Chulalongkorn Medical Journal


Background : Nonablative fractional laser resurfacing has been shown to have sizereduction effect on hypertrophic scar with minimal side effects; andantifibrotic effect of vitamin D in keloid fibroblasts has been reportedin vitro. A combination of the two treatments should gain additional benefitsfrom facilitation of wound healing, transdermal drug delivery and recurrenceprevention.Objectives : To evaluate the efficacy of nonablative fractional laser resurfacing combinedwith topical calcipotriol for the treatment of keloid and hypertrophic scar.Methods : Subjects were treated with six fractional 1,550 nm Ytterbium/Erbium: fiberlaser treatment weekly for entire lesion. Each lesion was randomly treatedwith topical calcipotriol or white petrolatum twice daily. Follow-up visitswere done at week 6th and 12th. Clinical appraisal achieved by Patient andObserver Scar Assessment Scale (POSAS) and evaluator blindedphotographic clinical assessment.Results : Twelve subjects completed treatments in the study. Mean POSAS showedsignificant reduction (P <0.05) at week 6 but no statistical differencebetween groups was observed. Photographic clinical assessment had mild(1 - 25%) to moderate (26 - 50%) improvement in majority of the cases butthere was no statistical difference between groups.Conclusion : Nonablative fractional laser is an effective treatment for keloids andhypertrophic scars while the benefit of topical calcipotriol could not bedemonstrated in the study.Keywords : Fractional erbium laser, hypertrophic scar, keloid, vitamin D3 analogue,topical calcipotriol.


Faculty of Medicine, Chulalongkorn University

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