{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:42:17Z","timestamp":1790030537353,"version":"4.0.1"},"reference-count":58,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Skin scars represent a complex therapeutic challenge, with significant functional, aesthetic, and psychological implications. Despite advances in laser therapy, monotherapy has significant limitations, particularly for patients with complex scars with atrophic, hypertrophic, vascular, and pigmentary components. The combined use of multiple laser sources, in sequential or simultaneous mode, allows for the selective targeting of specific tissue components and improves clinical efficacy while maintaining a good safety profile. This narrative review critically analyses the available evidence on combination therapies for atrophic, hypertrophic, keloid, and post-surgical and burn scars. Protocols combining ablative lasers (CO2, Er:YAG), non-ablative lasers (1540\u20131550 nm), vascular lasers (PDL, Nd:YAG) and intense pulsed light (IPL) are reported. Possible integrations with adjuvant techniques, such as radiofrequency, platelet-rich plasma (PRP), and laser-assisted drug delivery, are also mentioned as areas for future development. The available data suggest a promising role for multimodal strategies, but the literature remains limited by small cohorts, heterogeneous protocols, and short follow-up periods. Although adverse events are generally mild and transient, typically involving erythema, oedema, or temporary dyschromia, an awareness of safety considerations remains essential, particularly in higher phototypes and when using ablative modalities. Further prospective and multicentre studies are needed to define standardised protocols and consolidate the role of combination therapies in the management of scars.<\/jats:p>","DOI":"10.3390\/bioengineering12121368","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T14:36:53Z","timestamp":1765895813000},"page":"1368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Combined Laser Strategies for Scar Treatment: A Comprehensive Review of Synergistic Protocols"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7001-7756","authenticated-orcid":false,"given":"Alessandro","family":"Clementi","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cannarozzo","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9678-6409","authenticated-orcid":false,"given":"Luca","family":"Guarino","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8167-0325","authenticated-orcid":false,"given":"Elena","family":"Zappia","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-1122","authenticated-orcid":false,"given":"Fortunato","family":"Cassalia","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8656-2927","authenticated-orcid":false,"given":"Andrea","family":"Danese","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, Department of Integrated Medical and General Activity, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-1524","authenticated-orcid":false,"given":"Marco","family":"Gratteri","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annunziata","family":"Dattola","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-3896","authenticated-orcid":false,"given":"Caterina","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-0883","authenticated-orcid":false,"given":"Steven Paul","family":"Nistic\u00f2","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/jdv.18856","article-title":"The Impact of Visible Scars on Well-Being and Quality of Life: An International Epidemiological Survey in Adults","volume":"37","author":"Amici","year":"2023","journal-title":"J. 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