Efficacy of Fractional Co2 Laser with PRP for Cutaneous Leishmaniasis Scar
Article Sidebar
Main Article Content
Abstract
Background Atrophic or dyschromic scars are frequently left behind after cutaneous leishmaniasis (CL) healing, leading to both psychological misery and physical deformity. Although they eliminate parasites, current antileishmanial treatments do not stop scarring. Although there is little data regarding CL scars, novel regenerative techniques such as fractional CO2 laser and platelet-rich plasma (PRP) have demonstrated potential in treating acne and traumatic scars. Objective To explore the efficacy a of fractional CO₂ laser with PRP in improving cutaneous leishmaniasis scars, focusing on both clinical and patient-reported outcomes. Methods One hundred patients (18–50 years old) with CL scars that had been there for at least six months were enrolled in a qualitative study at a dermatology department in Quetta. Following fractional CO₂ laser treatment, participants received topical autologous PRP. Clinical photography, outcome measures, and patient interviews were used to gather data during a six-month period. Scar look, texture, pigmentation, psychological impact, social acceptance, satisfaction, and side effects were identified as important topics by thematic content analysis. Results Most participants had facial scars (55%), were female (62%), and were young adults (78%). Scar texture (68%) and pigmentation (61%), according to the patients, have improved. Enhanced social acceptance (57%) and psychological advantages (74%) were frequently reported. In general, 79% of patients expressed satisfaction or high satisfaction with their care. Erythema (70%), swelling (52%), crusting (25%), and hyperpigmentation (10%) were among the mild and temporary side effects; 15% of patients reported no negative side effects. Conclusion For cutaneous leishmaniasis scars, fractional CO₂ laser with PRP seems to be a potential minimally invasive treatment that offers notable social, psychological, and esthetic benefits with little recovery time. To produce evidence-based guidelines and validate long-term efficacy, more controlled trials with defined techniques are required.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. de Vries, H. J. C., & Schallig, H. D. (2022). Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments. American journal of clinical dermatology, 23(6), 823–840. https://doi.org/10.1007/s40257-022-00726-8
2. Azim M, Khan SA, Ullah S, Ullah S, Anjum SI (2021) Therapeutic advances in the topical treatment of cutaneous leishmaniasis: A review. PLoS Negl Trop Dis 15(3): e0009099. https://doi.org/10.1371/journal.pntd.0009099
3. Cruciani, M., Masiello, F., Pati, I., Pupella, S., & De Angelis, V. (2024). Platelet rich plasma use for treatment of acne scars: an overview of systematic reviews. Blood transfusion = Trasfusione del sangue, 22(3), 226–238. https://doi.org/10.2450/BloodTransfus.536
4. Gawdat HI, Tawdy AM, Hegazy RA, et al. Autologous platelet-rich plasma versus cross-linked hyaluronic acid for the treatment of atrophic acne scars: a split-face comparative study. Dermatol Surg. 2014;40(8):864-873.
5. Abdelghani R, Fawzy M, El-Khalawany M. Treatment of atrophic acne scars: a comparative study of fractional CO₂ laser alone versus combined fractional CO₂ laser and platelet-rich plasma therapy. Dermatol Surg. 2016;42(12):1432-1439.
6. Jung JY, Lee JH, Ryu DJ, Lee SJ, Bang D, Cho SB. Lower fluence, higher-density versus higher-fluence, lower-density treatment with a 10,600-nm carbon dioxide fractional laser system: a split-face, evaluator-blinded study. Dermatol Surg 2010;36(12):2022-9.
7. Nilforoushzadeh MA, Jaffary F, Ansari N, Moradi S, Siadat AH (2011) The comparisonbetween trichloroacetic acid 50% and CO2 laser in the treatment of cutaneous leishmaniasis scar. Indian J Dermatol 56:171–173
8. Zachary CB, Rofagha R (2012) Laser therapy. In: Bolognia JL, Jorizzo JL, Schaffer JV (eds) Dermatology, 3rd edn. Mosby, Spain, pp 2271–2275
9. Alghamdi KM (2010) Successful treatment of atrophic scars from cutaneous leishmaniasis using a fractional laser. J Cutan Med Surg 14:303–306
10. Petrov, A., & Pljakovska, V. (2016). Fractional Carbon Dioxide Laser in Treatment of Acne Scars. Open access Macedonian journal of medical sciences, 4(1), 38–42. https://doi.org/10.3889/oamjms.2016.004.
11. Ptaszek, B., Czernecka, M., & Podsiadło, S. (2025). The Use of a Fractional Laser in Acne Scar Treatment-A Systematic Review. Life (Basel, Switzerland), 15(6), 915. https://doi.org/10.3390/life15060915
12. Majid, I., & Imran, S. (2014). Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars. Journal of cutaneous and aesthetic surgery, 7(2), 87–92. https://doi.org/10.4103/0974-2077.138326
13. Banihashemi, M., Nahidi, Y., Maleki, M., Esmaily, H., & Moghimi, H. R. (2016). Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis. Lasers in medical science, 31(4), 733–739. https://doi.org/10.1007/s10103-016-1919-6
14. Nilforoushzadeh MA, et al. Comparison the efficacy of ablative CO₂ laser and fractional CO₂ laser on healing of the wound and the size of cutaneous leishmaniasis scars. Advances in Dermatology and Behavior Medicine. 2014.
15. Galal, O., Tawfik, A. A., Abdalla, N., & Soliman, M. (2019). Fractional CO2 laser versus combined platelet-rich plasma and fractional CO2 laser in treatment of acne scars: Image analysis system evaluation. Journal of cosmetic dermatology, 18(6), 1665–1671. https://doi.org/10.1111/jocd.12909
16. Godara, S., Arora, S., Dabas, R., Arora, G., Renganathan, G., & Choudhary, R. (2020). A Comparative Study on the Efficacy of Fractional CO2 Laser and Fractional CO2 Laser with Autologous Platelet-Rich Plasma in Scars. Indian dermatology online journal, 11(6), 930–936. https://doi.org/10.4103/idoj.IDOJ_174_20
17. Faghihi G, Keyvan S, Asilian A, Nouraei S, Behfar S, Nilforoushzadeh MA. Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial. Indian J Dermatol Venereol Leprol 2016;82:162-168
18. Tawfik, Abeer Attia1; Rageh, Mahmoud A.2,*. Fractional CO2 laser as monotherapy or combined with platelet-rich plasma in the treatment of atrophic postacne scars: A narrative review. Dermatologica Sinica 42(1):p 3-11, Jan–Mar 2024. | DOI: 10.4103/ds.DS-D-23-00154.
19. Godara, S., Arora, S., Dabas, R., Arora, G., Renganathan, G., & Choudhary, R. (2020). A Comparative Study on the Efficacy of Fractional CO2 Laser and Fractional CO2 Laser with Autologous Platelet-Rich Plasma in Scars. Indian dermatology online journal, 11(6), 930–936. https://doi.org/10.4103/idoj.IDOJ_174_20
20. Jaffary F, Faghihi G, Radan MR, et al. Fractional CO₂ laser combined with platelet-rich plasma in the treatment of atrophic facial scars: a split-face trial. Lasers Med Sci. 2020;35(2):489-495.