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Comparison of intense pulsed light to 595-nm long-pulsed pulsed dye laser for treatment of hypertrophic surgical scars: a pilot study.

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.

METHODS: Breast reduction scars (N = 10 scars) and abdominoplasty scars (N=5 scars) were treated using both LPDL and IPL. For breast reduction scars, one side was treated with each technique. For abdominoplasty scars, one half of the scar was treated with each device. Two treatments were performed 2 months apart. Physician global assessment scores of improvement were determined by side-by-side comparison of preoperative and randomly presented postoperative photographs. Patient pain scores during treatment were also obtained and the presence of post, treatment purpura was assessed.

RESULTS: Mean improvement on a 0 to 3 point scale was 2.2 (55%) after the first LPDL treatment and 3.2 (80%) after the second. Mean improvement was 1.8 (45%) after the first IPL treatment and 2.6 (65%) after the second. Differences in improvement between the LPDL and IPL sides were not statistically significant. Patients rated IPL as more painful than LPDL. The incidence of post-treatment purpura was lower with IPL.

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.

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