Prospective, single-blind, randomized, controlled study to assess the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser and silicone gel sheeting in hypertrophic scar treatment

Objective: To determine the efficacy of the 585-nm flashlamp-pumped pulsed- dye laser and silicone gel sheeting in the treatment of hypertrophic scars in lighter- and darker-skinned patients. Design: Prospective, single-blind, randomized, inter -nally controlled, comparison investigation. Setting: Large academic dermatology department. Patients: Twenty patients with hypertrophic scars (19 completed the laser t reatments and 18 completed the silicone gel sheeting treatments). Main Outcome Measures: Clinical measurements included hypertrophic scar blo od flow, elasticity, and volume. Patients' subjective complaints of pruritu s, pain, and burning were also monitored. Histological assessment of fibros is, number of telangiectasias, and number of mast cells was performed. Stat istically significant improvements in clinical measurements and patients' s ubjective complaints determined treatment success. Results: Mean scar duration was 32 months (range, 4 months to 20 years). Th ere was an overall reduction in blood flow, volume, and pruritus over time (P = .001, .02, and.005, respectively). However. no differences were detect ed among treatment and control groups. There was no reduction in pain or bu rning (0-40 weeks), elasticity (8-40 weeks), or fibrosis (0-40 weeks, n = 5 biopsies) in the treated or control sections of the scars. Unlike in a pre vious study, the number of mast cells in the scars was similar to the numbe r of mast cells in healthy skin. Conclusion: Clinical results demonstrate that the improvements in scar sect ions treated with silicone gel sheeting and pulsed-dye laser were no differ ent than in control sections.