A Randomized Controlled Pilot Study on Ablative Fractional CO2 Laser for Consecutive Patients Presenting With Various Scar Types

BACKGROUND Although ablative fractional laser is the gold standard for acne scars, evidence is still lacking for other types of scars. OBJECTIVE To evaluate the efficacy and safety of the ablative fractional 10,600-nm CO2 laser in the treatment of various scar types. MATERIALS AND METHODS The authors performed an intraindividual single-blinded randomized controlled split-lesion trial. Adult patients received 3 laser treatments at 8-week intervals for scars existing at least 1 year. Primary end points were the Physician Global Assessment (PhGA) and the assessment of adverse effects. RESULTS Twenty-five consecutive patients with atrophic (52%) or hypertrophic (48%) scars located mainly on the body (84%) were included in the study. At 6-month follow-up of 21 patients, the PhGA showed no statistically significant difference between the treated and untreated side of the scar (p = .70). Persistent erythema, postinflammatory pigmentary changes, and scarring after ulceration (n = 3) were observed as side effects. CONCLUSION In this trial involving various types of scars, the efficacy of ablative fractional CO2 laser could not be confirmed. The authors presume that different types of scars have a different response to treatment. Future studies should aim to identify the type of scars that may benefit from ablative fractional laser therapy.