrolled in this study, including 45 receiving combined treatment, and 19 receiving single treatment. There was no significant difference in demographic data between the two groups. Notably, combined therapy could more effectively reduce the score of Vancouver scar scale (P=0.026) without significantly increasing the incidence of adverse complications.However, no significant difference was observed in scar thickness between the two groups. Moreover, multiple treatments could further increase the effectiveness of combined therapy according to either the score of Vancouver scar scale or the thickness of scars. Subgroup analysis revealed that combined therapy could reduce the score of Vancouver scar scale and scar thickness in patients much more at the early stage than at the late stage (P=0.032 and 0.042, respectively).Conclusions: This study revealed that fractional micro-plasma radio-frequency treatment combined with ablative fractional CO 2 laser treatment could be more effective in improving hypertrophic scars then single therapy. Also, multiple treatments could enhance the effectiveness of combined treatment, and patients should be encouraged to receive treatment as early as possible.

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Hypertrophic Scar Outcomes in Fractional Laser Monotherapy Versus Fractional Laser-Assisted Topical Corticosteroid Delivery: A Randomized Clinical Trial

Cited by 14 publications

References 36 publications

Update on lasers in pediatric dermatology: how primary care providers can help patients and families navigate appropriate treatment options and timelines

Update on lasers in pediatric dermatology: how primary care providers can help patients and families navigate appropriate treatment options and timelines

Lycorine Inhibits Hypertrophic Scar Formation by Inducing ROS-Mediated Apoptosis

Effectiveness and safety of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide laser treatment for hypertrophic scar: a retrospective study

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