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. 2025 Sep 4.
doi: 10.1007/s00266-025-05219-7. Online ahead of print.

Combination Therapy Involving Pulsed Dye and Fractional CO2 Laser Followed by Ultrasound-Assisted Transdermal Drug Delivery Technique for Hypertrophic Scars in Pediatric Patients

Zhongliang Lang #  1   2 , Guangdi Yin #  1 , Qiusheng Zhang  1 , Xiaohong Zhong  1 , Tao Lin  1 , Jing Lv  3 , Qiang Wang  4 , Liping Zhao  5
Affiliations

Combination Therapy Involving Pulsed Dye and Fractional CO2 Laser Followed by Ultrasound-Assisted Transdermal Drug Delivery Technique for Hypertrophic Scars in Pediatric Patients

Zhongliang Lang et al. Aesthetic Plast Surg. .

Abstract

Background: Hypertrophic scarring is a common pathological condition often associated with significant clinical symptoms. In pediatric patients, it can impair function and is difficult to treat due to the limited availability of effective treatment options.

Objective: To investigate the efficacy of pulsed dye and fractional CO2 laser combined with ultrasound-assisted transdermal drug delivery technology in the treatment of hypertrophic scars in pediatric patients.

Methods: A retrospective cohort study and a self-controlled before-and-after method were used. Thirty-six patients with 41 sites of hypertrophic scars who visited our hospital between July 2022 and December 2023 were included, comprising 18 males and 18 females, aged 2-17 years. All patients underwent a combination of pulsed dye and fractional CO2 laser treatment, followed by the triamcinolone acetonide using ultrasound-assisted transdermal drug delivery technique. A second combined treatment was performed after an interval of 6-8 weeks. Scars were assessed by physicians and parents using the Patient and Observer Scar Assessment Scale (POSAS) before the first treatment, and at 6 and 12 months after the final treatment. Family satisfaction with treatment efficacy was evaluated at both 6 and 12 months post-treatment, and overall satisfaction was documented at each follow-up.

Results: The study revealed a notable decline in the total patient and observer scar scale scores (74.3±4.7 versus 23.6±2.9), with a P-value of less than 0.001 for each specific POSAS score item at the 12 months follow-up period in comparison to the baseline. The overall satisfaction rate was 98%, and no serious adverse reactions were observed during the follow-up period.

Conclusion: Pulsed dye and fractional CO2 laser combined with ultrasound-assisted transdermal drug delivery technique demonstrates excellent therapeutic efficacy in the treatment of hypertrophic scars in children. The treatment is associated with minimal discomfort, high patient compliance, and no significant adverse reactions.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords: Children; Hypertrophic scar; Laser; Laser-assisted drug delivery.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflicts of interest to disclose. Human and Animal Rights: This study was approved by the Ethics Committee of The First Affiliated Hospital of USTC (No.:XJS2023-2-24(WK)). Informed Consent: Patient provided informed consent to participate in this study.

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