Picosecond Laser Therapy for Traumatic and Surgical Scars: a Systematic Review.

BACKGROUND

Traumatic and surgical scars may cause functional impairment, cosmetic concerns, and reduced quality of life. This review evaluated the effectiveness and safety of picosecond laser therapy for traumatic and surgical scars.

METHODS

we conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. PubMed, Scopus, Web of Science, Embase, Cochrane Library, MEDLINE, LILACS, and VERTINDEX were searched from inception through August 2025 without language or date restrictions; database alerts were monitored through December 2025. Clinical studies evaluating picosecond laser therapy for non-acne traumatic or surgical scars were included. Risk of bias in randomized trials was assessed using RoB 2.

RESULTS

13 studies (446 patients, 475 scars), including five randomized controlled studies, met eligibility criteria. Most studies showed improvement in validated scar scales, global aesthetic assessments, and objective measures. Controlled trials generally favored picosecond laser therapy over untreated controls and showed advantages over fractional carbon dioxide laser for selected outcomes, although superiority was not consistent across all domains. Four randomized studies were judged to have some concerns and one was at high overall risk of bias. Adverse events were predominantly mild and transient, with no serious or permanent events.

CONCLUSIONS

current evidence supports picosecond laser therapy as a promising and generally well-tolerated option for traumatic and surgical scars. However, heterogeneity in scar characteristics, treatment protocols, and outcome measures.