585-nm pulsed-dye laser provides clinical and histologic improvement in hypertrophic scars with or without using corticosteroids

Journal of Drugs in Dermatology, April, 2003

Pulsed dye laser (PDL) treatment and intralesional corticosteroids have both been reported to be effective in reducing hypertrophic scar bulk and symptoms. This investigator compared the efficacy of combination PDL and intralesional corticosteroid treatment to PDL treatment alone to produce better hypertrophic scar improvement. The investigator selected bilateral hypertrophic inframammary scars in 22 females and randomly assigned the scars to receive treatment with 585-nm PDL alone or in combination with intralesional corticosteroid. Clinical evaluations and scar pliability scores were determined before each of the two treatment sessions and 6 weeks after the final treatment. In four patients, histologic evaluations were performed of skin biopsies obtained before and after treatment. All scars demonstrated increased pliability and decreased symptoms (pruritus) after each of the two treatments. Clinical improvement scores were not significantly better with the concomitant use of intralesional corticosteroids. Side effects were limited to mild purpura and transient hyperpigmentation. Decreased sclerosis was seen in scars after PDL treatment, with or without intralesional corticosteroids. The investigator's findings suggested that treatment of hypertrophic inframammary scars with 585-nm PDL irradiation alone provided demonstrable clinical and histologic improvement. However, the concomitant use of intralesional corticosteroids did not significantly improve clinical outcome except in those scars that were most symptomatic.

Alster T. Laser Scar Revision: Comparison Study of 585-nm Pulsed Dye Laser With and Without Intralesional Corticosteroids. Dermatol Surg 2003 Jan; 29(1):25-9.