Successful Treatment of Chickenpox Scars With Microdermabrasion and a Nonablative, Submillisecond, 1064-nm Nd:YAG Laser

The use of lasers in patients with darker skin types presents a remarkable challenge to laser practitio­ners, especially when treating large areas of atrophic scarring following chickenpox infection. Treatment options often are limited because of an increased risk for pigmentary complications, including hypopig­mentation and hyperpigmentation. This retrospective study evaluated the efficacy of a nonablative, sub­millisecond, 1064-nm Nd:YAG laser used in combination with microdermabrasion (MDA) therapy over 6 months to treat facial chickenpox scarring in 15 males with Fitzpatrick skin type IV or V. Participants were treated at a fluence of 14 to 16 J/cm² and a pulse duration of 0.4 milliseconds with a repetition rate of 5 Hz. Five to 6 laser treatments were performed on each participant every 3 to 4 weeks and 8 MDA treatments were performed 7 to 10 days apart. The mean follow-up time was 9.1 months after the final treatment session (range, 3–12 months). Both the participants and the treating physicians were asked to complete a questionnaire regarding changes in scarring and skin texture as well as postinflamma­tory hyperpigmentation (PIH) using a 4-point scale (2=marked improvement; 1=mild improvement; 0=no change; –1=worsening). Blinded assessments were performed by 3 independent physicians using before and after photographs (unlabeled) that were not arranged in chronologic order. Reviewers were instructed to identify the before and after photographs and evaluate the degree of improvement or worsening in scarring, skin texture, and PIH secondary to chickenpox infection. Clinically significant improvements in scarring, skin texture, and PIH were evaluated. Ultimately, data collected in this study suggest that a nonablative, submillisecond, 1064-nm Nd:YAG laser used in combination with MDA therapy is an effective treatment method for atrophic chickenpox scarring in patients with darker skin types, delivering clinically significant results with reduced risks for pigmentary complications and patient discomfort.