Clinical Effect of a Single Pulsed Dye Laser Treatment of Fresh Surgical Scars: Randomized Controlled Trial

Clinical Effect of a Single Pulsed Dye Laser Treatment of Fresh Surgical Scars: Randomized Controlled Trial
January 2006
To cite this article: Murad Alam MD, Kucy Pon MD, S. Van Laborde MD, Michael S. Kaminer MD, Kenneth A. Arndt MD, Jeffrey S. Dover MD, FRCPC (2006)
Clinical Effect of a Single Pulsed Dye Laser Treatment of Fresh Surgical Scars: Randomized Controlled Trial
Dermatologic Surgery 32 (1), 21Ò25.
doi:10.1111/1524-4725.2006.32029
Blackwell Synergy

Murad Alam, MD,**Section of Cutaneous and Aesthetic Surgery, Department of Dermatology, Northwestern University, Chicago, Illinois Kucy Pon, MD,‹‹Skin Care Physicians of Chestnut Hill, Chestnut Hill, Massachusetts S. Van Laborde, MD,‹‹Skin Care Physicians of Chestnut Hill, Chestnut Hill, Massachusetts Michael S. Kaminer, MD,‹‹Skin Care Physicians of Chestnut Hill, Chestnut Hill, Massachusetts··Section of Cutaneous Oncology and Dermatologic Surgery, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut??Department of Medicine (Dermatology), Dartmouth Medical School, Hanover, New Hampshire Kenneth A. Arndt, MD,‹‹Skin Care Physicians of Chestnut Hill, Chestnut Hill, Massachusetts··Section of Cutaneous Oncology and Dermatologic Surgery, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut??Department of Medicine (Dermatology), Dartmouth Medical School, Hanover, New HampshireDepartment of Dermatology, Harvard Medical School, Boston, Massachusetts and Jeffrey S. Dover, MD, FRCPC‹‹Skin Care Physicians of Chestnut Hill, Chestnut Hill, Massachusetts··Section of Cutaneous Oncology and Dermatologic Surgery, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut?

Murad Alam, MD, Kucy Pon, MD, S. Van Laborde, MD, Michael S. Kaminer, MD, Kenneth A. Arndt, MD, and Jeffrey S. Dover, MD, FRCPC, have indicated no significant interest with commercial supporters.

Address correspondence and reprint requests to: Jeffrey S. Dover, MD, FRCPC, 1244 Boylston Street, Suite 302, Chestnut Hill, MA 02467; or e-mail: jdover@skincarephysicians.net.

Abstract
BACKGROUND Pulsed dye laser has been used to decrease erythema and telangiectasia associated with scars, including surgical scars. There is limited evidence indicating improved surgical scar appearance if pulsed dye laser treatments are commenced immediately at the time of suture removal.

OBJECTIVE To determine whether a single one-pass pulsed dye laser treatment at the time of suture removal can improve the appearance of surgical scars.

METHODS Randomized controlled trial enrolling 20 patients (complete data for 17 patients) at two geographic sites, with blinded ratings of pre- and post-treatment photographs obtained at various time points. Included patients underwent elliptical excision for atypical nevi of the trunk and/or extremities, with at least one resulting scar of at least 5 cm in length or two scars of at least 2.5 cm in length. For each patient, each scar or half-scar (if a larger scar was used) was randomized to treatment or control groups. Treatment scars received a single one-pass treatment with a 595 nm pulsed dye laser (Vbeam, Candela Corporation, Wayland, MA, USA) at the time of suture removal (ie, 2 weeks after excision) at the following parameters: 7 J/cm2 fluence, 7 mm spot size, 1.5-millisecond pulse duration, and 30-millisecond spray, 20-millisecond delay of dynamic cooling. The treatment area included 1 cm on either side of the scar, and the round laser spots were overlapped 10%. Control scars were not treated with laser.

RESULTS Immediate purpura was induced from the laser treatment. Six weeks after laser treatment, no significant difference was found in the clinical appearance of surgical scars treated with a single pulsed dye laser treatment on suture removal day versus those surgical scars not treated with laser. Parameters on which no significant difference was found included visibility of incision, erythema, hyperpigmentation, hypopigmentation, induration, and atrophy. Both sets of scars improved overtime.

CONCLUSIONS A single pulsed dye laser treatment at the time of suture removal does not appear to have a beneficial effect on clinical scar appearance. The point of minimal benefit for such laser treatments may lie somewhere between one and three treatments.

Blackwell Synergy? is a Blackwell Publishing, Inc. registered trademark

You can view the abstract online. A subscription is required to view the full text or it can be purchased online.