Evaluation of Treatment of Scars using Carbon Dioxide Laser in the Skin of People of Colour

Abstract

Scar is an inevitable consequence of skin disruption following trauma, burn, or surgery. Burn and traumatic wounds are the most challengeable to be treated, because these are the worst in clinical medicine. CO2 lasers were one of the promising techniques in the treatment of scars, which were not tried in Sudanese patients. Objectives: To evaluate the efficacy and safety uses of fractional ablative CO2 laser in the treatment of traumatic scars in the skin of color (Sudanese patients). Methods: Study design: This was an uncontrolled open-label clinical trial, conducted at the Dermatology Consultancy Center (A private specialized skin center, Khartoum), during the period from December 2013 to December 2016. Forty two patients with traumatic scars were included in the study. The data were collected using a comprehensive structured questionnaire. Patients were photographed before the laser sessions, and after the completion of treatment. CO2 laser was used for the treatment, applying different modes and techniques according to the characters of the scar. The number of laser sessions were 2- 6, at 1-2 months intervals between the sessions. The Visual Analog Scale (VAS) with scar ranking was used in assessment of the results. The data were analyzed using SPSS version 22.0. Results:The total numbers of studied population were 42. 13 (31.0%) patients were males, and 29 (69.0%) were females. According to the types of lesions on presentation, 17 (40.2%) patients had hypertrophic scars, 18 (42.9%) had atrophic scars, 8 (19.0%) patients had linear scar, 7 (16.7%) had pigmented scar, while 2 (4.8%) patients had keloidal scars. Excellent results were obtained in 11 (26.1%) patients, 16 (38.1%) patients achieved very good results, 13 (31.0%) patients obtained good results, and in 2 (4.8%) patients, the results obtained were poor.The percentage improvement in each variable of the VAS (vascularity, pigmentation, acceptability, observer comfort and contour) showed significant improvement. Minimal transient side effects and complications in form of pain, hyperpigmentation, hypopigmentation and secondary infections were reported. Limitations: The study is limited by the small sample size because of the rarity of patients who seek such treatment, done in a single center, and no control or comparative group. Conclusions: Fractional ablative CO2 laser is an effective and safe method for treatment of traumatic scars with acceptable results, in the skin of color population.