Efficacy of Combined Narrow-Band IPL and Super-Pulsed CO2 Fractional Laser for Early Hypertrophic Scars: Longitudinal Therapeutic Trend

BACKGROUNDHypertrophic scars are characterized by excessive microvascular proliferation and abundant collagen deposition. Combined narrow-band intense pulsed light (NB-IPL) and super-pulsed CO2 fractional laser (SPCO2 FL) have become a promising therapeutic protocol. However, prior studies are limited by inconsistent treatment regimens and insufficient follow-up.

PURPOSETo retrospectively evaluate clinical efficacy of NB-IPL monotherapy versus NB-IPL combined with SPCO2 FL therapy for early hypertrophic scars at longitudinal follow-up visits.

METHODSPatients with early hypertrophic scars treated with laser at Nanjing Drum Tower Hospital from February 2023 to May 2025 were enrolled and allocated into the experimental group (combined NB-IPL and SPCO2 FL) and the control group (NB-IPL monotherapy). All received six treatment sessions at intervals of 8–10 weeks, with evaluations at baseline, mid-treatment, last treatment, and the 3- and 6-month follow-ups. Treatment pain, scar appearance, and overall scar status were respectively evaluated using the Visual Analog Scale (VAS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS). Pain and pruritus scores received from the POSAS Patient Scale were additionally analyzed. Repeated-measures ANOVA was adopted for longitudinal data analysis.

RESULTSOf the 100 initially enrolled patients, 14 were excluded, and 86 patients were finally analyzed (46 combination and 40 monotherapy). POSAS Patient Scale and Observer Scale scores were significantly reduced over time in both groups, with superior improvement observed in the experimental group. Repeated-measure analysis revealed significant time, group, and interaction effects for pain, while only a significant main time effect existed for pruritus. Both groups obtained significant improvements in pigmentation, vascularization, pliability, and thickness, and the experimental group had better efficacy. No intergroup differences in treatment-related VAS pain scores were detected, indicating similar treatment pain and tolerability.

CONCLUSIONCombined NB-IPL and SPCO2 FL yields better improvements in the appearance, pliability, and symptoms of hypertrophic scars than NB-IPL monotherapy. This combination protocol is an effective strategy for hypertrophic scar treatment.

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