title: Repigmentation of hypopigmented scars using an erbium-doped 1,550-nm fractionated laser and topical bimatoprost.
abstract: BACKGROUND
  Hypopigmented scarring is a challenging condition to treat, with current treatments showing limited efficacy and temporary results. Nonablative fractional resurfacing has been demonstrated to be an effective and safe modality in the treatment of hypopigmented scars.
  
  
  OBJECTIVE
  To demonstrate the efficacy and safety of combining fractional resurfacing with topical bimatoprost and topical tretinoin or pimecrolimus for the treatment of hypopigmented scars.
  
  
  METHODS
  Fourteen patients with hypopigmented scars were treated with a mean of 4.5 sessions of a fractionated 1,550-nm erbium-doped laser at 4- to 8-week intervals and subsequently started topical bimatoprost and tretinoin or pimecrolimus. An independent physician evaluated digital photographs taken before and 4 weeks after the last laser treatment using a quartile grading scale (grade 1, ≤25% improvement; grade 2, 26-50% improvement; grade 3, 51-75% improvement; grade 4, >75% improvement).
  
  
  RESULTS
  Five patients had >75% improvement in hypopigmentation, and 12 had >50% improvement. After a mean follow-up of 20.1 months, all patients demonstrated prolonged results. Side effects were limited to transitory post-treatment edema and erythema.
  
  
  CONCLUSIONS
  The combination of fractional resurfacing, topical bimatoprost, and tretinoin or pimecrolimus is a potential effective resource for the treatment of hypopigmented scars, with long-lasting results.
authors.affiliation: Goldman, Butterwick, Fitzpatrick, Groff, and Fabi Cosmetic Laser Dermatology, San Diego, California, USA.
authors.forename: Ane Beatriz Mautari Niwa
authors.initials: AB
authors.lastname: Massaki
authors.forename: Sabrina Guillen
authors.initials: SG
authors.lastname: Fabi
authors.forename: Richard
authors.initials: R
authors.lastname: Fitzpatrick
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D000069580:Bimatoprost; D002921:Cicatrix / Q000628:therapy*; D003008:Cloprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017496:Hypopigmentation / Q000628:therapy*; D007641:Keratolytic Agents / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014212:Tretinoin / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000577:Amides; D007641:Keratolytic Agents; D003008:Cloprostenol; D014212:Tretinoin; D000069580:Bimatoprost