FRACTIONAL PHOTOTHERMOLYSIS FOR TREATMENT OF HYPOPIGMENTED SCARS

Prior treatments of hypopigmented scars have shown limited efficacy. This study evaluated the safety and efficacy of fractional photothermolysis (Fraxel SR750, Reliant Technologies Inc., Mountain View, CA) for the treatment of hypopigmented facial and neck scars.

Seven patients with hypopigmented scars received 2 – 5 successive treatments at 4-week intervals with the 1550-nm erbium-doped fiber laser. Treatments were done with energy settings ranging from 8 – 20 mJ and a final density of 1000 - 2500 MTZs/cm2. Digital photographs were taken prior to each treatment and at 4 weeks after the final treatment. Independent physician clinical assessments were performed.

Independent physician clinical assessment 4 weeks after the final laser treatment revealed clinical improvements of 50-75% of the hypopigmented scars in 6 patients. One patient had only 25-50% improvement in hypopigmentation. Additionally, clinical improvements were noted in the overall texture of treated skin. The patient’s degree of satisfaction paralleled the physician’s assessment of improvement. All patients reported improvement in hypopigmentation lasting greater than six months after the final treatment. Side effects were limited to mild pain during treatment and mild post-treatment erythema and edema resolving within 2 – 4 days.

Fractional photothermolysis is a potentially effective and safe modality in the treatment of hypopigmented scarring on the face and neck. No adverse effects occurred and this technique may be used on nonfacial areas such as the neck. Fractional photothermolysis may stimulate normal nearby melanocytes to migrate to the treated tissue. Or, synthesis of collagen production may improve skin optics. Larger, longer term studies are need to optimize treatment parameters.

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