Scar formation is often seen in the proliferative phase of wound healing because of collagen remodeling to adequately approximate normal skin. Ineffective redistribution of collagen may lead to excessive scarring. 

CO₂ laser has made its name in improving scar quality by remodeling and redistributing dermal collagen fibers. A recent study investigated its effects on hypertrophic scars of the hands and upper extremities.

The progression of scar quality was assessed via the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Unpaired t-tests and Pearson correlation were used for further analysis.

The results were as follows:

• Among 90 enrolled patients, 54 completed serial scar assessment forms.
• Improvement was observed in all POSAS domains but Itching.
• Improvement was observed in all VSS domains
• A moderate correlation was found between the overall patient-reported opinion of scar quality and Discoloration, Stiffness and Thickness.
• A strong correlation was found between overall patient opinion and Irregularity.
• A strong correlation was found between all observer-reported domains and the overall observer opinion of scar quality.

These results verify the use of CO₂ laser as a treatment modality for excessive scarring in a wide-spectrum of surgical subspecialties.

Source: Cox C, Bettiol P, Le A, et al. CO2 laser resurfacing for burn and traumatic scars of the hand and upper extremity. Scars Burn Heal. 2022;8:20595131211047694.