Papers of The 7th Japan Scar Workshop

4. Nd:YAG treatment for Keloids and Hypertrophic Scars

Yuki Nagashima, Rei Ogawa, Satoshi Akaishi, Teruyuki Dohi, Sachiko Koike, Hiko Hyakusoku
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan

Pulsed dye laser (PDL) is effective for superficial vascular diseases (epidermis and papillary layer of the dermis), but does not work for deep dermal regions (reticular layer of the dermis). Thus, use of 1064nm Nd:YAG laser was started for deep vascular diseases including keloids and hypertrophic scars instead of PDL. Our group has used the contact mode for keloids and hypertrophic scars since 2009. In this paper, we analyzed the efficacy of the contact mode-1064nm Nd:YAG laser therapy and discussed its indication and limitations.
In total, 30 Japanese patients (6 males and 24 females) with keloids and hypertrophic scars were treated by 1064nm Nd:YAG laser. The patients were treated every 3-4 weeks with the long-pulsed, 1064 nm Nd:YAG laser (Cutera Inc., Brisbane, CA, USA), which was applied in the contact mode. The responsiveness of the pathological scars to the treatment was assessed using the evaluation part of the Japan Scar Workshop (JSW) Scar Scale 2011.
There were significant differences between pre and post treatment in all of the groups including keloids (p<0.05). However, 2 of 14 anterior chest keloids did not respond and the improved score was 0, however, none of the hypertrophic scars or keloids showed deterioration. Our results suggest that the contact mode will have better clinical outcomes than the non-contact mode in the treatment of keloids and hypertrophic scars. In the future, combination of non-contact mode and contact modes, or PDL and 1064nm Nd:YAG should be selected and the study performed based on precise diagnoses such as subjective and objective symptoms.
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