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Ablative Fractional laser (AFL), which has been widely used, but non-ablative and less invasive techniques such as picosecond laser with fewer side effects are available. To objectively determine the degree of scar improvement with picosecond laser compared with ablative fractional carbon dioxide laser in depressed facial scar. This prospective, evaluator-blinded trial enrolled patients with linear depressed atrophic scar. There were 26 patients in the picosecond laser group and 38 patients in the AFL patient group. Standardized images were acquired by the same person using the same device in the same place. Five physicians compared the scar improvement effect using modified Vancouver Scar Scale (mVSS) and Stony Brook Scar Evaluation Scale. No statistically significant demographic differences existed between the two laser groups. On the Stony Brook Scar Rating Scale, the improvement of depression and hatch marks was significantly greater with the picosecond laser group. The picosecond laser resulted in a better score improvement in the overall scar scale on both mVSS and Stony Brook Scar Evaluation Scale. In conclusion, the 755-nm picosecond laser is a safe and effective non-ablative modality for wide and depressed facial scar, with significantly superior scar improvement when compared with the AFL. AFL = ablative fractional laser, CO 2 = carbon dioxide, LiOB = laser-induced optical breakdown, PIH = postinflammatory hyperpigmentation, mVSS = Modified Vancouver scar scale.

Improvement in linear depressed atrophic scar using 755-nm picosecond alexandrite laser vs. ablative fractional carbon dioxide laser