Clinical characteristics of patients receiving fractional laser therapy for facial scars and their association with the duration of postoperative erythema.

OBJECTIVES: To investigate the clinical characteristics of patients with post-traumatic facial hypertrophic scars treated with fractional carbon dioxide (CO2) laser therapy and to identify factors associated with the duration of postoperative erythema. METHODS: This retrospective study included 106 patients who underwent fractional CO2 laser therapy for post-traumatic facial hypertrophic scars at Huzhou Maternity & Child Health Care Hospital between January and April 2025. Demographic data, scar characteristics (area, location, Vancouver Scar Scale [VSS] score), laser parameters, adverse reactions, and erythema duration were collected. Patients were categorized into short-duration and long-duration erythema groups using a 14-day cutoff. Clinical variables were compared between groups, and those with P < 0.05 were further analyzed using Spearman correlation. RESULTS: Among 106 included patients, most were children or adolescents. The median erythema duration was 11 days, and 25 patients experienced erythema lasting longer than 14 days. Patients in the long-duration group had significantly higher age, scar area, VSS score, and laser energy compared with those in the short-duration group (P < 0.05). All four variables showed a positive correlation with erythema duration (P < 0.0001). Analysis of adverse events revealed a significant difference in Fitzpatrick skin type distribution between patients with and without edema (P = 0.021). CONCLUSIONS: The duration of postoperative erythema is strongly associated with patient age, scar severity, and laser treatment parameters. Preoperative evaluation should account for these factors to guide individualized treatment planning and postoperative care, thereby minimizing the risk of prolonged erythema.