Laser technologies in the correction of post-traumatic atrophic scars

The multifactorial genesis of collagen synthesis disorders in atrophic scars suggests the need to develop combined methods of scar tissue remodeling. Objective: to determine the therapeutic effects of various combinations of high-intensity laser therapy (HILT) in patients with traumatic atrophic scars. Methods: 34 patients were studied in two groups with developing (N = 15) and mature (N = 19) skin scars. Homogeneous photothermolysis (λ = 1,064 microns) followed by fractional photothermolysis by laser radiation (λ = 10,6 microns) was used in patients with developing scars, and homogeneous photothermolysis (λ = 1,064 microns) and planar ablative laser photodestruction (λ = 10.6 microns) of scars were applied in patients with mature scars. Dermatoscopic methods were used to assess the functional properties of the skin, morphometric analysis of scars, assessment of the quality of life and integral effectiveness of HILT in patients. Results: An improvement in the functional properties of atrophic scars was found mainly due to smoothing the borders with the surrounding skin, restoring the thickness of the epidermis by reducing the thickness of all layers, especially the spiny layer with an increase in the volume of keratinocytes of the granular layer. As a result of the course of treatment, an improvement in the quality of life indicators on the DQLI scale was revealed. The effectiveness of HILT in patients with developing scars was 81 %, with mature — 75 %. Conclusion: A comparative analysis of the dynamics of the state of developing and mature scars under the influence of various protocols of high-intensity laser therapy will allow individualizing their use in the schemes of atrophic scars correction.