Fractional CO₂ laser in the treatment of facial scars in children

Facial scars in children have a profound psychosocial impact and require early and aggressive treatment. In this age group in particular, however, attention must be placed on the methodology so as not to trigger additional trauma - whether physical or emotional - as a sequela to the treatment. We assess the safety and efficacy of fractional CO₂ in a prospective study of pediatric facial scars from various etiologies. Twenty four children, age 2-16 years, underwent fractional CO₂ laser resurfacing. Recovery, clinical response, and adverse events were monitored at 3 days, 1 week, 1 month, 2 months, and 6 months. Photographs taken before treatment and 2 months after final treatment were independently evaluated and scored by two physicians. All patients tolerated treatment well, with minimal erythema an edema. The clinical improvement was scored as excellent in 14 patients (58 %), good in 7 (29 %), and fair in 3 (13 %). No cases were graded as poor or worse. No adverse events were noted. The study supports the use of fractional CO₂ resurfacing of pediatric facial scars as well tolerated and effective. Given the particularly rapid healing and clinical improvement of pediatric skin, fractional CO₂ treatment should be offered early to mitigate both the physical and psychosocial stigmata of scars as early as possible.