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Fractional laser resurfacing improved most second-, third-degree burns

Nonablative fractional laser resurfacing resulted in overall improvement for 90% of patients with second- and third-degree burns in a prospective study.

Ten patients (eight women; aged 23-68 years) with scarring from second- and third-degree burns on the face, neck, chest, arms, hands, abdomen, legs and foot were treated with five nonablative fractional resurfacing treatments at 4-week intervals. The procedure used a 1,550 nm nonablative fractional laser with 40 mJ/pulse to 70 mJ/pulse and a treatment density range of 17% to 38% tissue coverage with adjunctive cooling. Patients were advised to avoid sun exposure during the study.

At 3 months post-treatment, three independent physicians evaluated clinical improvements, first identifying photographs as “before” and “after,” then using a quartile scale to rate overall appearance, texture, dyschromia and degree of atrophy or hypertrophy. Patients used the same scale for self-assessment of subjective improvements in burn scar area at 1, 3 and 6 months post-treatment and rated their self-esteem.

Based on physicians’ scores, 90% of patients experienced improvement in overall appearance (60% rated results moderate to excellent). Ninety percent had improvements in skin texture, 80% in dyschromia and 80% in degree of atrophy or hypertrophy. Patients reported moderate to excellent improvement in burn scar area, with significant gains in self-esteem at 3 months post-treatment (P=.03). Self-esteem changes were similar at 1 and 6 months but failed to achieve statistical significance.

Researchers, including Jill Waibel, MD, of the Miami Dermatology & Laser Institute in Florida, cautioned that the pilot study was small and lacked a control group, and patients’ self-esteem was highly variable. They said the study “considered only monotherapy; however, combinations of therapeutic methods may lead to the best treatment outcomes.”

“Fractional resurfacing is a promising new treatment modality for burn scars,” the researchers concluded. “We should continue to identify novel approaches and management strategies for burn deformities. The best results likely will be achieved through multispecialty collaboration, innovative technology and a combination of therapeutic treatments.”

Disclosure: See the study for a full list of relevant disclosures.