Pulsed dye laser versus long-pulsed Nd:YAG laser in the treatment of hypertrophic scars and keloid: A comparative randomized split-scar trial

Introduction: Keloids and hypertrophic scars are benign fibrous growths that occur after trauma or wounding of the skin and present a major therapeutic problem. Objective: The purpose of this study is to evaluate and compare the effectiveness of pulsed dye laser (PDL) versus Nd:YAG laser in hypertrophic scar and keloid. Methods: Twenty patients with hypertrophic scars and keloid were included in this prospective, randomized, split-scar study. Half of each scar was randomized to treatment with a 595-nm PDL and the contralateral half with the 1064-nm Nd:YAG. Each patient received 6 laser treatment sessions at 1-month intervals. The scars were evaluated at baseline and one month after the last laser session using the Vancouver scar scale (VSS). Results: One month after the last laser treatment, final total VSS analysis of treated sites by PDL and long-pulsed Nd: YAG laser revealed significant improvements (p<0.001), whereas the average percentage of improvement in the total VSS was 55.14% for PDL and 65.44% for Nd: YAG laser. However, there were no statistically significant differences between PDL- and long-pulsed Nd: YAG laser-treated sites for total VSS (p<0.074). Limitations: This was a single-center non-controlled trial, which included a small number of patients and subjective outcome measures. Conclusion: PDL and long-pulsed Nd: YAG laser treatments for keloid and hypertrophic scar provide significant improvement with insignificant difference between both modalities.