Fractional CO₂ laser combined with intradermal and topical platelet-rich plasma for hypertrophic scars: a randomized controlled trial.
Junjie Sun, Jun Wang, Shujun Song et al.
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In 30 seconds
This prospective, randomized, assessor-blinded trial compared fractional CO₂ laser plus intradermal and topical platelet-rich plasma (PRP) with laser plus saline in 120 patients with hypertrophic scars. Participants received four treatment sessions at 4–6-week intervals. At the prespecified endpoint, 6 months after the final session, the combined-treatment group had a lower Vancouver Scar Scale score, with an estimated between-group difference of -1.85 points (95% CI -2.48 to -1.22). Patient and observer scar scores also favored PRP, while procedural pain was greater.
Key findings
- At 6 months, the estimated between-group difference in Vancouver Scar Scale total score was -1.85 points (95% CI -2.48 to -1.22), favoring PRP plus laser.
- POSAS scores were lower with combined treatment from T1 onward (P = 0.022 at T1; P < 0.001 at T2, T3, and T4).
- Ultrasound-measured scar thickness was lower at 3 months (P = 0.045); the 6-month difference was of borderline statistical significance.
- Procedural pain was greater with PRP plus laser (mean between-group difference 1.34 points on a 0-10 VAS; P < 0.001).
Why it matters
The trial suggests that adding intradermal and topical PRP to fractional CO₂ laser can improve clinical scar scores beyond laser alone, providing evidence for PRP as a potential adjunct in hypertrophic-scar treatment. The findings also clarify a trade-off: combined treatment caused more procedural pain, and the evidence for a sustained reduction in scar thickness at 6 months was less certain.
What to keep in mind
The abstract reports a 6-month post-treatment endpoint; longer-term durability is not established. The 6-month ultrasound thickness difference was borderline across missing-data approaches.