Patient-Reported Pain and Itch Scores After a Course of Laser Therapy for the Treatment of Postburn Hypertrophic Scar Are Impacted by Mental Health Status

Burn injuries are often associated with physical scarring in addition to severe psychosocial consequences, including heightened pain and pruritus (itch). These symptoms can persist long after the injury and often become recalcitrant to standard treatments, such as gabapentin and antihistamines. Fractional ablative CO2 laser scar revision (FLSR) has gained popularity as an adjunctive therapy to address the limitations of existing treatments. However, despite this treatment, some patients continue to experience both symptoms, which negatively impacting their quality of life and daily functioning. A retrospective review of 110 patients receiving laser scar revision between 2018 and 2024 was conducted at a single institution, with patients divided into two cohorts: those with a diagnosed mental health condition and those without. Patients with a mental health diagnosis (MHD) reported a more significant reduction in pain and pruritus over the course of three laser sessions compared to those without an MHD. Despite these differences in perception, no variation was observed in the objective measures of scar healing between the cohorts. Gabapentin dosage was associated with reductions in pain perception, particularly in the MHD group. This finding suggests that mental health interventions may enhance the subjective experience of recovery, potentially through neuroplastic changes influenced by psychotherapy as compared to medications. This study underscores the need to integrate mental health care into the physical recovery of burn patients. Future research should investigate the long-term outcomes of combined mental health and scar therapy interventions to improve patient quality of life postinjury.