Objective To investigate the clinical efficacy and safety of CO2 fractional laser therapy used alone in treating post-burn scars complicated with chronic eczema. Methods From January 2021 to June 2024，53 patients with post-burn hypertrophic scars complicated by chronic eczema on the extremities were enrolled. Among them，28 patients received laser treatment （treatment group）， with each scar-eczema area undergoing six sessions of CO2 fractional laser therapy at 8-week intervals； Twenty-five patients received conservative treatment with topical corticosteroids （control group）. Assessments including the investigator’s global assessment （IGA）， eczema area and severity index （EASI） score， visual analog scale （VAS） score， recurrence rate， and other adverse reactions were conducted before treatment， as well as one month and six months after the final treatment. Results In the treatment group， the EASI score decreased from 2.39±1.14 before treatment to 0.89±0.55 at one-month post-treatment and further to 0.78±0.47 at the six-month follow-up. The difference before and  after treatment was statistically significant （P<0.001）， and the efficacy compared to the control group was also statistically significant （P<0.01）. The IGA scores before treatment were 2.64±0.87， which decreased to 1.11±0.88 and 1.07±0.77 post-treatment. The differences before and after treatment were statistically significant （P<0.001）， with a statistically significant advantage over the control group （P<0.05）. The VAS score decreased from 5.57±1.97 before treatment to 2.53±1.45 post-treatment and 2.57±1.64 at follow-up. The difference in VAS scores before and after treatment was statistically significant （P<0.001）， but there was no statistically significant difference compared to the control group （P=0.896）. The six-month recurrence rate was 17.86% in the treatment group and 32% in the control group. Conclusion CO2 fractional laser therapy demonstrates significant clinical efficacy in treating post-burn scars complicated with chronic eczema， with a low recurrence rate and no significant adverse reactions. This provides a novel approach for clinical management.

Scar, Chronic eczema, CO

fractional laser, Low-energy