Restoration of form and function after
burn injury remains challenging, but emerging
laser and pulsed light technologies now offer hope for patients with
hypertrophic scars, which may be associated with persistent
hyperemia, chronic
folliculitis, intense
pruritis, and
neuropathic pain. In addition to impairing body image, these
scars may limit functional recovery, compromise
activities of daily living, and prevent return to work. Three different platforms are now poised to alter our reconstructive algorithm: (1) vascular-specific
pulsed dye laser (PDL) to reduce
hyperemia, (2) ablative fractional CO(2)
laser to improve texture and pliability of the
burn scar, and (3) intense pulsed light (IPL) to correct
burn scar dyschromia and alleviate chronic
folliculitis. In this paper, we will provide an overview of our work in this area, which includes a systematic review, a retrospective analysis of our preliminary experience, and interim data from our on-going, prospective, before-after cohort trial. We will demonstrate that
laser- and light-based
therapies can be combined with each other safely to yield superior results, often at lower cost, by reducing the need for reconstructive surgery. Modulating the
burn scar, through minimally invasive modalities, may replace conventional methods of
burn scar excision and yield outcomes not previously possible or conceivable.