Department of Dermatology, Jiangsu Province Hospital of Chinese Medicine/Afliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
Nanjing University of Chinese Medicine, 138 Xianlin Rd, Nanjing, 210023, China.
Lasers Med Sci. 2022 Sep;37(7):2947-2953. doi: 10.1007/s10103-022-03564-6. Epub 2022 Apr 28.
The objective of the study was to evaluate the efficacy of combining 1565-nm non-ablative fractional laser with low-dose compound betamethasone topical application in the treatment of immature early red hypertrophic scar. We enrolled 38 cases of patients who had immature red hypertrophic scar due to surgery or trauma which are all less than 6 months old. About 28 patients were assigned to the treatment group, and 10 patients were assigned to the control group. The patients in the treatment group were all treated with 1565-nm non-ablative fractional laser with the following parameters: spot size 10-16 mm, round or square-shaped according to lesional morphology, fluence 20-35 mJ/cm, and density 150-200 microspot/cm. The treated area was then applied immediately with low-dose compound betamethasone through topical application. Treatment cycles were repeated every month for a total 5 months. Photos were taken before the start of the treatment, and then monthly after. Vancouver Scar Scale score was used to evaluate the scar changes; all the patients were followed up for 3 more months after the last treatment. All side effects were documented. The patients in the control group received no treatment at all. All the parameters were recorded as the same as the treatment group. The total VSS score after the combination therapy is 0.96 ± 1.53, which in comparison with prior treatment VSS score 8.86 ± 1.43, showed a significant reduction following the treatments (P < 0.001). The control group without any treatment shows VSS score 7.10 ± 0.99 at the end of the study vs VSS score 7.70 ± 0.82 at the start of the study (P > 0.05). The patient satisfaction rate reaches 89.2% after treatment, The major side effects reported include 3 patients with post-inflammatory hyperpigmentation (10.7% of patients in the treatment group), and other minor discomfort such as transient warmth, erythema, and swelling of treatment sites. The combination approach using 1565-nm non-ablative laser and low dose of local application of compound betamethasone can effectively improve the immature red hypertrophic scar with no significant side effects; this should provide our practitioners with a new weapon in fighting those hard-to-manage early scar formations.
本研究旨在评估 1565nm 非剥脱性点阵激光联合小剂量复方倍他米松局部应用治疗未成熟早期红色增生性瘢痕的疗效。我们纳入了 38 例因手术或外伤导致的未成熟红色增生性瘢痕患者，这些患者的瘢痕均小于 6 个月。约 28 例患者被分配到治疗组，10 例患者被分配到对照组。治疗组患者均接受 1565nm 非剥脱性点阵激光治疗，参数如下：光斑大小 10-16mm，根据皮损形态呈圆形或方形，能量 20-35mJ/cm，密度 150-200 微点/cm。治疗后立即对治疗区域进行小剂量复方倍他米松局部应用。治疗周期为 1 个月，共 5 个月。治疗前、治疗后每月拍摄照片。采用温哥华瘢痕量表（Vancouver Scar Scale，VSS）评分评估瘢痕变化；所有患者在末次治疗后 3 个月进行随访。记录所有不良反应。对照组患者不进行任何治疗，所有参数均与治疗组相同。联合治疗后总 VSS 评分为 0.96±1.53，与治疗前的 8.86±1.43 相比，治疗后明显降低（P<0.001）。对照组患者未接受任何治疗，研究结束时 VSS 评分为 7.10±0.99，与研究开始时的 7.70±0.82 相比差异无统计学意义（P>0.05）。治疗后患者满意度达 89.2%。主要不良反应包括 3 例患者出现炎症后色素沉着（治疗组患者的 10.7%），以及治疗部位短暂性温热、红斑和肿胀等其他轻微不适。1565nm 非剥脱性激光联合小剂量局部应用复方倍他米松可有效改善未成熟红色增生性瘢痕，且无明显不良反应；这应为我们的临床医生提供一种治疗难治性早期瘢痕形成的新武器。
