Thesis (Ph.D.) - Cairo University - Faculty of National Institute for Laser Enhanced Sciences - Department of Laser Applications in Medical and Biological

Background: Topical 5 fluorouracil (5-FU) has been reported as one of the standard treatments for hypertrophic scars (HTS). Ablative fractional laser was found to have promising results in treatment of HTS also in the delivery of topical drugs into the skin by creating vertical channels through which the drugs can penetrate the skin. So far there have been no comparative studies performed to compare both modalities as monotherapy and as a combined therapy in the same patient and same anatomical region, especially in severe HTS. Objective: The aim of this study was to compare the efficacy between topical 5-FU monotherapy, ablative fractional erbium YAG laser monotherapy and combined approach in treatment of HTS. Patients and methods: Twenty four patients suffering from severe HTS lesions were divided into two groups. Each group was twelve patients. In the first group we compared treatment by 5-FU monotherapy and 5-FU combined with ablative fractional erbium YAG laser. Each lesion was divided into two parts. One part was treated with topical 5-FU and the other part was treated with combined topical 5-FU and ablative fractional erbium YAG laser.In the second group we compared treatment by ablative fractional erbium YAG monotherapy and ablative fractional erbium YAG laser combined with 5-FU. Each lesion was divided into two parts. One part was treated with ablative fractional erbium YAG laser and the other part was treated with combined laser and topical 5-FU.The topical 5-FU was applied twice weekly and the ablative fractional erbium YAG laser was done once per month.Duration of the treatment was 8 months. The scars{u2019}improvement was evaluated by Vancouver scar scale (VSS) and skin analysis camera. Results: In the first group, assessment by VSS showed a significant reduction in the mean height, pliability, and vascularity of the lesions which were treated with combined approaches compared to 5-FU monotherapy. Pain and ulceration occurred at a higher rate in the combination therapy

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