Comparison of the therapeutic effect of microneedling with carbon dioxide laser in hypertrophic burn scars: a randomized clinical trial

Background: Microneedling is recently used to treat skin scars mostly atrophic scars; however, there are limited data about its effectiveness on hypertrophic burn scars. Carbon dioxide (CO2) laser is an effective method for the treatment of burn scars. Here, we aim to compare the efficacy of microneedling to CO2 laser in the treatment of hypertrophic burn scars in a randomized clinical trial.Methods: Patients with second and third-degree burn scars (n=60) were randomized to receive 3 sessions of microneedling (n=30) or CO2 laser (n=30), 4-6 weeks apart. The outcomes, including physical characteristics of the scar scored by Vancouver Scar Scale (VSS) and patients’ satisfaction with the treatment measured by Visual Analogue Scale (VAS), were investigated at baseline, at the end of the treatment period, and at the 3-month follow-up.Results: The VSS score at the follow-up visit showed a significant reduction from 6.63±1.95 to 3.8±2.3 in the microneedling group and from 7.1+2.3 to 5.6±1.7 in the CO2 laser group; while, the reduced VSS score was significantly higher in the microneedling group (P<0.05), especially in reducing the thickness (P=0.001) and pliability (P=0.001) scores. The patients’ subjective assessments for acne improvement were significantly more satisfactory in the microneedling group (P=0.025).Conclusion: Microneedling seems to be an effective method to improve hypertrophic burn scars. It also causes better scores in the physical characteristics of scar and the patients’ satisfaction compared to the CO2 laser at the 3-month follow-up.