Laser-Assisted Prostaglandin Analogs in the Treatment of Hypopigmented Scars: A Systematic Review

Pooja H Rambhia; Angel D Pagan; Karan Lal; David Goldberg

Laser-Assisted Prostaglandin Analogs in the Treatment of Hypopigmented Scars: A Systematic Review

J Clin Aesthet Dermatol. 2023 Sep;16(9):28-32.

Authors

Pooja H Rambhia¹, Angel D Pagan², Karan Lal³, David Goldberg^{3

4}

Affiliations

¹ Dr. Rambhia is with the Department of Dermatology at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New Hyde Park, New York.
² Mr. Pagan is with Ponce Health Sciences University School of Medicine in Ponce, Puerto Rico.
³ Drs. Lal and Goldberg are with the Skin Laser and Surgery Specialists Division of Schweiger Dermatology in New York, New York.
⁴ Addtionally, Dr. Goldenberg is with the Department of Dermatology at Icahn School of Medicine at Mount Sinai in New York, New York.

PMID: 37720195
PMCID: PMC10503939

Abstract

Background: Hypopigmented scars are challenging to treat due to a lack of effective treatments and often transient results. Recent reports suggest that prostaglandin analog-induced hyperpigmentation may have favorable dermatological applications.

Objective: Analyze previous studies involving the use of prostaglandin analogs in the treatment of hypopigmented scars.

Methods: PubMed/Medline was queried through 10/01/2022 with the following search terms: (bimatoprost AND scar), (latanoprost AND scar), (travoprost AND scar), (prostaglandin analogs AND hypopigmented scars), (PGF2alpha AND hyperpigmentation), (prostaglandin analogs AND hyperpigmentation).

Results: In total, 88 unique studies were reviewed for eligibility. Five studies met inclusion criteria including two prospective, double-blinded, randomized (only one was placebo-controlled), one prospective case series, one retrospective chart review, and one case report; comprising a total of 87 patients. All five studies utilized topical prostaglandin analogs as an adjunctive treatment via laser-assisted delivery. While both, the placebo-controlled and non-placebo-controlled, trials reported more than 75 percent of patients experienced at least 50 percent or more (Grade 3 or higher) improvement, the retrospective study reported 100 percent of patients experienced at least 75 percent or more (Grade 4 or higher) improvement, measured as scar repigmentation. The prospective case series and the reported single case showed overall qualitative improvement in all patients measured as repigmentation of hypopigmented and depigmented scars.

Limitations: Different laser devices, parameters, treatment frequency, and follow-up timepoints.

Conclusion: All studies evaluated demonstrated favorable treatment outcomes with no reported adverse events. Additional, large randomized controlled trials are needed to fully assess the effectiveness and long-term safety of PGF2α agonists for hypopigmented scars.

Keywords: bimatoprost; hyperpigmentation; hypopigmented scars; lasers; prostaglandin analogs; skin of color; systematic review.

Publication types

Review