Efficacy and safety of ablative CO₂ fractional laser and narrowband intense pulsed light for the treatment of hypertrophic scars: a prospective, randomized controlled trial

Abstract

Background and Objectives

Hypertrophic scarring is a complex process, and numerous methods have been introduced to treat scars. This study aims to evaluate the effect of combined CO₂ fractional laser and narrowband intense pulsed light (IPL) compared to IPL alone in the treatment of hypertrophic scars.

Materials and Methods

This was a prospective, randomized controlled study enrolled 138 patients with hypertrophic scars. The participants were randomly divided into two groups: CO₂-IPL and IPL group, and received three sessions at 10–14-week intervals for 3-month follow-up. Two independent plastic surgeons evaluated the treatments using the Patient and Observer Scar Assessment Scales (POSAS). Overall satisfaction was evaluated using the Patient Satisfaction Scale (PSS).

Results

101 subjects completed the study. Compared to single IPL, the combination CO₂-IPL group showed a significant improvement in itching, color, stiffness, thickness, and irregularity, except for pain, and an enhancement in vascularization, pigmentation, thickness, relief, and pliability of the scar, assessed by POSAS (p < .01). 100% patients in the combination group were satisfied compared to 84% in IPL alone.

Conclusion

The combination of CO₂ fractional laser and narrowband IPL efficiently improved the appearance and profile of hypertrophic scars, offering a comprehensive and reliable approach for scar therapy.

Keywords:

• Hypertrophic scar
• laser
• CO₂ fractional laser
• intense pulsed light
• IPL

Disclosure statement

No potential conflict of interest has been reported by the authors.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author upon reasonable request.

Additional information

Funding

This study was supported by “National Double First-Class” and Shanghai-Top-Level” high education initiative at Shanghai Jiao Tong University School of Medicine.