Comparison of the effects of short- and long-pulse durations when using a 585-nm pulsed dye laser in the treatment of new surgical scars. [2010.01]
More than 70 million surgical procedures are performed annually in the USA with the majority involving a skin lesion and almost all individuals in their lifetime will have one or more surgical procedures resulting in scars... Both short-pulse and long-pulse PDL are safe and effective in improving the quality and cosmetic appearance of surgical scars in skin type's I-IV starting on the day of suture removal with no significant difference between the two pulse durations.
Comparison of a long-pulse Nd:YAG laser and a combined 585/1,064-nm laser for the treatment of acne scars: a randomized split-face clinical study. [2009.11]
BACKGROUND: Nonablative laser is gaining popularity because of the low risk of complications, especially in patients with darker skin. OBJECTIVE: To compare the efficacy and safety of a long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and a combined 585/1,064-nm laser for the treatment of acne scars... CONCLUSION: Both lasers ameliorated acne scarring with minimal downtime. In light of this finding, optimal outcomes might be achieved when laser treatment types are chosen after considering individual scar type and response.
The use of silicone gel in the treatment of fresh surgical scars: a randomized study. [2009.08]
AIM: To evaluate the effectiveness of a silicone gel in treating surgical wounds compared with a control group of the same phenotype and same scar site for which a placebo was advised... CONCLUSIONS: The results of this study indicate that silicone gel is able to reduce the formation of keloid and hypertrophic scars and the signs/symptoms associated with the healing process (paraesthesia, pulling sensation, alterations in colour).
Multimodality scar management program. [2009.07]
BACKGROUND: This trial was undertaken to assess the efficacy of a multimodality management regime used for the prevention of hypertrophic scars. It follows previous research and experience (A.D. Widgerow et al, Aesthetic Plast Surg, 24(3):227-234, 2000) with a similar program but with the addition of active agents with specific effects against prolonged inflammation and enhanced hydrative capacity. The modalities specifically targeted are tension on the scar, hydration of the scar, collagen maturation, and controlled inflammation... CONCLUSION: Treated groups showed improvement outcomes in all variations of assessment. Patient and observer assessments correlated well, and morphologic appearances of the scars following the final assessment at 6 months showed statistically significant positive scar outcomes in the treatment groups. The multimodality approach to scar control showed significant benefits in the patient groups tested in this series.
Do postsurgical interventions optimize ultimate scar cosmesis. [2009.06]
Keloids and other scars are different manifestations of the normal wound healing process.
Efficacy of a polyurethane dressing versus a soft silicone sheet on hypertrophic scars. [2009.05]
CONCLUSION: Both regimens were associated with a significant reduction in the clinical signs of hypertrophic scars over 12 weeks of treatment. The polyurethane dressing demonstrated a significantly more pronounced reduction in severity of these clinical signs after four and eight weeks of treatment and was better tolerated than the silicone sheet. l Declaration of interest: This study was funded by Beiersdorf AG. proDERM is an independent research company, and none of the authors have an interest in the sponsors commercial activities.
Prophylactic administration of avotermin for improvement of skin scarring: three double-blind, placebo-controlled, phase I/II studies. [2009.04.11]
BACKGROUND: Research into mechanisms of skin scarring identified transforming growth factor beta3 (TGFbeta3) as a potential antiscarring therapy. We assessed scar improvement with avotermin (recombinant, active, human TGFbeta3)... INTERPRETATION: Avotermin has potential to provide an accelerated and permanent improvement in scarring.
Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. [2009.03]
BACKGROUND: Keloids and hypertrophic scars are benign growths of dermal collagen that can cause physical and psychological (cosmetic) problems for patients... CONCLUSION: The overall efficacy of TAC + 5-FU was comparable with TAC, but the TAC + 5-FU combination was more acceptable to patients and produced better results.
Fractional nonablative 1540 nm laser resurfacing for thermal burn scars: a randomized controlled trial. [2009.03]
BACKGROUND AND OBJECTIVE: Burn scars cause permanent and disfiguring problems for many patients and limited treatments are available. Nonablative fractional lasers induce a wound healing response, which may lead to remodeling of burn scar texture. This randomized trial evaluates efficacy and adverse effects of 1540 nm fractional laser versus untreated control for burn scars... CONCLUSIONS: Nonablative 1540 nm fractional laser improves burn scar texture, which raises a new potential for future burn scar treatment. Copyright 2009 Wiley-Liss, Inc.
Clinical trial of a pinpoint irradiation technique with the CO2 laser for the treatment of atrophic acne scars. [2008.09]
Ablative laser resurfacing is an effective treatment for atrophic acne scars. However, it often induces complications such as edema, prolonged erythema, scarring and hyperpigmentation... Clinical improvement was achieved in all 35 patients with minimal adverse effects.
Evaluating the tolerability and efficacy of etanercept compared to triamcinolone acetonide for the intralesional treatment of keloids. [2008.08]
BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory and profibrotic cytokine that inhibits degradation of collagen and glycosaminoglycans. Etanercept, a recombinant TNF-alpha receptor fusion protein, may decrease excessive fibrous tissue in keloids. OBJECTIVE: To evaluate the tolerability and efficacy of etanercept as compared to triamcinolone acetonide (TAC) for the treatment of keloids... CONCLUSION: Etanercept was safe, well tolerated, improved several keloid parameters, and reduced pruritus to a greater degree than TAC therapy. However, further studies are required before it can be recommended for the treatment of keloids.
The ability of onion extract gel to improve the cosmetic appearance of postsurgical scars. [2008.06]
Superior wound healing with excellent cosmesis is critical in superficial dermal wounds created when cosmetically unacceptable lesions are removed from the body. Dermatologists frequently remove seborrheic keratoses, nevi, and angiomas from the body with a superficial shave excision... The study showed that the onion extract gel significantly improved scar softness, redness, texture, and global appearance at the excision site at study weeks 4, 6, and 10 as assessed by the blinded investigator.
Scar redness in humans: how long does it persist after incisional and excisional wounding? [2008.02]
BACKGROUND: The natural history of scar redness in humans has never been formally described, and the point at which normal scar redness fades is unknown... CONCLUSIONS: Scar redness fades on average at 7 months. This is influenced by the wound type and position. The authors advocate the use of the term "rubor perseverans" to describe the physiologic redness of a normal scar as it matures beyond the first month, a process that does not involve inflammation.
Fractional photothermolysis for the treatment of acne scars: a report of 27 Korean patients. [2008]
OBJECTIVES: Atrophic post-acne scarring remains a therapeutically challenging condition despite various currently available technologies. Fractional photothermolysis (FP) is a novel concept of cutaneous resurfacing which induces non-contiguous microscopic thermal injury. The aim of this study is to evaluate the safety and efficacy of FP in the treatment of acne scars in Asian patients... CONCLUSIONS: The 1550-nm erbium-doped FP is associated with significant patient-reported improvement in the appearance of acne scars, with minimal downtime.
Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, Phase III clinical trial. [2007.03]
BACKGROUND: Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. OBJECTIVE: The purpose of this study was to determine efficacy and side effects of autologous living fibroblast injections versus placebo in a randomized Phase III trial for the treatment of various facial contour defects... CONCLUSIONS: Our results indicate that autologous fibroblast injections can safely and effectively produce improvements in rhytids, acne scars, and other dermal defects continuing for at least 12 months after injection.
Clinical trial of a laser device called fractional photothermolysis system for acne scars. [2006.09]
Ablative laser resurfacing is an effective treatment for acne scars. However, edema and prolonged erythema are common...
Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a prospective randomized controlled trial. [2006.07]
BACKGROUND: With rapid advancement in cutaneous laser therapy, Q-switched lasers have become the standard treatment for tattoo removal. The longer wavelength Q-switched Nd:YAG laser is used when removing tattoos in darker skin patients to avoid scarring and permanent pigment changes. Nevertheless, the local experience revealed that nearly 25% of the Chinese patients developed scarring. Meanwhile, multiple clinical studies have shown that Contractubex gel (Merz Pharma, Frankfurt, Germany) was effective in the treatment and prevention of hypertrophic scars and keloids. OBJECTIVE: To evaluate the efficacy of Contractubex gel in the prevention of scarring after laser removal of tattoos in Chinese patients... CONCLUSION: Contractubex gel is effective in scar prevention in Chinese patients having laser removal of tattoos.
Evaluation of a self-adherent soft silicone dressing for the treatment of hypertrophic postoperative scars. [2006.05]
CONCLUSION: The results suggest that patients treated with the soft silicone dressing experienced greater and more rapid improvements compared with non-treated patients. These results concur with those of previous studies. The fact that Mepiform is self-adhesive and causes limited damage to the stratum corneum on removal gives it an added value compared with non-adhesive silicone gel dressings.
Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. [2006.02]
BACKGROUND: Cutaneous scars resulting from surgical procedures can be erythematous, hypertrophic, pruritic, painful, or cosmetically unacceptable. An onion extract-based topical gel (Mederma, Merz Pharmaceuticals, Greensboro, NC, USA) has been marketed as a product to improve scar appearance and texture. However, few data are available to substantiate these claims. OBJECTIVE: To compare the efficacy between the onion extract gel and a petrolatum-based emollient (Aquaphor, Beiersdorf, Inc., Wilton, CT, USA) in improving the appearance and symptoms of new surgical scars... CONCLUSION: Petrolatum-based topical agents constitute standard therapy in the management of postoperative wounds. In this side-by-side, randomized, double-blinded, split-scar study, the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment.
Treatment of surgical scars with the cryogen-cooled 595 nm pulsed dye laser starting on the day of suture removal. [2006.01]
BACKGROUND: Cosmetic results after skin surgery are a key component of patient satisfaction and self-image. Various lasers have been used to attempt scar improvement, without consistent results. The optimal time to initiate laser treatment has not been determined. A recent study using a noncooled 585 nm pulsed dye laser starting on the day of suture removal demonstrated substantial improvement in scar appearance. OBJECTIVE: To determine the efficacy of the 595 nm cryogen-cooled pulsed dye laser in the treatment of surgical scars starting on the day of suture removal... CONCLUSION: The cryogen-cooled 595 nm pulsed dye laser is a safe and effective option to improve the cosmetic appearance of surgical scars in skin types I to IV starting on the day of suture removal.
Clinical effect of a single pulsed dye laser treatment of fresh surgical scars: randomized controlled trial. [2006.01]
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... 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.
A randomized, controlled trial to determine the efficacy of paper tape in preventing hypertrophic scar formation in surgical incisions that traverse Langer's skin tension lines. [2005.11]
BACKGROUND: How a scar is managed postoperatively influences its cosmetic outcome. After suture removal, scars are susceptible to skin tension, which may be the trigger for hypertrophic scarring. Paper tape to support the scar may reduce multidirectional forces and prevent hypertrophic scarring... CONCLUSIONS: The development of hypertrophic and stretched scars in the treatment group only after the tape was removed suggests that tension acting on a scar is the trigger for hypertrophic scarring. Paper tape is likely to be an effective modality for the prevention of hypertrophic scarring through its ability to eliminate scar tension.
Scar management: prevention and treatment strategies. [2005.08]
PURPOSE OF REVIEW: Aberrant wound healing results in unsightly scar, hypertrophic scar, and keloid formation, causing functional and cosmetic deformities, discomfort, psychological stress, and patient dissatisfaction... Strategies for prevention and management of keloids and hypertrophic scars continue to develop, as the basic science mechanisms underlying aberrant wound healing are elucidated.
Comparison of intense pulsed light to 595-nm long-pulsed pulsed dye laser for treatment of hypertrophic surgical scars: a pilot study. [2005.07]
BACKGROUND: The short-pulsed pulsed dye laser (PDL) has been previously reported to improve the appearance of hypertrophic scars. Prolonged purpura following treatment led to the development of the newer long-pulsed pulsed dye laser (LPDL). Intense pulsed light (IPL) has been extensively used to improve the various components of photo damage and to reduce the incidence of purpura, but its effect on scars has not been analyzed. The objective of this pilot study was to prospectively determine and compare the safety and efficacy of LPDL and IPL on surgically induced scars... CONCLUSIONS: This pilot study suggests that LPDL and IPL are equally effective in improving the appearance of hypertrophic surgical scars. IPL offers a novel method of treating scars that minimizes the risk of purpura.
[Evaluation of a compound with dan-shen root and azone for scar treatment] [2004.05]
OBJECTIVE: To evaluate the effect of the compound of Dan-shen root and azone for scar treatment... CONCLUSION: The Dan-shen root with azone could be easier to permeate the skin and more effective to treat the hypertrophic scar.
Atrophic and a mixed pattern of acne scars improved with a 1320-nm Nd:YAG laser. [2003.09]
CONCLUSION: The 1320-nm Nd:YAG laser is a safe and effective nonablative modality for the improvement of atrophic and a mixed pattern of facial acne scars.
Pulsed dye laser treatment of burn scars. Alleviation or irritation? [2003.05]
INTRODUCTION: Burn scars are very common in both children and adults, causing great morbidity and often pose a difficult management problem. This study investigated the efficacy of the dye laser in patients with symptomatic burn scars and analysed the impact of the laser treatment on scar redness, surface texture and pruritis... CONCLUSION: The 585 nm flashlamp-pumped pulsed dye laser is an effective treatment for the intense pruritis often experienced during the healing process after a burn injury. This study has not shown other benefits, such as reduction in scar redness, height and textural improvement to be statistically significant. There is evidence that blood vessel diameters in hypertrophic scar tissue are much smaller than the vessels in port wine stains for which this laser was designed to treat. Therefore, by decreasing the pulse width, more vascular specific damage in the scar may be possible. It is likely that the beneficial effects demonstrated thus far result from changes to the chemical signals that regulate the scar growth and symptoms.
Laser scar revision: comparison study of 585-nm pulsed dye laser with and without intralesional corticosteroids. [2003.01]
BACKGROUND: Hypertrophic scars affect 1.5% to 4.5% of the general population and remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with treatment. Pulsed dye laser (PDL) treatment and intralesional corticosteroids have individually been reported to be effective in reducing hypertrophic scar bulk and symptoms. OBJECTIVE: To determine whether combination PDL and intralesional corticosteroid treatment produces better hypertrophic scar improvement than PDL treatment alone... CONCLUSIONS: Treatment of hypertrophic inframammary scars with 585-nm PDL irradiation alone effected substantial clinical and histologic improvement. The adjunctive use of intralesional corticosteroids did not significantly enhance clinical outcome except in those scars that were most symptomatic.
585-nm pulsed dye laser in the treatment of surgical scars starting on the suture removal day. [2003.01]
BACKGROUND: The optimal time frame to improve the quality and cosmetic appearance of scars by laser therapy has not been clearly elucidated by prior controlled clinical trials. OBJECTIVE: To determine the efficacy of the 585-nm pulsed dye laser (PDL) in the treatment of surgical scars starting on the day of suture removal... CONCLUSION: The 585-nm PDL is effective and safe in improving the quality and cosmetic appearance of surgical scars in skin types I-IV starting on the day of suture removal.
Treatment response of keloidal and hypertrophic sternotomy scars: comparison among intralesional corticosteroid, 5-fluorouracil, and 585-nm flashlamp-pumped pulsed-dye laser treatments. [2002.09]
OBJECTIVE: To compare the clinical response of keloidal and hypertrophic scars after treatment with intralesional corticosteroid alone or combined with 5-fluorouracil (5-FU), 5-FU alone, and the 585-nm flashlamp-pumped pulsed-dye laser (PDL)... CONCLUSIONS: Clinical improvement of keloidal and hypertrophic scars after treatment with intralesional corticosteroid alone or combined with 5-FU, 5-FU alone, and PDL seemed comparable, with the exceptions of the incidence of adverse reactions, which were most common with intralesional corticosteroid. Intralesional 5-FU is comparable to the other therapies.
Treatment of atrophic facial acne scars with a dual-mode Er:YAG laser. [2002.07]
BACKGROUND: Scar revision with CO2 and Er:YAG lasers has become popular in recent years. Reports on the newest (modulated, dual-mode) Er:YAG systems have been limited mostly to the treatment of photodamaged skin and rhytides. OBJECTIVE: To prospectively evaluate the efficacy and safety of a dual-mode 2940 nm Er:YAG laser for atrophic scar revision... CONCLUSION: Dual-mode Er:YAG laser skin resurfacing is a safe and effective modality for the treatment of atrophic facial scarring.
Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting. [2001.07]
BACKGROUND: Topical silicone gel sheeting has been used for more than 20 years to help reduce the size of hypertrophic scars and keloids. Its clinical efficacy and safety is well established. OBJECTIVE: To determine whether topical silicone gel sheeting can be used to prevent hypertrophic scars and keloids from forming following dermatologic skin surgery... CONCLUSION: Topical silicone gel sheeting, with a 20-year history of satisfaction in dermatology, now appears to be useful in the prevention of hypertrophic scars and keloids in patients undergoing scar revision.
Effect of four treatment variants on the functional and cosmetic state of mature scars. [2000.07]
A randomised, intra-individual, comparative study demonstrated that both qualitative improvements and significant changes in skin functional condition can be achieved in the tissue of older, mature scars. Four treatment modalities were studied in an intra-individual comparison involving 12 volunteers with 2.5 to 4-year-old scars...
A newly formulated topical triple-antibiotic ointment minimizes scarring. [2000.06]
A randomized study of polymyxin B sulfate-bacitracin zinc-neomycin sulfate versus simple gauze-type dressings in dermabrasion wounds assessed the effects that each treatment had on scarring. Each of three uniform dermabrasion wounds created on the upper backs of 70 subjects was treated concurrently with a triple-antibiotic ointment (polymyxin B-bacitracin-neomycin), a double antibiotic (polymyxin B-bacitracin), or a simple, non-occlusive, gauze-type dressing, twice daily for up to 14 days...
Prospective, single-blind, randomized, controlled study to assess the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser and silicone gel sheeting in hypertrophic scar treatment. [1999.09]
OBJECTIVE: To determine the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser and silicone gel sheeting in the treatment of hypertrophic scars in lighter- and darker-skinned patients... CONCLUSION: Clinical results demonstrate that the improvements in scar sections treated with silicone gel sheeting and pulsed-dye laser were no different than in control sections.
The effects of topical vitamin E on the cosmetic appearance of scars. [1999.04]
BACKGROUND: Vitamin E is a generic term for a group of tocol and tocotrienol derivatives. Since the discovery that vitamin E is the major lipid soluble antioxidant in skin, this substance has been tried for the treatment of almost every type of skin lesion imaginable. Anecdotal reports claim that vitamin E speeds wound healing and improves the cosmetic outcome of burns and other wounds. Many lay people use vitamin E on a regular basis to improve the outcome of scars and several physicians recommend topical vitamin E after skin surgery or resurfacing. OBJECTIVE: We attempted to determine whether topically applied vitamin E has any effect on the cosmetic appearance of scars as suggested by multiple anectodal reports... CONCLUSIONS: This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar. In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore we conclude that use of topical vitamin E on surgical wounds should be discouraged.
Laser scar revision: comparison of CO2 laser vaporization with and without simultaneous pulsed dye laser treatment. [1998.12]
BACKGROUND: Over the past decade, the 585-nm pulsed dye laser (PDL) has been used successfully to treat a variety of cutaneous vascular lesions as well as hypertrophic scars. Laser scar revision has been revolutionized by the recent development of high-energy, pulsed carbon dioxide (CO2) laser systems. These new CO2 lasers allow controlled vaporization of thin layers of skin while minimizing damage to surrounding dermal structures. OBJECTIVE: To determine the effect of a high-energy, pulsed CO2 laser alone and in combination with a 585-nm PDL on nonerythematous hypertrophic scars... CONCLUSION: Concomitant use of the high-energy, pulsed CO2 and PDL laser systems was superior to CO2 laser vaporization alone for revision of nonerythematous hypertrophic scars. Once again, the vascular specificity of the 585-nm PDL has been linked to improvement in hypertrophic scar tissue.
The use of silicone occlusive sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation. [1998.11]
The development of hypertrophic scars and keloids is an unsolved problem in the process of wound healing.If both groups were taken together, the scars treated with silicone materials even developed significantly more hypertrophy compared with the Micropore-applicated scars.
A comparison of Sil-K and Epiderm in scar management. [1996.09]
Twenty-six patients with a total of 45 scars were studied to determine the efficacy of the new silicone sheet, Sil-K, in treating hypertrophic scars. Twenty-eight scars were treated with Sil-K and 17 scars were treated with the conventional gel, Epiderm.Epiderm and Sil-K were also compared across factors such as cost, durability, conformity and hygiene to assist therapists in choosing the suitable silicone sheet for each individual patient.
Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. [1995.07]
BACKGROUND.
A comparison of intralesional triamcinolone and cryosurgery in the treatment of acne keloids. [1994.04]
Keloid scarring presents a difficult therapeutic problem... Treatment with intralesional triamcinolone was also beneficial, but the response to cryosurgery was significantly better in early, vascular lesions.
Outcomes of cryosurgery in keloids and hypertrophic scars. A prospective consecutive trial of case series. [1993.09]
CONCLUSIONS: Cryosurgery was found effective and safe in keloids and, especially, in hypertrophic scars, in an open, uncontrolled study. Satisfactory results could be obtained after at least three cryosurgical sessions of 30 seconds each, applied once monthly using the contact method of treatment.
Treatment of scars and keloids with a cream containing silicone oil. [1990.11]
The clinical effect of silicone cream containing 20% of silicone oil was tested on 47 patients with hypertrophic scars and keloids. A silicone cream/occlusive dressing technique, quite similar in manner to silicone gel treatment, resulted in a remarkable improvement of scars and keloids in 9 of 11 cases (82%) whereas the simple application of the cream onto the scars and keloids of 36 cases resulted in only mild improvement in 8 (22%)...
A controlled trial of intralesional recombinant interferon-gamma in the treatment of keloidal scarring. Clinical and histologic findings. [1990.10]
Interferon-gamma (IFN-gamma) suppresses the synthesis of collagen by fibroblasts in vitro and the synthesis of collagen in vivo in animal models. Therefore, recombinant human IFN-gamma was examined for its ability to clinically modify keloids... Dose-ranging studies are required to establish whether IFN-gamma can fulfill a true clinical need in the treatment of keloidal scarring.
