Papers of The 2nd Japan Scar Workshop

21. Efficacy of 1064nm Nd:YAG laser on keloid and hypertrophic scar

Satoshi Akaishi, Kyoko Kobe, Sachiko Koike, Hiko Hyakusoku
Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan

OBJECTIVE: Lasers have been used in the treatment of hypertrophic scars and keloids since the 1980ís. Pulsed dye lasers are currently considered the best choice though many studies were suspicious about their effectiveness. The purpose of this study is to investigate the effect of 1064nm Nd:YAG laser on hypertrophic scars and keloids. METHODS: Twelve keloids and 3 hypertrophic scars of 15 patients were treated using a 1064nm Nd:YAG laser with a 5 mm spot size, fluences of 14 J/cm2 and pulse widths of 0.3 msec, every 3 to 4 weeks. Biopsies of treated and untreated regions were examined and assessed histologically and microscopically. RESULTS: After a mean of 11.8 treatment sessions, clinical assessments of the scars were improved. Clinical assessment (scar volume, erythema, hardness, itch and pain) were classified from 0 to 3 points. There was a decrease from 9.2 to 6.7 points after laser treatment. Histological and microscopic examination revealed that the collagen fibers where laser was applied were disrupted at 3 days after irradiation but not at 1 day after irradiation. RESULTS: During the laser treatments, a decrease in clinical assessment was reported. Histological and microscopic findings will support the effectiveness of Nd:YAG laser. The optimal laser is currently 585 nm PDL, although the recent results of 1064nm Nd:YAG laser are promising.
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