Analysis: Scar Reduction Seen with Fractional CO2 and 5-FU Laser Treatments

Results from a new meta-analysis suggest that fractional carbon dioxide (FCO₂) plus 5-fluorouracil (5-FU) laser therapy was effective in treating hypertrophic and keloid scars.

Researchers for the analysis included data from 18 studies (N = 550). The team comprehensively searched databases for relevant studies published until July 2023. They used R software to extract and analyze data, expressing results as mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous data.

According to the results, FCO₂ combined with 5-FU significantly improved outcomes on the Vancouver Scar Scale (VSS), pliability score, and thickness of scars compared to the control group [respectively, MDs were -5.97 (95% CI: -7.30, -4.65) for VSS; -2.68 (95% CI: -4.03, -1.33) for pliability; and -2.22 (95% CI: -3.13, -1.31) for thickness]. No significant differences in erythema, vascularity, redness, perfusion, and pigmentation were reported.

"Our NMA found that the FCO₂ plus 5-FU was the most effective intervention in decreasing the VSS and thickness, while FCO₂ plus CO₂ was the most effective intervention in decreasing the pliability score," they wrote in the study. "Further research is needed to determine the optimal laser parameters and long-term efficacy of laser therapy in hypertrophic and keloid scars."

Source: Foppiani J, et al. Aesthetic Plastic Surgery. DOI: 10.1007/s00266-024-04027-9