Fractional Microneedle Radiofrequency Versus Fractional Carbon Dioxide Laser in the Treatment of Postburn Hypertrophic Scars

Background And Objective: New and improved treatment modalities, including lasers and energy-based devices, are promising treatment options for hypertrophic scars. This study aimed to assess the efficacy and safety of fractional microneedle radiofrequency (FMR) compared with fractional carbon dioxide (CO ) laser in the treatment of postburn hypertrophic scars.

Patients And Methods: Twenty patients with hypertrophic scars were enrolled in the study. Two areas in each patient were randomly assigned to fractional CO laser or FMR. Four sessions, 6-8 weeks apart were performed. The Patient and Observer Scar Assessment Scale (POSAS) was used for clinical evaluation, H & E and orcein-stained samples were examined for histopathological assessment, and tissue transforming growth factor beta 1 (TGFβ ) levels were measured for biochemical evaluation.

Results: Both fractional CO and FMR-treated areas showed significant improvement in all parameters 1 month after treatment. Fractional CO2-treated areas showed a higher degree of improvement compared with FMR in OSAS (p = 0.025), elastin grading (p = 0.004), and TGFβ levels (p = 0.000). Patients reported less downtime and showed less postinflammatory hyperpigmentation with FMR compared with fractional CO but this did not reach statistical significance (p = 0.327, p = 0.231; respectively).

Conclusion: Our results demonstrate the value of FMR as an effective alternative to fractional CO in the treatment of hypertrophic scars, with a potentially favorable safety profile.