A Randomized Comparative Study of Fractional CO2 Laser versus Silicone Gel Sheet and Pressure Garment in Scar Quality Modulation

Abstract Scar modulation can be achieved using noninvasive, minimally invasive, or invasive techniques. Conventional methods such as silicone gel sheets and pressure garment therapy are widely used, while newer approaches like fractional CO2 laser therapy have shown promise. However, there is no conclusive evidence favoring one therapy over another. In this randomized study, patients were divided into two groups. One group received fractional CO2 laser therapy, while the other received a combination of silicone gel sheet and pressure garment therapy. The treatment duration in both groups was 3 months. Scar quality improvement was assessed at the end of treatment, at 1 month, and at 3 months posttreatment. Patients evaluated their scars using a simple 4-point scale (poor, fair, good, and very good), while an independent observer assessed the scars using the Vancouver scar scale. Improvement in scar quality was observed in both groups as reported by patients and the independent observer. The group receiving silicone gel sheet and pressure garment therapy showed earlier aesthetic improvement at the 1-month mark. However, by 3 months, both treatment groups demonstrated comparable outcomes. Scar modulation requires an individualized treatment approach based on patient-specific concerns and desired improvements. Fractional CO2 laser appears more suitable for pigmented and hypertrophic scars, whereas silicone gel sheet and pressure garment therapy may be preferable for improving scar pliability and vascularity.