Treatment of atrophic scars with fractionated CO2 laser facilitating delivery of topically applied poly-L-lactic acid.
BACKGROUND
Atrophic scars represent a loss of collagen and a challenging reconstructive dilemma with disappointing traditional treatments.


OBJECTIVE
To study the safety and efficacy of the treatment of atrophic scars using an ablative fractionated CO2 laser and topical poly-L-lactic acid (PLLA) immediately after to improve atrophic scars.


METHODS
This was an uncontrolled, institutional review board-approved, prospective study evaluating the treatment of atrophic scars. Four blinded dermatologists evaluated a total of 20 photographs taken at baseline and 3 months after the laser and PLLA treatments using the Modified Manchester Scar Scale. Four criteria were evaluated: (1) overall improvement, (2) improvement in scar atrophy, (3) improvement in scar color/dyschromia mismatch, and (4) improvement in scar contour.


RESULTS
All 4 observers accurately identified 76 of the 80 "before" and "after" photographs. Therefore, the blinded evaluating physicians agreed that at the 3-month follow-up visit, 95% of the scars had improved. Each criterion demonstrated an average improvement of at least 33%.


CONCLUSIONS
The combination of using an ablative fractional CO2 laser and PLLA in the treatment of atrophic scars has a synergistic effect on their inherent properties in up-regulating new collagen synthesis to improve atrophic scars.
*Department of Dermatology, Henry Ford Hospital; †Miami Dermatology and Laser Institute, Miami, Florida.
Ali
A
Rkein
David
D
Ozog
Jill S
JS
Waibel
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D001284:Atrophy; D002921:Cicatrix / Q000473:pathology* / Q000628:therapy*; D003094:Collagen / Q000187:drug effects; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019344:Lactic Acid / Q000008:administration & dosage*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
D003879:Dermatologic Agents; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D003094:Collagen