Trial reportLasers in medical science2026
Fractional CO₂ laser combined with intradermal and topical platelet-rich plasma for hypertrophic scars: a randomized controlled trial.
Trial report in Lasers in medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
purposeThis study compared the clinical efficacy and safety of fractional CO₂ laser combined with platelet-rich plasma (PRP) delivered by intradermal injection plus topical application versus fractional CO₂ laser alone for the treatment of hypertrophic scars.
methodsIn this prospective, randomized, assessor-blinded trial, 120 patients were assigned to a combined group (laser + PRP, n = 60) or a control group (laser + saline, n = 60). Four sessions were delivered at 4-6-week intervals. The primary outcome was Vancouver Scar Scale (VSS) total score. The prespecified primary endpoint was the between-group difference in VSS total score at T4 (6 months after the final treatment session). Secondary outcomes included POSAS scores, ultrasound-measured scar thickness, patient satisfaction, and adverse events.
resultsBoth groups showed significant VSS improvement (both P < 0.001). The combined group had significantly lower VSS total scores than the control group from T1 onward (P = 0.036 at T1; P < 0.001 at T2 and T4; P = 0.007 at T3; estimated between-group difference at T4 -1.85 points, 95% CI -2.48 to -1.22, from the primary mixed-effects model) and lower POSAS scores from T1 onward (P = 0.022 at T1; P < 0.001 at T2, T3, and T4) than the control group. Ultrasound-measured scar thickness was lower in the combined group at 3 months (P = 0.045); at 6 months the difference was attenuated and of borderline statistical significance (P = 0.042-0.065 across missing-data approaches). Patient satisfaction was higher in the combined group (P < 0.001). Procedural pain was greater in the combined group (mean between-group difference 1.34 points on a 0-10 VAS; P < 0.001). Post-inflammatory hyperpigmentation was numerically lower in the combined group (18.33% vs. 33.33%; P = 0.094).
conclusionFractional CO₂ laser combined with intradermal and topical PRP provided greater improvement in clinical scar scores than laser alone, with an acceptable safety profile. The advantage in ultrasound-measured thickness at 6 months was of borderline statistical significance. These findings support PRP as a potential adjunct for hypertrophic scars.
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