*Corresponding author’s e-mail: noort1980@outlook.sa ASM Sc. J., 17, 2022 https://doi.org/10.32802/asmscj.2022.1215 The Combination Effect of CO 2 Laser and Topical Growth Factor Solution for Treatment of Atrophic Post-Burn Scar Noor Taha Ismaeel 1* , Murtadha Al-janabi 2 and Ali Shukur Mahmood 1 1 Institute of Laser for Postgraduate Studies, University of Baghdad 2 Department of Dermatology, Faculty of Medicine, University of Kufa Burn scars are among the most disfiguring scars seen in clinical practice, and patients may experience physical and psychological problems due to them. Combining Fractional CO2 Laser with Rejuvenating Complex solution (G.F.) provided an enhancement response for resurfacing therapy for post-burn scars. Treatment aimed to evaluate the response of post-burn scar for combination therapy. The sessions for each patient will be done monthly. The (G.F.) Rejuvenating Complex solution has been applied immediately after laser treatment. Thirty percent of the patients showed more than 75% improvement, 40% showed 51-75% improvement, 20% showed 25-50% improvement, and 10% showed less than 25% improvement. This line of treatment was safe and effective. Keywords: CO2 Laser; Topical Growth Factor; Atrophic Post-Burn Scar I. INTRODUCTION Both clinically and cosmetically, post-burn scars are a major issue in dermatology. The adverse effects and long treatment times associated with various therapeutic approaches for treating burn scars contribute to the patients' burden and severe morbidity (Brusselaers et al., 2010). By ablating the majority of the tissue and triggering collagen remodelling and regenerative mechanisms, conventional ablative lasers, especially conventional erbium-doped yttrium aluminium garnet lasers, erbium YAG (Er: YAG), and conventional CO2 lasers, have proven to be quite efficient in scar treatment (Tanzi & Alster, 2003). Fractional CO2 laser therapy is now being utilized to treat a variety of scars, including burn scars, with minimal side effects and pleasing outcomes (Kauvar et. al., 2020; Seago et al., 2020). The fractional photo-thermolysis idea allowed for considerably deep penetration, allowing for resurfacing by generating micro- columns of coagulated tissue that extend deep into the dermis while keeping the epidermis intact (Manstein et. al., 2004; Alster et al., 2007). As a result of the injury, heat shock proteins, matrix metalloproteinases (MMPs), transforming growth factor (TGF), and myofibroblasts are released, stimulating the production of cytokines that initiate the physiological wound healing process. The interactions of these cytokines result in appropriate scar reformation (Azzam et al., 2016). Growth factor (GF) therapy has demonstrated some success in the treatment of resistant wounds such as chronic venous ulcers (Upton et al., 2011), and diabetic foot ulcers (Uchi et al., 2009) with favourable clinical outcomes. This present study aimed to assess the efficacy of a combination of fractional ablative CO2 lasers and growth factors in treating post-burn scars. II. MATERIALS AND METHOD This was a clinical therapeutic study conducted at the Institute of laser/ University of Baghdad during the period extending from October 2018 to October 2019. All patients agreed on written consent, after explaining the nature of the research, the nature of the disease, prognosis, treatment method, duration of follow‐up, and the possible complications.