Combination Therapy of Intense Pulsed Light and Fractional Carbon Dioxide Laser Versus Botulinum Toxin Type A in Post-thyroidectomy Scar Prevention: A Prospective, Randomized Controlled Trial.

[OBJECTIVE] This study compared the efficacy and safety of botulinum toxin type A (BTX-A) injection and CO ablative fractional laser combined with intense pulsed light (COAFL-IPL) therapy in preventing hypertrophic scarring after thyroidectomy.

[APPROACH] In this single-center, prospective, randomized controlled trial, 105 patients undergoing open thyroidectomy were assigned to three groups: silicone dressing (control), COAFL-IPL therapy, or BTX-A injection. Scar outcomes were assessed over 12 months using the Patient and Observer Scar Assessment Scale (POSAS), modified Vancouver Scar Scale (mVSS), 3D imaging, colorimetry, and adverse event reports.

[RESULTS] Both BTX-A and COAFL-IPL groups showed significantly improved POSAS and mVSS scores compared to the control group at 6 and 12 months (p < 0.001), with no significant difference between the two treatment arms. BTX-A treatment had fewer adverse events and lower pain scores. Colorimetry and 3D imaging revealed no significant differences between groups.

[CONCLUSION] Both BTX-A and COAFL-IPL effectively prevented post-thyroidectomy scarring, each outperforming silicone dressings. While their efficacy was comparable, BTX-A offered greater convenience, safety, and patient comfort, making it a more practical option for routine clinical use, with COAFL-IPL serving as an effective alternative where laser therapy is available.

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