title: Fractional photothermolysis for the treatment of hypertrophic scars: clinical experience of eight cases.
abstract: BACKGROUND
  Hypertrophic scars are common problems and represent a challenging condition to treat. Fractional photothermolysis has been effective at resurfacing photodamaged skin, acne scars, and atrophic scars, but there are few reports on its use for hypertrophic scars.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of 1,550-nm erbium-doped fiber laser treatment of hypertrophic scars in eight patients.
  
  
  METHODS
  Eight patients (skin phototypes II-IV) with hypertrophic scars received monthly treatments with a 1,550-nm erbium-doped fiber laser. Energy settings ranged from 35 to 50 mJ, and eight to 10 passes were applied with treatment levels 6 to 8. An independent physician evaluator assessed the treatment response by comparing pre- and posttreatment clinical photographs using a quartile grading scale (grade 1, < or =25%=minimal to no improvement; grade 2, 26-50%=moderate improvement; grade 3, 51-75%=marked improvement; grade 4, >75%=near total improvement.
  
  
  RESULTS
  At four weeks after the last treatment session, a mean grade of 2.4 was achieved based on an independent physician's clinical assessment. Improvement in pigmentation occurred in all hyperpigmented scars.
  
  
  CONCLUSIONS
  Hypertrophic scars can be effectively and safely improved with 1,550-nm erbium-doped fiber laser treatment.
authors.affiliation: Clínica Nuno Osório, São Paulo-SP, Brazil. aneniwa@gmail.com
authors.forename: Ane Beatriz Mautari
authors.initials: AB
authors.lastname: Niwa
authors.forename: Ana Paula F
authors.initials: AP
authors.lastname: Mello
authors.forename: Luís Antonio
authors.initials: LA
authors.lastname: Torezan
authors.forename: Nuno
authors.initials: N
authors.lastname: Osório
mesh_terms: D000328:Adult; D000368:Aged; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D010789:Phototherapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents