Laser-Induced Shock Wave Therapy Using a Diamond Particle Acoustic Patch for Early Facial Scar Modulation: A Case Series.

BACKGROUND: Early scar formation represents a dynamic phase of wound healing characterized by active fibroblast proliferation, extracellular matrix remodeling, and mechanosensitive signaling. Interventions applied during this immature stage may modulate scar architecture more effectively than treatments targeting mature scars. Shock wave-based therapies have demonstrated regenerative and remodeling effects in various tissues; however, their application to early cutaneous scar modulation remains limited. OBJECTIVE: To describe the clinical feasibility and outcomes of laser-induced shock wave therapy (LISWT) using a diamond particle acoustic patch for early scar modulation. METHODS: This retrospective four-patient case series included patients with immature (early-phase) facial scars, defined as recently formed scars that remained in the active remodeling phase, characterized clinically by erythema and/or contour alteration before scar maturation, who were treated with LISWT. A diamond particle acoustic patch was applied over the scar area with ultrasound coupling gel, followed by irradiation using a Q-switched 1064-nm Nd:YAG laser. Treatment parameters were adjusted according to scar maturity, and the patients received 3-7 treatment sessions at individualized intervals according to scar characteristics and clinical response. Clinical outcomes were evaluated using standardized photography and validated scar assessment tools, including the Vancouver Scar Scale (VSS), the Patient and Observer Scar Assessment Scale (POSAS), and a patient satisfaction visual analog scale (VAS). RESULTS: All four patients demonstrated progressive improvement in scar contour, texture, and erythema, accompanied by reductions in VSS and POSAS scores. Across the four patients, VSS scores decreased by 4-6 points, POSAS Observer scores by 10-13 points, and POSAS Patient scores by 8-12 points from baseline to final follow-up. Patient-reported satisfaction increased over the treatment course. No clinically significant adverse events or downtime were observed. CONCLUSION: LISWT using a diamond particle acoustic patch may represent a novel, nonthermal approach for early scar modulation by delivering controlled mechanical stimulation during wound healing. This case series supports its feasibility and short-term safety and warrants further investigation.