Tratamento de sequelas de queimadura de face com laser de CO2 fracionado em pacientes com fototipos III a VI

摘要

BACKGROUND: Reports on improvement in post-traumatic or pathological scars with the use of fractional CO2 laser (CO2F) conclude that it is a safe and effective technology, though used only in patients with phototypes II to III. The aim of this study was to evaluate the effectiveness of CO2F in patients with facial burn sequelae with phototypes III to VI. METHODS: A total of 14 patients (average age, 29 years) with facial burn sequelae and phototypes III to VI were subjected to a CO2F laser treatment. After 2 months, the burns were evaluated using a 6-parameter scale, including color, texture, hydration, surface irregularities, volume, and distensibility. RESULTS: The average durations of pain, edema, and hyperemia were 19 hours, 1.3 days, and 6.5 days, respectively. The fall of crusts was completed between 5 and 36 days with an average of 13.4 days. Two months after the session, 5 patients developed punctiform hypochromia in a checkerboard pattern corresponding to the points of laser ablation. The subjective satisfaction of the evaluators (i.e., both patients and physicians) with the treatment was 84.6%. The patients reported improvements in surface irregularities, distensibility, and skin texture (57% of the cases); hydration (43%); volume (28%); and color (14%). Meanwhile, the doctors reported improvements in surface irregularities and distensibility (43%). CONCLUSIONS: The treatment with CO2F laser with mild parameters was well tolerated and resulted in high satisfaction rates for patients with facial burn sequelae as well as improved skin texture, distensibility, and surface irregularities. The high incidence of hypopigmentation must be considered while prescribing CO2F laser treatment to patients with phototypes IV to VI.