Managing Burn Scar with a Combination Therapy of Long Pulsed 1064 Nm Nd: YAG (LPND) Laser, Topical Tretinoin and Hydroquinone
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Abstract
Background: Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, contractures and disfigurement to psychosocial impairment. Newer and advanced therapies for the treatment of burn scars have been developed, including lasers, and other topical treatments
Case Illustration: An asian woman with history of having hypertrophic scar arising from the edges of previous skin graft for her second degree of burns. We performed contact-mode long pulsed 1064 nm Nd:YAG laser treatment in combination with topical tretinoin and hydroquinone. Ten months after initial combination treatment, the scar showed improvement in term of colour, contour, and consistency.
Discussion. Burn scars have tendency to enlarge, hypertrophic and become keloids. Long pulsed 1064 nm Nd:YAG laser helps to reduce hypervascularization that usually found in hypertrophic scars or even keloid. Tretinoin is a derivate of vitamin A which has many different mechanisms in wound healing enhancement. Hydroquinone inhibits melanogenesis and plays role in maintaining pH level in wound healing process.
Conclusions: Burn scar responded well to long pulsed 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser treatment. A combination therapy with topical tretinoin and hydroquinone improved the burn scar in term of better color, contour and consistency.
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