Laser-Assisted Drug Delivery for Hypertrophic Scar Treatment: A Scoping Review

Fractional ablative laser (FAL) is a minimally invasive method of hypertrophic scar management first introduced in 2004. Laser technologies and techniques have continued to evolve since that time and have included the addition of laser-assisted drug delivery (LADD) to augment the effects of the laser on scars. Laser-assisted drug delivery is increasingly reported in the literature and standard treatment protocols, underscoring the popularity of this technique among clinicians. Given this popularity, it is important to scrutinize evidence relating to the clinical outcomes LADD may achieve for patients. This scoping review examined literature relating to LADD for the treatment of hypertrophic scars in humans, aiming to clarify what clinical outcomes are achieved with its use and examining how these outcomes were studied and measured. PubMed, EMBASE, Cochrane, the WHO International Clinical Trials Registry and ClinicalTrials.gov were systematically searched, and data about study methodology, outcome measurement tools and results were extracted. Fifty-five publications that discussed LADD for the treatment of hypertrophic scars in humans were identified. Sixteen different substances, most frequently corticosteroids, were used for LADD treatment of hypertrophic scars, most often in conjunction with a carbon dioxide FAL. Study designs, outcome measurement strategies and follow-up time-frames were highly variable, as were the patient outcomes achieved. The clinical outcomes achieved with LADD are unclear, largely due to the variability of study methodology and outcome measurement. The efficacy of this technique requires further investigation with robustly designed, large trials which have comparison groups and use validated scar outcome measurement tools.