Picosecond Nd:YAG versus Fractional CO2 Lasers in Management of Postburn Scars

Background: The picosecond laser was primarily designed to enhance tattoo removal. Because it has a new innovative mechanism for energy delivery, it has been modified to be used in other conditions such as skin resurfacing, which was usually treated with fractional CO 2 laser. Comparing both technologies in managing postburn scars has not been widely addressed. Methods: The current prospective comparative randomized intrapatient study was done on 15 patients who presented with unsightly postburn scarring. As a split study, one-half of the affected areas were treated using the picosecond Nd: YAG laser. The other areas were treated with a fractional CO 2 laser. After three treatment sessions, the results were analyzed both objectively and subjectively. Results: The assessment by the image analysis system (Antera camera) showed improvement in all the parameters in both groups. The melanin relative variation decreased from 11.65 ± 2.86, 15.85 ± 5.63 to 10.60 ± 1.96, 12.56 ± 3.98, respectively in picosecond laser sites and fractional CO 2 sites. The percentage change in overall opinion decreased in in favor of the fractional CO 2 laser sites, which is a statistically significant improvement. Instead, color scores revealed a greater reduction in the picosecond sites in comparison with the fractional CO 2 sites, as it decreased from 7.67 ± 1.76, 7.73 ± 1.83 to 2.87 ± 1.06, 6 ± 1.2, respectively. Conclusions: When compared with fractional CO 2 lasers, picosecond Nd:YAG shows comparable improvements in scars’ erythema, texture, and height, with some superiority in the management of hyperpigmented scars.