Facilitated delivery of topical steroids after fractional ablative carbon dioxide laser failed to prevent the postthyroidectomy hypertrophic scar

Ko Chien Lin, Shao Chun Wu, Shun Yu Chi, Hui Ping Lin, Cen Hung Lin, Yueh Ju Tsai, Mu Han Hsieh, Shiun Yuan Hsu, Ching Hua Hsieh*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations

Abstract

Background: The ablative fractional laser can destroy the epidermal barrier and enhance the infiltration and distribution of drugs into the dermis. Objectives: This study was designed to investigate whether steroid delivery followed by the fractional ablative laser can prevent the formation of postthyroidectomy scar. Methods: This prospective split-scar design study recruited 12 adult female patients who underwent thyroidectomy between March 2018 and December 2018. The whole scar was treated with a fractional ablative carbon dioxide laser with topical 0.05% clobetasol propionate ointment only applied on the treatment side. The Patient and Observer Scar Assessment Scale (POSAS) questionnaire was used for outcome assessment at 1 year following the first treatment. The follow-up assessment by scar esthetic scale using digital photographs at 6 months and 1 year after first treatment was also done by three blinded plastic surgeons. Results: The POSAS revealed the improvement was not significant on vascularity, pigmentation, thickness, relief, pliability, surface area, and overall opinion on the improvement (all P > 0.05). The digital photographs evaluation also did not reveal a significant difference between the treatment side and control side. The overall esthetic score in the assessment of digital photographs was 4.4 ± 1.5, 4.2 ± 1.9, and 3.4 ± 1.9 at 6 months, and 2.8 ± 1.9, 3.1 ± 1.9, and 2.4 ± 2.1 at 1 year, with 0-10 indicating totally identical to significantly different comparing the whole scar with surrounding normal skin. Conclusion: This prospective scar-split study revealed that the application of topical steroid after fractional ablative carbon dioxide laser has no significant effect to prevent the formation of postthyroidectomy scar.

Original languageEnglish
Pages (from-to)118-124
Number of pages7
JournalDermatologica Sinica
Volume39
Issue number3
DOIs
StatePublished - 01 07 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Journal of the Anatomical Society of India. All rights reserved.

Keywords

  • Clobetasol propionate ointment
  • fractional ablative carbon dioxide laser
  • hypertrophic scar
  • laser assisted drug delivery
  • steroid ointment
  • thyroidectomy

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