Treatment of Traumatic Facial Atrophic Scars Using a Combined Laser Protocol Including Variable-Pulse Picosecond Technology: A Case Report

The management of traumatic facial atrophic scars presents significant aesthetic and functional challenges. Traditional surgical approaches, while having documented efficacy, carry inherent risks of invasive procedures and the potential for creating secondary scarring. Therefore, this study aims to evaluate the effectiveness of a combined laser therapy approach, specifically utilizing potassium titanyl phosphate (KTP)/Nd:YAG, variable-pulse picosecond fractional laser, and Er:YAG lasers, as a non-surgical alternative for treating these complex traumatic scars. A 42-year-old man presented with a 30-day-old atrophic facial scar resulting from a sharp-point trauma. Given the patient's desire to avoid surgical intervention, a multimodal laser protocol was initiated over four sequential sessions. The treatment targeted various aspects of the scar pathophysiology, including vascular remodeling (KTP), deep collagen stimulation (long-pulse Nd:YAG), fractional micro-injury (picosecond), and precise resurfacing (Er:YAG). A progressive and significant reduction in scar depth and thickness was achieved, as documented by a marked improvement in the Vancouver Scar Scale (VSS) score, which dropped from a baseline of 10 to a final score of 1. The procedure was characterized by minimal adverse effects and resulted in high patient satisfaction. Combined laser therapy, integrating KTP/Nd:YAG, variable-pulse picosecond fractional, and Er:YAG lasers, represents a safe and effective alternative to surgical intervention for traumatic facial atrophic scars. This multimodal approach provides a means to achieve significant aesthetic improvement with minimal associated downtime and adverse effects. Further studies with larger patient populations and extended follow-up periods are warranted to confirm long-term efficacy and standardize treatment protocols.