NEW ORLEANS The pulsed dye lasers 585 nm and 595 nm are equally effective in surgical-scar ablation, Maria P. Rivas, M.D., reported at the annual meeting of the American Academy of Dermatology.
Although there were no significant histologic or clinical differences between the treated sites, the sites treated with the lower-fluence laser showed slightly more elastic fibers and slight advantages in pliability, vascularity, and scar height, said Dr. Rivas of the department of dermatology and cutaneous surgery at the University of Miami.
She and her colleagues examined outcomes on 19 linear postsurgical scars greater than 3 cm; the scars occurred on 14 patients aged 18-85 years. Their skin types were I-IV. A blinded examiner evaluated the scars on suture-removal day and after treatment using the Vancouver Scar Scale, which assesses pigmentation, vascularity, pliability, and height. The investigators also rated the scars for cosmetic appearance using a cosmetic visual-analog scale.
Each scar was divided into three equal segments. The center segment was left untreated, and the outer segments were randomized to treatment with either pulsed dye laser (PDL) 585 nm or 595 nm (10-mm spot size, 3.5 J/cm2).
Each scar was treated once a month for 3 months, and final assessment was made 1 month after series completion.
At that time, sites treated with the 585-nm PDL showed slightly more elastic fibers on histology than did sites treated with the 595-nm PDL.
All treated sites showed a greater improvement than control sites on the Vancouver Scar Scale. The control sites showed an average 32% improvement, the 595-nm sites showed an average 55% improvement, and the 585-nm sites showed and average 67% improvement. The difference between the treated sites was not statistically significant.
All the Vancouver Scar Scale parameters were more improved on the treated sites than on the control sites, with vascularity and pliability showing the greatest improvements. All treated sites scored significantly higher than the untreated sites on the cosmetic visual-analog scale. Again, the 585-nm sites score slightly higher than the 595-nm sites, but not significantly so.
Comparison of efficacy of 585-nm vs. 595-nm pulsed dye laser on treating surgical scars is shown on suture removal day. Courtesy Dr. Maria P. Rivas