Fractional CO2 (FxCO2) Laser Therapy Combined with Erythromycin Ophthalmic Ointment-Based Moist Wound Healing for Facial Pigmented Scars: A Retrospective Observational Study.

BACKGROUND: Treatment of pigmented scars requires simultaneous scar remodeling, pigment regulation, and prevention of postinflammatory hyperpigmentation (PIH). AIM: To evaluate the efficacy and safety of fractional CO2 laser therapy combined with moist healing for pigmented scars. PATIENTS/METHODS: This retrospective self-controlled study included 34 patients with facial pigmentation scars treated with fractional CO2 laser therapy. Postoperative wound care consisted of a standardized moist healing regimen using topical erythromycin ophthalmic ointment. Treatment efficacy was assessed at baseline and 3 months after the final treatment using the Patient and Observer Scar Assessment Scale (POSAS) and a four-grade efficacy scale. Treatment parameters, number of sessions, and adverse reactions were recorded. RESULTS: Scar appearance significantly improved after a mean of 5.44 ± 1.80 treatments. The total POSAS score decreased from 83.97 ± 4.16 points before treatment to 33.56 ± 3.27 (P < 0.0001). The overall effective rate was 100.00%. Adverse reactions, mainly transient erythema and edema, were mild. Mild PIH occurred in three patients and resolved spontaneously within 3 months. No serious adverse events, including infection, permanent depigmentation, or scar aggravation, were observed. CONCLUSION: Fractional CO2 laser therapy combined with moist healing effectively improves facial pigmented scars with a favorable safety profile.