Laser-assisted drug delivery (LADD) of Rosa damascena exosomes using a 1,927 nm thulium laser for post-thyroidectomy scar rehabilitation

Background Overcoming the biological barrier of the stratum corneum remains a critical challenge in transdermal therapy and cutaneous regenerative medicine. Laser-assisted drug delivery (LADD) utilizes fractional photothermolysis to generate transient microchannels, facilitating the penetration of high-molecular-weight biologics. This study evaluates the delivery of Rosa damascena stem cell-derived extracellular vesicles (exosomes) using a 1,927 nm laser for mature thyroidectomy scar remodeling. Methods 11 female patients (aged 50–87 years) with mature postoperative scars underwent LADD therapy combining a 1,927 nm fractional thulium laser with the immediate topical delivery of standardized plant-derived exosomes. Digital visible light imaging was performed at baseline (T 0 ), day 2 (T 1 ), and week 8 post-treatment (T 2 ). Objective skin evaluation included CIE L*a*b* colorimetry, thresholded high-luminance fibrotic area segmentation (L* > 60), Gray-Level Co-occurrence Matrix (GLCM) texture metrics (contrast, homogeneity, entropy), Laplacian variance (sharpness/roughness), and 3D surface topography reconstruction. Results Digital image analysis revealed distinct multiphasic tissue dynamics following the LADD procedure. At T 1 , acute thermal microcoagulation and transient edema triggered a temporary surge in surface irregularity, marked by an increase in GLCM contrast. After 8 weeks, profound architectural remodeling was observed: high-reflectance fibrotic areas exhibited an almost sevenfold reduction, while surface roughness measured via Laplacian variance, decreased by nearly 30%. Conclusion GLCM homogeneity reached its peak value with a marked decline in tonal contrast, and colorimetric shifts indicated active revascularization and neocollagenesis, collectively demonstrating a measurable flattening and structural normalization of the mature scar tissue. The combination of a 1927 nm fractional thulium laser and topical Rosa damascena exosomes represents an effective, minimally invasive LADD platform. Quantitative optical analysis demonstrated rapid structural homogenization and the elimination of dense scar tissue, offering a promising, non-invasive therapeutic strategy for post-surgical scar management and regenerative skin therapies.