Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars

Abstract

Background: Open thyroidectomy is conventionally performed at the anterior side of neck, which is a body part with a comparatively great degree of open exposure; due to this, postoperative scarring may cause distress in patients. We aimed to compare the effects of ablative and nonablative fractional laser treatments on thyroidectomy scars. We examined medical records in a retrospective manner and analyzed scars based on their digital images by using the modified Manchester Scar Scale (mMSS).

Methods: Between February 2012 and May 2013, 55 patients with thyroidectomy scars were treated with ablative (34 patients) or nonablative (21 patients) fractional laser. Each patient underwent 4 laser treatment sessions in 3-4 week intervals, 1-2 months postoperatively. Scar improvement was assessed using patient images and the mMSS scale.

Results: The mean decrease in scar score was 3.91 and 3.47 in the ablative and nonablative groups, respectively; the reduction between 2 groups did not exhibit any significant difference (P=0.16). We used the scale once again to individually evaluate scar attributes. The nonablative group accounted for a considerably higher color score value (P=0.03); the ablative group accounted for a considerably higher contour score value (P<0.01). Patient satisfaction was high and no complications occurred.

Conclusions: Both types of fractional laser treatments can be used successfully for thyroidectomy scar treatment with minimal complications; however, results indicate that higher effectiveness may be obtained from the use of ablative and nonablative lasers for hypertrophic scars and early erythematous scars, respectively. Therefore, the appropriate laser for scar treatment should be selected according to its specific characteristics.

Keywords: Cicatrix; Laser therapy; Thyroidectomy.

Fig. 1. Ablative fractional laser

A 33-year-old woman had a thyroidectomy scar on her neck. (A) Before treatment, the modified Manchester scar scale score was 13. (B) After 4 sessions of ablative fractional laser treatment (10,600-nm eCO2; Lutronic Corp., Goyang, Korea), the score decreased to 9.

Fig. 2. Nonablative fractional laser

A 53-year-old woman had a thyroidectomy scar on her neck. (A) Before treatment, the modified Manchester Scar Score was 12. (B) After 4 sessions of non-ablative fractional laser treatment (1,550-nm Mosaic; Lutronic Corp., Goyang, Korea), the score decreased to 9.

Fig. 3. In the ablative group

In the ablative group, the total modified Manchester Scar Score (mMSS), the visual analogue scale (VAS) score (5.35 to 3.62), color score (2.68 to 1.97), matte/shine score (1.35 to 1.21), contour score (2.35 to 1.35), and distortion score (1.53 to 1.21) significantly decreased after treatment.

Fig. 4. In the non-ablative group

In the non-ablative group, the total modified Manchester Scar Score (mMSS), the visual analogue scale (VAS) score (5.43 to 3.76), color score (2.71 to 1.76), matte/shine score (1.52 to 1.33), contour score (2.1 to 1.71), and distortion score (1.38 to 1.1) significantly decreased after treatment.