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Topical 5 fluorouracil cream versus combined 5 flurorouracil and fractional erbium YAG laser for treatment of severe hypertrophic scars

Authors Tawfik AA, Fathy M, Badawi A, Abdallah N, Shokeir H

Received 16 October 2018

Accepted for publication 12 February 2019

Published 14 March 2019 Volume 2019:12 Pages 173—180


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Jeffrey Weinberg

Abeer Attia Tawfik,1 Maha Fathy,2 Ashraf Badawi,1,3 Noha Abdallah,1 Hisham Shokeir1

1Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt; 2Al-Houd Al Marsoud Hospital, Cairo, Egypt; 3Dermatology and Allergology Department, University of Szeged, Szeged, Hungary

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 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 in the same patient and same anatomical region, especially in severe HTS.
Objective: The aim of this study was to compare the effectiveness of topical 5-FU and combined topical 5-FU and laser in treating severe HTS.
Patients and methods: Twenty-four severe HTS lesions were treated 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 twice weekly for 8 months. The other part was treated with combined topical 5-FU and ablative fractional erbium YAG laser once per month for 8 months. The scars’ improvement was evaluated by Vancouver scar scale (VSS) and skin analysis camera.
Results: The 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 group.
Conclusion: Treatment of severe HTS with combined 5-FU and ablative fractional erbium YAG laser is more effective than 5-FU alone.

Keywords: hypertrophic scars, fractional erbium YAG laser, 5-FU, transcutaneous drug delivery, scar management, fractional lasers, skin ablation, wound healing

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