Manuskiatti Woraphong, Kaewkes Arisa, Yan Chadakan, Ng Janice Natasha, Glahn Joshua Zev, Wanitphakdeedecha Rungsima
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700 Bangkok, Thailand. E-mail:
Acta Derm Venereol. 2021 Mar 17;101(3):adv00416. doi: 10.2340/00015555-3781.
Topical corticosteroid delivery following fractional laser treatment is an effective means of treating hypertrophic scars. However, the relative efficacy of adjuvant corticosteroid treatment vs fractional laser mono-therapy alone is unclear. The aim of this study was to compare the efficacy and safety of fractional laser-assisted topical corticosteroid delivery with fractional laser monotherapy in the treatment of hyper-trophic scars. In this randomized, comparative, split-scar trial of 19 subjects, a borderline significant reduction in scar thickness was observed at 3-month follow-up in the laser+steroid group compared with laser+petrolatum (p = 0.049). However, no significant long-term difference in scar flattening was observed between the 2 groups. Patient and Observer Scar Assessment Scale scores showed significant improvement in scar appearance from baseline without significant differences between treatment groups. In conclusion, fractional laser monotherapy is an effective treatment for hypertrophic scars, and the application of topical corticosteroid provides no long-term synergistic effect to fractional laser monotherapy.
分次激光治疗后局部应用皮质类固醇是治疗增生性瘢痕的有效方法。然而，辅助性皮质类固醇治疗与单纯分次激光单药治疗的相对疗效尚不清楚。本研究的目的是比较分次激光辅助局部应用皮质类固醇与分次激光单药治疗增生性瘢痕的疗效和安全性。在这项针对19名受试者的随机、对照、双侧瘢痕试验中，与激光+凡士林组相比，激光+类固醇组在3个月随访时瘢痕厚度有临界显著降低（p = 0.049）。然而，两组之间在瘢痕变平方面未观察到显著的长期差异。患者和观察者瘢痕评估量表评分显示，瘢痕外观较基线有显著改善，各治疗组之间无显著差异。总之，分次激光单药治疗是治疗增生性瘢痕的有效方法，局部应用皮质类固醇对分次激光单药治疗无长期协同作用。
