Traumatic Scars: Evaluation of the Best Timing for Early Intervention With Fractional CO 2 Laser Using Optical Coherence Tomography

ABSTRACT Background No consensus on when to start fractional CO 2 laser in traumatic scars. Objective Evaluation of three timings of early fractional CO 2 laser intervention. Methods Forty‐five patients with facial traumatic scars were randomly divided into three groups. Fractional CO 2 laser (three sessions at 4 weeks interval) was started immediately, 2 and 4 weeks after suture removal in groups A, B, and C respectively. The parameters were 25‐watt, stack 2, dwell time 800 μs and spacing 1000 μm (5% density). Vancouver Scar Scale (VSS) and optical coherence tomography (OCT) were performed at baseline and 1 month after the last session. Patients reported their satisfaction using 4‐point scale. Results VSS was significantly improved in group A ( p value = 0.001), B ( p value = 0.001), and C ( p value = 0.003) without significant difference between the three groups ( p value = 0.258). Pigmentation was significantly improved only in group B ( p value = 0.004). OCT revealed significant improvement in epidermal thickness ( p value = 0.001) and scar depth ( p value = 0.015) in group B. Conclusion The current work supports early treatment of traumatic scars with fractional CO 2 laser, especially 2 weeks after suture removal.