Efficacy of Combined 595-nm Pulsed Dye Laser and Intralesional Corticosteroids Versus Intralesional Corticosteroids Alone for Treating Postmastectomy Hypertrophic Scars and Keloids in Transgender Men: A Randomized Controlled Trial

IF 2.5 4区医学 Q2 DERMATOLOGY Journal of Cosmetic Dermatology Pub Date : 2025-03-04 DOI:10.1111/jocd.70029

Suthinee Rutnin, Nawara Sakpuwadol, Tanat Yongpisarn, Cherrin Pomsoong, Amornrut Namasondhi, Teerapong Rattananukrom, Kunlawat Thadanipon

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Abstract

Background

Top surgery masculinizes the chest appearance for transgender men (TM); however, some individuals may experience hypertrophic scars (HTS) or keloids following the surgery.

Objectives

This study aimed to evaluate the efficacy of combined 595-nm pulsed dye laser (PDL) and intralesional triamcinolone acetonide injection (IL TAC) compared to IL TAC monotherapy for treating HTS and keloids.

Methods

Twenty-five TM with 35 pairs of bilateral symmetric postmastectomy HTS or keloids were randomly allocated to receive the combined PDL and IL TAC on the scar(s) on one side of the chest and IL TAC monotherapy on the contralateral scar(s) in four monthly treatment sessions. Clinical improvement was evaluated using the Vancouver Scar Scale (VSS). Melanin index, hemoglobin index, and scar roughness were determined before each treatment session and at 1, 3, and 6 months after the last treatment. Participant-rated satisfaction and adverse events were documented.

Results

After two treatment sessions, scars treated with combined PDL and IL TAC demonstrated significantly greater improvements in the VSS (p = 0.012) and melanin index (p = 0.004) compared to those treated with IL TAC alone. The superior outcomes of the combined therapy persisted for 3 and 6 months after the end of treatment sessions for the VSS (p = 0.001) and melanin index (p = 0.048), respectively. Participants reported higher satisfaction for combined PDL and IL TAC than IL TAC monotherapy (p = 0.005). No serious or permanent adverse event was reported.

Conclusion

The addition of 595-nm PDL to IL TAC may provide more favorable outcomes for treating postmastectomy HTS and keloids among TM.

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595纳米脉冲染料激光联合病灶内皮质类固醇与单独病灶内皮质类固醇治疗变性男性乳房切除术后肥厚性疤痕和瘢痕疙瘩的疗效：随机对照试验

背景：跨性别男性（TM）的胸部手术使其男性化；然而，有些人可能会在手术后出现增生性疤痕（HTS）或瘢痕疙瘩。目的评价595 nm脉冲染料激光（PDL）联合局部注射曲安奈德（IL TAC）治疗HTS和瘢痕疙瘩的疗效。方法选取25例双侧对称乳房切除术后HTS或瘢痕疙瘩35对患者，随机分组，单侧瘢痕行PDL + IL - TAC联合治疗，对侧瘢痕行IL - TAC单药治疗，疗程为4个月。采用温哥华疤痕量表（VSS）评估临床改善情况。在每次治疗前和最后一次治疗后1、3、6个月测定黑色素指数、血红蛋白指数和疤痕粗糙度。记录参与者评价的满意度和不良事件。结果在两次治疗后，与单独IL TAC治疗相比，PDL和IL TAC联合治疗的疤痕在VSS （p = 0.012）和黑色素指数（p = 0.004）方面表现出更大的改善。在VSS （p = 0.001）和黑色素指数（p = 0.048）治疗结束后，联合治疗的优越结果分别持续了3个月和6个月。受试者报告PDL和IL TAC联合治疗的满意度高于IL TAC单药治疗（p = 0.005）。没有严重或永久性不良事件的报道。结论在IL TAC的基础上加入595 nm PDL治疗乳腺癌术后HTS和瘢痕疙瘩的效果较好。

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来源期刊

Journal of Cosmetic Dermatology DERMATOLOGY-

CiteScore

4.30

自引率

13.00%

发文量

818

审稿时长

>12 weeks

期刊介绍： The Journal of Cosmetic Dermatology publishes high quality, peer-reviewed articles on all aspects of cosmetic dermatology with the aim to foster the highest standards of patient care in cosmetic dermatology. Published quarterly, the Journal of Cosmetic Dermatology facilitates continuing professional development and provides a forum for the exchange of scientific research and innovative techniques. The scope of coverage includes, but will not be limited to: healthy skin; skin maintenance; ageing skin; photodamage and photoprotection; rejuvenation; biochemistry, endocrinology and neuroimmunology of healthy skin; imaging; skin measurement; quality of life; skin types; sensitive skin; rosacea and acne; sebum; sweat; fat; phlebology; hair conservation, restoration and removal; nails and nail surgery; pigment; psychological and medicolegal issues; retinoids; cosmetic chemistry; dermopharmacy; cosmeceuticals; toiletries; striae; cellulite; cosmetic dermatological surgery; blepharoplasty; liposuction; surgical complications; botulinum; fillers, peels and dermabrasion; local and tumescent anaesthesia; electrosurgery; lasers, including laser physics, laser research and safety, vascular lasers, pigment lasers, hair removal lasers, tattoo removal lasers, resurfacing lasers, dermal remodelling lasers and laser complications.