Treatment of Acquired Bilateral Nevus of Ota-Like Macules (Hori''s Nevus) with a Combination of the 532 nm Q-Switched Nd:YAG Laser Followed by the 1,064 nm Q-Switched Nd:YAG Is More Effective: Prospective Study

BACKGROUND: Acquired bilateral nevus of Ota-like macules (Hori's nevus) is a common dyschromatosis among Asian women. Q-switched lasers have been used successfully as a treatment modality. OBJECTIVE: The purpose of this study was to compare the efficacy of using the Q-switched 532 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser followed by the 1,064 nm laser versus the Q-switched 1,064 nm Nd:YAG laser alone in the treatment of Hori's nevus. METHODS: This is a prospective left-right comparative study. Ten women with bilateral Hori's nevus were recruited and treated with a combination of the Q-switched 532 and 1,064 nm Nd:YAG lasers on the right cheek and the Q-switched 1,064 nm Nd:YAG laser alone on the left cheek. Only one laser treatment session was performed. The degree of pigmentation was objectively recorded with a mexameter. Subjective assessment was made by both patients and two blinded, nontreating dermatologists. RESULTS: At 6 months, there was a statistically significant difference (p = .009) of 35.10 points using objective mexameter measurements between the two sides, favoring the side treated with a combination of 532 and 1,064 nm laser treatment. Subjective grading by the patients and blinded dermatologists also confirmed that combination therapy was more successful after one treatment. Although combination treatment had a higher incidence of mild postinflammatory changes, this disappeared within 2 months. CONCLUSIONS: Concurrent use of the Q-switched 532 nm Nd:YAG laser in combination with the 1,064 nm laser is more effective in pigment clearance than the Q-switched 1,064 nm Nd:YAG laser alone for Hori's nevi.     

Q开关Nd：YAG激光治疗色素性皮肤病5000例疗效观察

目的：观察Q开关Nd：YAG激光治疗色素性皮肤病的疗效、影响因素及副反应。方法：使用Q开关Nd：YAG激光治疗色素性皮肤病患者5000例,浅表性色素损害雀斑、咖啡斑和老年斑采用Q532nm波长,太田痣和文身采用Q1064nm波长。结果：本组患者经1～6次治疗,总有效率达96．14％,术后出现暂时性色素沉着269例（5．38％）,无瘢痕发生。结论：Q开关Nd：YAG激光治疗色素性皮肤病疗效较好,安全性高。     

Comparison of a 1,064 nm Laser and a 1,320 nm Laser for the Nonablative Treatment of Acne Scars

Background. There have been many reports of the use of nonablative lasers for the treatment of acne scars.
Objective. To evaluate the ability of the 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser to treat acne scars and compare it with that of the 1,320 nm Nd:YAG laser.
Methods. Twelve patients with Fitzpatrick skin types I to III were randomly selected to have half of the face or back treated with the Lyra 1,064 nm Nd:YAG laser (Laserscope Corporation, San Jose, CA, USA) and the other half with the CoolTouch II 1,320 nm Nd:YAG laser (ICN Pharmaceuticals, Inc., Costa Mesa, CA, USA). Three treatments at 4-week intervals were performed. Patients were evaluated by photographic and profilometric methods before and 6 months after the last treatment.
Results. Immediate changes included mild erythema with the 1,064 nm Nd:YAG laser and mild edema and erythema with the 1,320 nm Nd:YAG laser. No long-term adverse changes were seen with either laser system. Using the 1,320 nm system, 42% of the patients had 30 to 40% clinical improvement, 42% had 11 to 29%, and 16% had 10% or less. With the 1,064 nm system, 58% had 30 to 40% clinical improvement and 42% had 11 to 29%. Average improvement in acne scars evaluated by three independent observers was 22% with the 1,320 nm laser compared with 28% with the 1,064 nm laser. The subjects' own grading was 39% with the 1,320 nm laser compared with 37% for the 1,064 nm laser. Prolifometric studies demonstrated comparable improvement, with no statistical difference using either laser.
Conclusion. These data indicate that both the 1,064 nm laser and the 1,320 nm Nd:YAG laser are safe and effective systems for the nonablative treatment of acne scars, achieving similar improvement. There appears to be a greater response with the 1,064 nm laser system as assessed by the clinical investigators.     

Comparison of the Frequency-Doubled Q-Switched Nd:YAG Laser and 35% Trichloroacetic Acid for the Treatment of Face Lentigines

BACKGROUND: Face lentigines are one of the manifestations of photodamaged skin and often put people in socially embarrassing situations. Several lasers have been used to remove lentigines at vast expense. However, trichloroacetic acid (TCA) is an alternative for treating lentigines that costs much less. OBJECTIVE: To compare the efficacy of the frequency-doubled Q-Switched Nd:YAG laser (532 nm) and 35% TCA for the treatment of face lentigines. METHODS: Twenty patients (Fitzpatrick skin Types III-IV) with a total of 37 lentigines on faces were randomly collected; each lentigo was divided into medial and lateral halves. Frequency-doubled Q-switched Nd:YAG laser (532 nm) and 35% TCA were applied to the medial and lateral halves of each lentigo respectively. The efficacy after 1 treatment was compared after 6 months. RESULTS: The frequency-doubled Q-switched Nd:YAG laser (532 nm) had a better result than that of 35% TCA for the treatment of facial lentigines. CONCLUSION: In order to get a better result after one treatment, the authors suggest the frequency-doubled Q-switched Nd:YAG laser (532 nm) rather than 35% TCA for treating lentigines even though the cost of frequency-doubled Q-switched Nd:YAG laser (532 nm) is greater than that of 35% TCA for both physician and patient.     

脉冲染料激光治疗充血性瘢痕的机理研究

目的 研究585 nm的闪光灯泵浦脉冲染料激光（FLPDL）对充血性瘢痕的影响.方法 对治疗前、治疗后的瘢痕行常规病理、胶原纤维VG染色及兔抗人八因子多抗行微血管染色以观察FLPDL对胶原及瘢痕内微循环的影响.同时行临床观察及记录.结果 PDL治疗后瘢痕内毛细血管减少,瘢痕内胶原沉积下降,临床症状明显改善.结论 ①585 nm FLPDL激光通过破坏瘢痕内微血管,使胶原降解增多,合成减少.从而有效改善充血性瘢痕的症状、高度、皮肤纹理、颜色等.②其对瘢痕形成的病理过程进行了有效干预,因此,也可以用于预防伤后瘢痕增生.③临床治疗需3次左右,每次间隔应为4～6周.     

Q开关Nd:YAG激光不同波长治疗面部毛细血管扩张疗效比较

目的：观察Q开关Nd：YAG激光不同波长治疗面部毛细血管扩张的疗效及副反应。方法：128例病人按治疗波长随机分为532nm组75例，585nm组53例，治疗光斑2．0mm，能量密度2．2-6．8J／cm。，脉宽10ns；术后3个月根据术前照片判定疗效，标准分为Ⅳ级。结果：治疗次数1-4次，间隔时间3-5个月，两组共治愈71例(55，47％)，疗效与治疗次数成正相关。其中532nm组治愈36例(48．00％)，平均治愈次数2．64次；585nm组治愈35例(66．04％，)，平均治愈次数2．40次，两组痊愈率及副反应差异无显性。结论：Q开关Nd:YAG激光倍频532／nm和585nm两种波长对密度较低、直径较细的面部毛细血管扩张均有可靠疗效，术后除色素沉着发生较高外，其他不良反应较少。     

An In vivo Trial Comparing the Use of Different Types of 532 nm Nd:YAG Lasers in the Treatment of Facial Lentigines in Oriental Patients

BACKGROUND: Versapulse is a system that consists of four laser modalities and was developed with the aim of increasing cost-effectiveness. However, as these lasers share a common power supply, for the Q-switched (QS) Nd:YAG 532 nm laser a large spot diameter is necessary to lower the fluence to a suitable level. This can increase the risk of hyperpigmentation when used for the treatment of lentigines in dark-skinned patients. OBJECTIVE: The aim of our study was to access the clinical efficacy and the complication rate of the Versapulse QS Nd:YAG 532 nm laser, the Versapulse long-pulsed Nd:YAG 532 nm laser (without the chill tip), and a conventional QS Nd:YAG 532 nm laser in the treatment of lentigines in Chinese patients. METHODS: Thirty-four Chinese patients with lentigines were randomized to receive laser surgery, with one side of the face treated by one laser and the other side treated by a different system. Patients were monitored for 6 weeks to assess the degree of clearing, hyperpigmentation, hypopigmentation, and erythema. Assessments involved patients interviewed using a visual analog questionnaire and two blinded observers who evaluated the pre- and posttreatment clinical photographs. RESULTS: The Versapulse QS Nd:YAG 532 nm laser was associated with a statistically higher risk of complications. The Versapulse long-pulsed Nd:YAG 532 nm laser was compatible with the conventional QS Nd:YAG 532 nm laser in terms of clinical efficacy and complication rates. CONCLUSION: The Versapulse long-pulsed 532 nm laser is more effective and should be used instead of the Versapulse QS Nd:YAG 532 nm laser for the treatment of lentigines in dark-skinned patients.     

Q-开关Nd:YAG激光治疗外源性皮肤色素性病变124例

目的：观察Q-开关Nd：YAG激光治疗外源性皮肤色素性病变的临床效果。方法：用Q-开关Nd：YAG激光1064nm波长治疗黑色、灰色或蓝色皮肤色素性病变；532nm波长治疗红色色素性病变，共计124例。结果：此方法可明显去除外源性皮肤色素性病变，效果好、无瘢痕产生，但需多次治疗。结论：Q-开关Nd：YAG激光治疗外源性皮肤色素性病变安全有效。     

Treatment of hypertrophic scars using a long-pulsed dye laser with cryogen-spray cooling

Hypertrophic scars are common and cause functional and psychologic morbidity. The conventional pulsed dye laser (585 nm) has been shown previously to be effective in the treatment of a variety of traumatic and surgical scars, with improvement in scar texture, color, and pliability, with minimal side effects. This prospective study was performed to determine the effectiveness of the long-pulsed dye laser (595 nm) with cryogen-spray cooling device in the treatment of hypertrophic scars. Fifteen Asian patients with 22 hypertrophic scars were treated by the long-pulsed dye laser (595 nm) with cryogen-spray cooling device. In 5 patients, the scar area was divided into halves, one half of which was treated with the laser, whereas the other half was not treated and was used as a negative control. All patients received 2 treatments at 4-week intervals, and evaluations were done by photographic and clinical assessment and histologic evaluation before the treatment and 1 month after the last laser treatment. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. Symptoms such as pain, pruritus, and burning of the scar improved significantly. VGH scores improved in all treated sites, and there was a significant difference between the baseline and posttreatment scores, corresponding to an improvement of 51.4 +/- 14.7% (P < 0.01). Compared with the baseline, the mean percentage of scar flattening and erythema elimination was 40.7 +/- 20.7 and 65.3 +/- 25.5%, respectively (P < 0.01). The long-pulsed dye laser (595-nm) equipped with cryogen spray cooling device is an effective treatment of hypertrophic scars and can improve scar pliability and texture and decrease scar erythema and associated symptoms.     

A Comparison of Four Frequency-Doubled Nd:YAG (532 nm) Laser Systems for Treatment of Facial Telangiectases

BACKGROUND: Telangiectases are cosmetically concerning for millions of individuals who develop them on the face as they mature. The causative factors are numerous. Lasers have recently become the focus for treating small facial telangiectases because of their ability to selectively target vessels. OBJECTIVE: The purpose of this study was to compare the efficacy of four different frequency-doubled neodymium:yttrium-aluminum-garnet (FD Nd:YAG) laser (532 nm) systems for the treatment of facial arteriolar telangiectases. METHODS: Forty adult subjects with Fitzpatrick skin phenotypes I and II were randomly assigned to four treatment groups. Each group, consisting of 10 subjects, had telangiectases less than 1000 microm in diameter treated with one of four different FD Nd:YAG laser systems with a wavelength of 532 nm. Patients were treated once and clinical improvement and potential adverse effects were assessed at 1 and 8 weeks after treatment. RESULTS: All treated patients showed improvement after one laser session. No patients were seen to have scarring or pigmentary changes. There was no significant difference in the clinical response following treatment with each laser. CONCLUSION: The four different FD Nd:YAG lasers performed equally well in treating facial telangiectases. With a wavelength of 532 nm and pulse durations in the millisecond range, vessels can be selectively targeted with a minimal incidence of post-operative complications.     

非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd:YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例(占30.4%)出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd:YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd:YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例(占30.4%)出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd:YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

调Q Nd：YAG脉冲激光和二氧化碳激光治疗面部色素痣疗效对比观察

目的：观察调QNd：YAG脉冲激光和二氧化碳激光治疗面部色素痣的临床疗效与美容效果。方法：将315例门诊患者随机分成两组：甲组167例,采用调QNd：YAG脉冲激光治疗,波长1064nm,光斑2～3mm,能量密度4。0～4．2J／cm2,频率1～2Hz,点射至肉眼观无黑色组织;乙组148例,采用二氧化碳激光治疗,连续扫射至肉眼观无黑色组织,观察皮损祛除与瘢痕情况。结果：甲组治疗有效率97．97％,乙组治疗有效率97．00％,两组相比P〉0．05,没有统计学差异;甲组瘢痕出现率64．07％,乙组瘢痕出现率为75．00％,两组瘢痕出现率比较,P〈0．05,有统计学差异;甲组中,不同疹型间痊愈率和瘢痕出现率比较均P〈0．05,有统计学差异。结论：调ONd：YAG脉冲激光治疗面部色素痣与二氧化碳激光相比,美容效果优于后者;调QNd：gAG脉冲激光对斑疹型色素痣的疗效优于丘疹型色素痣。     

Using a Side Effect to Therapeutic Advantage: The Darkening of Red Eyebrow Tattoo Pigment Following Q-Switched Laser Treatment

BACKGROUND: Q-switched lasers are commonly used to achieve tattoo removal, utilizing the principle of selective photothermolysis. However, certain tattoo pigments may darken following laser pulsing. OBJECTIVE: To determine whether this side effect can be used to therapeutic advantage in a woman who previously had her eyebrows enhanced with a dark tattoo that spontaneously changed to a reddish hue over time. METHOD: The woman's eyebrows were pulsed with the Q-switched Nd:YAG laser at both 532 nm and 1064 nm. RESULTS: The test areas pulsed with the 1064 nm laser revealed partial clearing. However, 532 nm Q-switched Nd:YAG pulses produced darkening of tattoo pigment both at the test sites and in the subsequent treatment. CONCLUSION: Q-switched lasers can produce darkening of red tattoo pigment. In some cases this side effect can be used to therapeutic advantage.     

The Use of Pulsed Dye Laser for the Prevention and Treatment of Hypertrophic Scars in Chinese Persons

BACKGROUND: Pulse dye laser has been used with variable degrees of success in the treatment of hypertrophic scars, and although earlier reports suggested a significant degree of improvement, more recent studies have raised concern about its effectiveness. Furthermore, most previous studies examined its use in patients with light skin types, and the use of pulse dye laser in dark-skinned patients for the treatment of hypertrophic scars is not well established. OBJECTIVE: The objective was to assess the role of pulsed dye laser therapy in the treatment and prevention of hypertrophic scars in Chinese persons. METHODS: Twenty-nine patients (35 scars) who had scars for less than 6 months were recruited into the prevention group, and 27 patients (36 scars) who had scars for more than 6 months were recruited into the treatment arm of the study. Each received pulse dye laser treatment (585 nm, 1.5-msec pulse duration, 5-mm spot size, 7-8 J/cm(2)) for three to six treatments at 8-week intervals. Half of the scar was treated with the laser and the other half was used as a control. All patients were assessed for subjective improvement with the use of a structured questionnaire and objectively with ultrasonography for thickness and a cutometer for viscoelasticity. Scars were marked on every patient and mapped with a translucent paper at the first appointment to ensure the consistency of location. At the end of the study, 15 patients from the prevention group (15 scars) and 23 patients from the treatment group (34 scars) agreed to return for spectrophotometer assessment. RESULTS: Fifty-four percent of patients in the prevention group and 66% of patients in the treatment group considered their scars to be better or much better. For both groups of patients, there was significant improvement in term of pruritics after laser treatment. For objective assessment, although scar thickness reduced significantly compared to baseline in the treatment group, such change was not significant when changes in the control side were taken into consideration. There was insignificant change in viscoelasticity. Spectrophometer assessment indicated a significant degree of lightening in the treatment group. CONCLUSION: Our study indicated that although there was significant symptomatic improvement, there was an insignificant degree of objective improvement in terms of scar thickness and viscoelasticity in the prevention group compared to the control group. Our findings are in line with several previous controlled studies and contradict the results of several others. Such differences can be due to differences in assessment methodology, laser settings, skin type, and scar location. Suprapurpuric pulsed dye laser should not be considered as the standard of practice for the treatment and prevention of hypertrophic surgical scars especially in the chest in Asians patients.     

Histologic Evaluation of a Q-Switched Nd:YAG Laser in the Nonablative Treatment of Wrinkles

BACKGROUND: A variety of nonablative dermal remodeling techniques are currently available. The Q-switched Nd:YAG laser, in addition to its role in tattoo removal, hair removal, and vascular and pigmented lesion treatment, may also play a role in dermal remodeling for the treatment of wrinkles. The histologic changes seen in human skin after Q-switched Nd:YAG laser exposure have yet to be evaluated. OBJECTIVE: To study histologic changes after the use of a Q-switched Nd:YAG laser in the nonablative treatment of photoaged skin. METHODS: Sun-damaged infrauricular skin from six female subjects was exposed to a Q-switched Nd:YAG laser at fluences of 7 J/cm2 with two laser passes. Histologic examinations were performed before laser treatment and 3 months later. RESULTS: Biopsy specimens showed slight fibrosis in the superficial papillary dermis with unremarkable epidermal changes. CONCLUSION: The Q-switched Nd:YAG laser produced morphologic changes similar to, but lesser in degree, than those seen with both CO2 and Er:YAG laser resurfacing.     

The Use of Variable Pulse Width Frequency Doubled Nd:YAG 532 nm Laser in the Treatment of Port-Wine Stain in Chinese Patients

BACKGROUND: Variable pulse width frequency doubled Nd:YAG 532 nm laser has previously been shown to be effective in the treatment of vascular lesions in Caucasians. For dark-skinned patients, such as Asians, its role has not been determined. OBJECTIVE: To assess the clinical efficacy and complication rate of the 532 nm Nd:YAG laser in the treatment of port-wine stain in Chinese patients. METHODS: Chinese patients with port-wine stain who had undergone Nd:YAG laser treatment were called for questionnaire assessment of their degree of clearing and clinical examination for complications by two independent observers. For 22 patients with pre- and posttreatment photographs, the two independent observers further assessed the degree of clearing. RESULTS: Assessment of the questionnaire indicated that 62.9% of the patients subjectively considered that they had more than 25% clearing, with 33.3% having more than 50% clearing. For those with pre- and posttreatment photographs, the objective degree of improvement was less impressive with 18.1% of patients having at least 25% improvement and only 13.6% having more than 50% improvement. Pigmentary and texture changes were seen in both groups (33% in group I and 11% in group II). The number of treatment sessions rather than previous use of pulsed dye laser therapy was an important risk factor for complications. CONCLUSION: Nd:YAG laser is only partially effective for the treatment of port-wine stain in Chinese patients. Although most patients recorded some degree of subjective improvement, many did not improve by objective assessment. High fluence is necessary to achieve the desirable clinical response, and while contact cooling reduces the risk of epidermal damage, texture changes can still occur. Further study is necessary to compare its use with other similar devices, such as a pulsed dye laser with cryogen spray cooling.     

A Preliminary Study of Utilization of the 1320-nm Nd:YAG Laser for the Treatment of Acne Scarring

BACKGROUND: Multiple treatment modalities have been used for the revision of acne scarring with varying degrees of success. Nonablative laser resurfacing has recently been shown to improve the appearance of atrophic acne scars. OBJECTIVE: The objective was to determine the efficacy of a 1320-nm Nd:YAG laser for the treatment of acne scars. METHODS: Eight patients with facial acne scars received six monthly treatments with a 1320-nm Nd:YAG laser with built-in cryogen cooling. Results were evaluated by objective and patient assessment using a 6-point improvement scale: 1=no improvement, 6=80% to 100% improvement. RESULTS: Acne scar improvement was statistically significant at both the 5-month and 1-year marks. Mean improvement by objective assessment was 3.9 points (p=0.002) at 5 months and 4.3 points (p=0.011) at 1 years. The mean acne scar improvement by patient assessment was 3.6 points (p=0.002) at 5 months. CONCLUSION: The 1320-nm Nd:YAG laser with cryogen cooling significantly improves the appearance of acne scarring.     

Improvement of Atrophic Acne Scars with a 1,320 nm Nd:YAG Laser: Retrospective Study

Background. Facial acne scarring has been treated with multiple methods with varying degrees of improvement. Although the 1,320 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has been widely used to improve photoaging, studies analyzing its effects on atrophic acne scarring are limited.
Objective. To evaluate the efficacy of a dynamic cryogen-cooled 1,320 nm Nd:YAG laser for the treatment of atrophic facial acne scars in a larger cohort of patients with long-term follow-up.
Methods. Twenty-nine patients (skin phototypes I–IV) with facial acne scarring received a mean of 5.5 (range 2–17) treatments with a 1,320 nm Nd:YAG laser. Objective physician assessment scores of improvement were determined by side-by-side comparison of preoperative and postoperative photographs at a range of 1 to 27 months (mean 10.4 months) postoperatively. Subjective patient self-assessment scores of improvement were also obtained.
Results. Acne scarring was significantly improved by both physician and patient assessment scores. Mean improvement was 2.8 (  p < .05  ) on a 0- to 4-point scale by physician assessment and 5.4 (  p < .05  ) on a 0- to 10-point scale by patient assessment. No significant complications were observed.
Conclusions. Nonablative laser skin resurfacing with a 1,320 nm Nd:YAG laser can effectively improve the appearance of facial acne scars with minimal adverse sequelae.     

Laser Scar Revision: Comparison Study of 585-nm Pulsed Dye Laser With and Without Intralesional Corticosteroids

BACKGROUND: Hypertrophic scars affect 1.5% to 4.5% of the general population and remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with treatment. Pulsed dye laser (PDL) treatment and intralesional corticosteroids have individually been reported to be effective in reducing hypertrophic scar bulk and symptoms. OBJECTIVE: To determine whether combination PDL and intralesional corticosteroid treatment produces better hypertrophic scar improvement than PDL treatment alone. METHODS: Bilateral hypertrophic inframammary scars in 22 females were randomly assigned to receive treatment with 585-nm PDL alone or in combination with intralesional corticosteroid. Clinical evaluations and scar pliability scores were determined before each of the two treatment sessions and 6 weeks after the final treatment. Histologic evaluation of skin biopsies obtained before and after treatment was performed in four patients. RESULTS: All scars showed clinical improvement with increased pliability and decreased symptoms (pruritus) after each of the two treatments. Clinical improvement scores were not significantly better with the concomitant use of corticosteroids. Side effects were limited to mild purpura and transient hyperpigmentation. Decreased sclerosis was seen in scars after PDL treatment (with or without concomitant corticosteroids). CONCLUSIONS: Treatment of hypertrophic inframammary scars with 585-nm PDL irradiation alone effected substantial clinical and histologic improvement. The adjunctive use of intralesional corticosteroids did not significantly enhance clinical outcome except in those scars that were most symptomatic.