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Objective evaluation of the efficacy of a non-ablative fractional 1565 nm laser for the treatment of deliberate self-harm scars

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Abstract

Scars resulting from deliberate self-harm (DSH) represent therapeutically challenging forms of scarring due to their highly variable patterns, with no official therapeutic guidelines available. In this pilot study, we aimed to evaluate the effectiveness and safety of a non-ablative fractional Er:glass 1565 nm laser, as a potential new, minimal-invasive approach for the improvement of DSH scars. Sixteen Caucasians suffering from mature DSH scars were included in this clinical study. Patients received a total of three treatments using a non-ablative fractional 1565 nm Er:glass laser every 4 weeks, employing two passes (300 μbeams/cm2, 40 mJ, onto the scar; 150 μbeams/cm2, 50 mJ, overall area). Measurements included questionnaires (DLQI, POSAS), digital photography, and objective three-dimensional analysis using PRIMOS and VECTRA software at baseline, 1 and 6 months after treatment. PRIMOS objective measurements showed highly significant changes in scar surface with a reduction of atrophic lesions by 27.5% at 6 months follow-up (FU), a decrease in scar height by 42.7% at 6 months FU, resulting in an overall diminished skin irregularity dropping from 678.3 μm at baseline to 441.6 μm throughout the course of the study (p = <0.001 respectively). Improvements in objective measurements were supported by clinical evaluation of scar parameters and showed a strong correlation with enhanced life quality of treated patients. Procedures were well-tolerated, with no lasting negative side effects and little to no downtime. The use of a fractional non-ablative 1565 nm Er:glass laser represents a promising and safe approach for the therapy of DSH scars. Although these scars will never fully resolve, their appearance can be significantly improved to a cosmetically and socially more acceptable appearance.

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Author information

Authors and Affiliations

  1. Clinic of Dermatology and Allergy, Department for Aesthetic Dermatology and Laser Medicine, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany

    Anne Guertler, Markus Reinholz, Stephanie Steckmeier, Hannah Schwaiger & Gerd G. Gauglitz

  2. Department for Plastic and Handsurgery, Regional Burn Center, Klinikum St. Georg, 04129, Leipzig, Germany

    Julian Poetschke

Authors
  1. Anne Guertler
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  2. Markus Reinholz
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  3. Julian Poetschke
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  4. Stephanie Steckmeier
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  5. Hannah Schwaiger
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  6. Gerd G. Gauglitz
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Contributions

AG performed measurements, collected and evaluated study data and wrote the manuscript; MR performed treatments and helped designing the study outline; JP helped obtaining data; HS helped collecting data; GGG wrote the manuscript and designed the study outline.

Corresponding author

Correspondence to Anne Guertler.

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Conflict of interest

GGG serves as speaker and advisor for Lumenis. AG, MR, JP, SS declare no conflict of interest.

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Cite this article

Guertler, A., Reinholz, M., Poetschke, J. et al. Objective evaluation of the efficacy of a non-ablative fractional 1565 nm laser for the treatment of deliberate self-harm scars. Lasers Med Sci 33, 241–250 (2018). https://doi.org/10.1007/s10103-017-2348-x

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  • DOI: https://doi.org/10.1007/s10103-017-2348-x

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