Comparison of non-ablative and ablative fractional laser treatment in postoperative scars

Abstract

Postoperative scarring following thyroidectomy is a problem for both patients and clinicians. Recently, both nonablative and ablative fractional laser systems (NFL and AFL) have attracted attention in the revision of thyroidectomy scars. The present split-scar study was designed to compare the efficacy of these two systems for post-thyroidectomy scars.Twenty females (mean age 42.1 years, range 22-55) with scarring 2-3 months post thyroidectomy were enrolled in the study. One half of the scar (chosen at random) was treated with NFL and the other half with AFL (MOSAIC™ and eCO2™, Lutronic, Ilsan, Korea). Two treatments were given two months apart. Clinical photographs were taken at baseline, before each treatment and at the final three-month evaluation, when both independent clinician grading of improvement and patient satisfaction were measured on a quartile scale. Color (erythema and melanin indices, EI & MI) and scar hardness were measured at baseline and at three months posttreatment with a dermaspectrometer and durometer, respectively.AFL was graded better than NFL by clinicians and patients in 7 and 6 patients, respectively, NFL versus AFL in 6 and 5 patients, respectively, and equal grading in 7 and 9 patients, respectively. The mean clinical improvement grades for AFL and NFL were 2.45±0.99 and 2.35±0.85, respectively, without statistical significance (p=0.752). Fourteen patients were very satisfied or satisfied with AFL compared with 13 patients for the NFL, and 2 patients were dissatisfied with both approaches. The EI and MI were significantly better for NFL versus AFL (p=0.035, p=0.003, respectively) and hardness was significantly better for AFL (p=0.026). Mild hypertrophic scarring was seen in 2 patients.Clinical improvement was not significantly different between the two systems, whereas AFL was better for scar hardness and NFL for color. These data suggest that a study with a combined approach might be merited in the revision of post-thyroidectomy scarring.