Efficacy of Erbium Yag Laser and Nd Yag Laser in the Management of Post-Burns & Post-Traumatic Scars in Type 4-5 Skin

Dr. Aniketh Venkataram, MS, MCH, DAFPRAS & Dr. Venkataram Msyore, MD, DNB, DipRCPath(Lond), FRCP(Glasgow), FISHRS.

It is generally agreed that post-burns scars and post-traumatic scars are difficult to manage, because of the textural changes, depth, thickness etc. The problem is particularly challenging in brown-black skin, where pigmentation is an added problem. While there have been some publications of CO2 Laser, data are limited for the management of Erbium Yag Laser.

Objectives: To study the efficacy of management of Erb-Yag and ND-Yag Laser in post-burns scars and post-traumatic scars in types of 4-5 skin.

Methods

Erbium Yag Laser by Fotona was tried in 20 cases of post-burns scars and post-traumatic scars. Of these 12 were atrophic scars, 8 were both hypertrophic and atrophic. Atrophic scars were treated with fractional Erb-Yag Laser (turbo 6-12) 2-3 passes, 4-6 sessions. Erythematous scars were treated with long pulse Nd Yag Laser pulse width 10-15 mSec 100-120 j. Hypertrophic scars were additionally treated with Long pulse Nd Yag Laser 30 msec 180-220 mj. Pigmented scars were also treated with dual toning short pulse Nd-Yag Laser 1.6 mSec. Results were assessed in terms of texture, colour, thickness, and also by a visual analog score. Patient satisfaction was also assessed.

Results

All scars showed moderate to good improvement, in texture, colour & thickness. No side-effects were observed in any case. A high amount of patient satisfaction was noted.

Conclusions

Combination of fractional Erb-Yag and Nd-Yag Lasers is useful in the management of post-burn and post-traumatic scars.