Repigmentation of Hypopigmented Scars Using an Erbium‐Doped 1,550‐nm Fractionated Laser and Topical Bimatoprost

• Published in: Dermatologic surgery 2012-07, Vol.38 (7pt1), p.995-1001
• Main Authors: Massaki, Ane Beatriz Mautari Niwa, Fabi, Sabrina Guillen, Fitzpatrick, Richard
• Format: Article
• Language: English
• Subjects: Administration, Cutaneous; Adult; Aged; Amides - administration & dosage; Amides - therapeutic use; Bimatoprost; Biological and medical sciences; Cicatrix - therapy; Cloprostenol - administration & dosage; Cloprostenol - analogs & derivatives; Cloprostenol - therapeutic use; Combined Modality Therapy; Dermatology; Female; Humans; Hypopigmentation - therapy; Keratolytic Agents - therapeutic use; Lasers, Solid-State - therapeutic use; Male; Medical sciences; Middle Aged; Pigmentary diseases of the skin; Retrospective Studies; Skin plastic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tretinoin - therapeutic use; Young Adult
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2012.02389.x

Background Hypopigmented scarring is a challenging condition to treat, with current treatments showing limited efficacy and temporary results. Nonablative fractional resurfacing has been demonstrated to be an effective and safe modality in the treatment of hypopigmented scars. Objectives To demonstrate the efficacy and safety of combining fractional resurfacing with topical bimatoprost and topical tretinoin or pimecrolimus for the treatment of hypopigmented scars. Materials and Methods Fourteen patients with hypopigmented scars were treated with a mean of 4.5 sessions of a fractionated 1,550‐nm erbium‐doped laser at 4‐ to 8‐week intervals and subsequently started topical bimatoprost and tretinoin or pimecrolimus. An independent physician evaluated digital photographs taken before and 4 weeks after the last laser treatment using a quartile grading scale (grade 1, ≤25% improvement; grade 2, 26–50% improvement; grade 3, 51–75% improvement; grade 4, >75% improvement). Results Five patients had >75% improvement in hypopigmentation, and 12 had >50% improvement. After a mean follow‐up of 20.1 months, all patients demonstrated prolonged results. Side effects were limited to transitory post‐treatment edema and erythema. Conclusion The combination of fractional resurfacing, topical bimatoprost, and tretinoin or pimecrolimus is a potential effective resource for the treatment of hypopigmented scars, with long‐lasting results.