Treatment of Scars with Laser-Assisted Delivery of Growth Factors and Vitamin C: A Comparative, Randomised, Double-blind, Early Clinical Trial

Abstract

Background: Scarring can jeopardize the final result of plastic surgeries. Deep dermal injuries activate dermal fibroblasts that produce excessive amount of collagen and 2 inflammatory cytokines and growth factors, which contributes to increased fibrous tissue and scarring tissue formation. Objectives:The aim of this double-blind, prospective, randomised clinical trial was to investigate the use of laser-assisted drug delivery (LADD) for scar improvement to support the establishment of LADD as standard therapy modality and to indicate suitable drugs for dermal administration.Material and Methods: In total, 132 patients seeking scar treatment were consented and randomised. The control group (64 patients) received laser resurfacing immediately followed by skin surface application of Vitamin C and 68 patients received laser treatment followed by skin surface application of a cosmeceutical containing growth factors (GFs) and Vitamin C. Photographs were obtained before and three months after the procedure and submitted to three-dimensional reconstruction by the software Dermapix®. Objective measurements provided by the software were statistically analysed and established the differences in the treatment result between the two groups.Results: There was a significant reduction in scar roughness and volume in both groups (p<0.01). Mann-Whitney test confirmed that the group treated vitamin C and GFs presented significantly better results than the group treated with vitamin C alone (p<0.01). Conclusion:LADD has proven efficient as scars were reduced in both study groups.Furthermore, the addition of growth factors provided statistically significant better outcomes and resulted in more inconspicuous scars. No adverse reactions were observed.

Laser-assisted delivery of vitamin c or vitamin c plus growth factors in the treatment of chloasma in women: a systematic review and meta-analysis

“…Recently, several publications have specified the use of LADD with vitamins to treat skin disorders. Vitamin C or vitamin C plus growth factors GFs was the predominant focus of a small-sample study conducted by Machado et al (Machado et al, 2021b). The individuals in the group that was treated with vitamin C and GFs showed significantly reduced skin roughness compared to those treated with vitamin C alone.…”

“…The individuals in the group that was treated with vitamin C and GFs showed significantly reduced skin roughness compared to those treated with vitamin C alone. Moreover, Mann-Whitney tests were conducted to compare the performances of two groups in studies (Machado et al, 2021a;Machado et al, 2021b). While these studies indicated satisfactory results, the interquartile range (IQR) and median results of the two studies varied.…”

“…At the same time, vitamin C remained the dominant type of vitamin used in the majority of studies. Two studies mentioned the use of cosmeceuticals (GFs) (Machado et al, 2021a;Machado et al, 2021b), and one study mentioned basic fibroflast growth factors bFGFs (Waibel et al, 2016). A study revealed the growth factors that were released from microneedling procedures.…”

“…Three studies with 331 patients (e.g., 136 events in Group A and 254 events in Group B) were used for skin disorder control meta-analysis (Machado et al, 2021a;Machado et al, 2021b;Rattanawiwatpong et al, 2020). Skin roughness (Rgh) or SEr and average wrinkle depth improvements were two necessary outcome measures used in these studies.…”

Automated Structural Analysis and Quantitative Characterization of Scar Tissue Using Machine Learning

“…Scars can be faded or removed, using a variety of techniques, including corticosteroid injections [ 2 ], cryotherapy [ 3 ], and laser therapy [ 4 ]. Identifying and evaluating scar tissue is the most crucial step in determining the extent of tissue damage and planning a suitable treatment pathway for scar management and removal [ 5 ]. However, determining and analyzing the scar regions in the skin tissue remains challenging.…”