The efficacy of fractional CO2 laser with or without triamcinolone acetonide or 5-fluorouracil in the treatment of early postburn hypertrophic scars

Hypertrophic scars (HTSs) are the result of an abnormal healing process resulting from burns and other severe traumas. The symptoms of that condition include skin irritation, discomfort, and itching. This study aimed to assess the efficacy of fractional carbon dioxide (CO₂) laser therapy alone or with triamcinolone or 5-fluorouracil (FU) in the treatment of early post-burn hypertrophic scars (HTSs) that develop during the first 6 months after the injury. A prospective, randomized, single-blind comparative study was conducted on 30 patients aged 16-65 with hypertrophic scars (HTS) resulting from burns. Patients had no prior treatment for their scars. We randomly assigned participants to one of three groups: Group A received fractional CO₂ laser therapy alone, Group B received fractional CO₂ laser therapy with topical 5-fluorouracil, and Group C received fractional CO₂ laser therapy with topical triamcinolone acetonide. All treatment groups showed significant improvements (p < 0.05) in overall scar severity and height. Patients in Group C (fractional CO₂ laser + triamcinolone) demonstrated significant improvements in scar pliability, height, and pigmentation (p < 0.05). In contrast, patients in Group B (fractional CO₂ laser + 5-FU) showed significant reductions in scar vascularity, pliability, and height following treatment (p < 0.05). While all groups reported minor changes in pain and itching, there were no significant differences in these symptoms between Group B and Group C. HTSs of this trial revealed reductions in overall scar surface area and thickness and improvement of pliability and pigmentation; however, there was not statistically significant difference between the effect of 5-fluorouracil and triamcinolone acetonide (TAC), suggesting that neither drug offers better efficacy over the other. Level I, singleblinded randomized control study.