Abstract Background The efficacy of segmental carbon dioxide laser (FCO 2 L) combined with pulsed dye laser (PDL) treatment versus single laser treatment for hypertrophic scars has not been fully evaluated. This study conducted a network meta-analysis to compare the efficacy of the combined treatment with that of the single laser treatment. Methods PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched up to 28 April 2025. Two independent reviewers conducted study selection, data extraction, and risk-of-bias assessment. The quality of the included studies was evaluated using the Risk of Bias (RoB) 2.0 tool. A Bayesian network meta-analysis model was employed to calculate the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) for VSS scores. Treatment rankings were determined using the surface under the cumulative ranking curve (SUCRA). Results A total of 14 randomized controlled trials were included, involving 326 patients. The network meta-analysis showed that the therapeutic effect of FCO 2 L combined with PDL was significantly better than that of the single therapy. Specifically: Compared with single PDL: SMD = − 1.29 (95% CI: − 1.94, − 0.65). The SUCRA probability ranking showed that the combined ranking of FCO 2 L combined with PDL was the highest (probability > 80%), followed by single FCO 2 L (70%-75%). Conclusion The combined use of FCO 2 L and PDL has significant advantages in improving hypertrophic scars. Although using FCO 2 L alone is effective, its therapeutic effect is not as good as the combined strategy. Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
He et al. (Wed,) studied this question.